Department of Epidemiology.
Cardiovascular Health Research Unit, Department of Medicine, University of Washington School of Public Health, Seattle, Washington.
Curr Opin Nephrol Hypertens. 2024 Nov 1;33(6):593-602. doi: 10.1097/MNH.0000000000001015. Epub 2024 Aug 6.
Plant-based diets are associated with a lower risk of hypertension, diabetes, cardiovascular disease, and mortality. Using the most recent evidence, we critically appraised the role of plant-based diets in primary and secondary prevention of chronic kidney disease (CKD) with a focus on key nutritional factors (dietary acid load, phosphorus, potassium, sodium, and fiber).
In healthy individuals, observational studies found that greater intake of plant protein and higher adherence to plant-based diets (overall, healthful, and provegetarian) was associated with a lower risk of CKD. In those with CKD, plant-based diets were associated with a lower risk of mortality, improved kidney function, and favorable metabolic profiles (fibroblast growth factor-23, uremic toxins, insulin sensitivity, inflammatory biomarkers). Only few studies reported nutrient content of plant-based diets. These studies found that plant-based diets had lower dietary acid load, lower or no significant difference in phosphorus and sodium, and higher potassium and fiber. One study reported that vegetarian diets were associated with severe vitamin D deficiency compared to nonvegetarian diets.
Plant-based diets provide several benefits for prevention and management of CKD, with little risk for individuals with CKD. Incorporation of vitamin D rich foods in plant-based diets may be helpful.
综述目的:植物性饮食与降低高血压、糖尿病、心血管疾病和死亡率的风险有关。利用最新的证据,我们批判性地评估了植物性饮食在慢性肾脏病(CKD)一级和二级预防中的作用,重点关注关键营养因素(饮食酸负荷、磷、钾、钠和纤维)。
最新发现:在健康人群中,观察性研究发现,植物蛋白摄入量增加和更严格遵循植物性饮食(整体上健康、素食)与 CKD 风险降低有关。在 CKD 患者中,植物性饮食与死亡率降低、肾功能改善和代谢谱改善(成纤维细胞生长因子 23、尿毒症毒素、胰岛素敏感性、炎症生物标志物)有关。只有少数研究报告了植物性饮食的营养成分。这些研究发现,植物性饮食的饮食酸负荷较低,磷和钠的含量较低或无显著差异,而钾和纤维的含量较高。一项研究报告称,与非素食饮食相比,素食饮食与严重的维生素 D 缺乏有关。
总结:植物性饮食为 CKD 的预防和管理提供了多种益处,对 CKD 患者的风险很小。在植物性饮食中加入富含维生素 D 的食物可能会有所帮助。