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[慢性肾衰竭的保守治疗]

[Conservative therapy of chronic kidney failure].

作者信息

Schmicker R, Fröhling P, Vetter K

出版信息

Z Gesamte Inn Med. 1978 Jun 1;33(11):344-51.

PMID:685329
Abstract

The optimum performance of the conservative therapy of the chronic renal insufficiency demands a good cooperation between the patients, the dietician and the physician. The foundation of centres of the nephrological care for patients with renal insufficiency guarantees the possibility of a continuous control. In the conservative therapy the measures in question are symptomatic ones, excluding the medicamentous therapy of the basic disease in acute episodes. The dietetic measures are the basis of the conservative therapy. The diet moderately poor in protein should be given at creatinine values in the serum 4 mg/100ml and the diet strongly poor in protein from 8 mg/100 ml (prophylactically perhaps from 6 mg/100 ml). In the dietetic measures apart from the protein restriction the calorie intake (35 to 40 calories/kg body weight a day), the intake and output of fluids and the electrolyte metabolism as well as the vitamin intake should particularly be taken into consideration. Additional symptomatic medicamentous measures are necessary in order to improve the clinical symptomatology of the chronic renal insufficiency. By means of the conservative therapy the period to the necessary dialytic treatment can be delayed. Apart from this a lengthening of life and an improvement of the rehabilitation is possible in those patients, in whom an active therapy is not taken into consideration.

摘要

慢性肾功能不全保守治疗的最佳效果需要患者、营养师和医生之间良好的合作。为肾功能不全患者建立肾脏病护理中心,能确保持续监控成为可能。在保守治疗中,所采取的措施是对症治疗措施,不包括急性发作期基础疾病的药物治疗。饮食措施是保守治疗的基础。血清肌酐值为4mg/100ml时,应给予适度低蛋白饮食;血清肌酐值达到8mg/100ml(预防性地或许从6mg/100ml起)时,则应给予严格低蛋白饮食。在饮食措施中,除了限制蛋白质摄入外,还应特别考虑热量摄入(每天每千克体重35至40卡路里)、液体的出入量、电解质代谢以及维生素摄入。为改善慢性肾功能不全的临床症状,还需要采取额外的对症药物治疗措施。通过保守治疗,可以推迟进行必要的透析治疗的时间。除此之外,对于那些不考虑进行积极治疗的患者,延长生命和改善康复状况也是有可能的。

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