Walser M
Johns Hopkins University School of Medicine, Baltimore, Maryland.
Curr Opin Nephrol Hypertens. 1994 May;3(3):301-4. doi: 10.1097/00041552-199405000-00011.
Results of the Diabetes Control and Complications Trial indicate that intensive insulin treatment of patients with type I diabetes would greatly reduce the incidence of diabetic nephropathy. Another multicenter trial indicates that modest protein restriction is of no value in children with chronic renal failure. The relationship between urea nitrogen excretion and total nitrogen excretion in children differs from that in adults. A repeated crossover study found that ketoacids slow progression of renal failure, in comparison with amino acid supplements to the same diet. Long-term protein restriction does not lead to protein deficiency at the onset of dialysis. When combined with essential amino acid supplements, a low-protein diet may gradually correct hypoalbuminemia in nephrotic subjects.
糖尿病控制与并发症试验的结果表明，对I型糖尿病患者进行强化胰岛素治疗可大幅降低糖尿病肾病的发病率。另一项多中心试验表明，适度的蛋白质限制对慢性肾衰竭儿童并无益处。儿童尿素氮排泄与总氮排泄之间的关系与成人不同。一项重复交叉研究发现，与在相同饮食中补充氨基酸相比，酮酸可减缓肾衰竭的进展。长期蛋白质限制在透析开始时不会导致蛋白质缺乏。低蛋白饮食与必需氨基酸补充剂联合使用时，可能会逐渐纠正肾病患者的低白蛋白血症。
