Mitch W E
Renal Division, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
J Am Coll Nutr. 1995 Aug;14(4):311-6. doi: 10.1080/07315724.1995.10718515.
Dietary protein restriction is an established method of preventing the symptoms of uremia but three questions should be asked before beginning this type of therapy: Will the diet maintain adequate nutrition? Can compliance be monitored? Will the low-protein diet prevent uremic symptoms and change the course of the disease? There are positive answers to these questions. Recently it has been shown that the metabolic acidosis associated with kidney failure causes catabolism by increasing the degradation of muscle protein and of essential amino acids. The mechanism for these responses includes increased mRNAs encoding enzymes involved in catabolic pathways. Activation of these pathways would impair the ability of patients to respond to a low-protein diet because the ability to reduce the oxidation of essential amino acids and degradation of protein would be limited.
饮食蛋白质限制是预防尿毒症症状的一种既定方法，但在开始这种治疗之前应提出三个问题：这种饮食能否维持充足的营养？能否监测依从性？低蛋白饮食能否预防尿毒症症状并改变疾病进程？这些问题的答案都是肯定的。最近有研究表明，与肾衰竭相关的代谢性酸中毒通过增加肌肉蛋白和必需氨基酸的降解而导致分解代谢。这些反应的机制包括编码参与分解代谢途径的酶的mRNA增加。这些途径的激活会损害患者对低蛋白饮食的反应能力，因为减少必需氨基酸氧化和蛋白质降解的能力将受到限制。
