维生素补充剂在慢性病患者中的使用:值得服用药丸吗?
Angela Yee-Moon Wang1, Rengin Elsurer Afsar2, Elizabeth J Sussman-Dabach3
1Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, People's Republic of China.
概括
患有慢性病 (CKD) 的患者由于摄入量不够和透析而面临维生素缺乏. 补充应该是个性化的,因为目前的证据缺乏支持常规维生素在CKD患者的使用.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 营养科学 营养科学
- 临床医学 临床医学
背景情况:
- 患有慢性病 (CKD) 的患者容易因饮食不良,厌食症和透析等因素而缺乏维生素.
- 慢性病患者维生素缺乏症的临床症状通常是微妙的,无法检测到的.
- 常规维生素水平测试由于测试可用性,成本和与身体储存的相关性而受到限制,除了叶酸,B12和25-氧维生素D.
研究的目的:
- 审查慢性病 (CKD) 患者群体中维生素补充的最新证据.
- 根据目前的研究,为CKD患者使用维生素补充剂提供指导.
主要方法:
- 对慢性病患者维生素补充的最新证据的系统审查.
- 随机试验和观察性研究分析关于维生素使用和CKD的结果.
主要成果:
- 目前没有随机试验支持任何维生素补充对脏,心血管或患者为中心的结局在CKD的好处.
- 建议个人补充水溶性维生素,考虑到饮食摄入量,营养状况和CKD相关因素.
- 营养维生素D缺乏需要纠正,根据缺乏水平和患者状况进行个性化剂量和配方.
- 由于潜在的毒性,不建议定期补充维生素A和维生素E.
结论:
- 在CKD中补充维生素应该是个性化的,优先考虑饮食摄入量和维生素密集的食物.
- 需要进一步的研究来澄清特定维生素补充剂在改善CKD结果中的作用.
- 患有CKD的患者应定期进行饮食评估,并专注于从天然食物来源获得维生素.
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