什么是营养的核心:蛋白质或摄入量?
Angela Yee-Moon Wang1, Francesca Mallamaci2, Carmine Zoccali3,4,5
1University Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, SAR, China.
Clinical kidney journal
|November 2, 2023
概括
饮食中蛋白质和盐的限制在慢性病 (CKD) 管理中很常见. 然而,关于特定值的证据很弱,新药可能会改变它们的必要性,需要进一步的研究.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 营养科学 营养科学
- 内部医学 内部医学
背景情况:
- 在慢性病 (CKD) 中的营养干预历史上针对损伤,尿素代谢物和营养状况.
- 限制蛋白质和盐的饮食是CKD患者的标准建议,但具体摄入门的证据有限.
- 患者的坚持和实际挑战阻碍了评估饮食治疗影响的随机试验.
研究的目的:
- 审查CKD管理中围绕蛋白质和盐限制的现有证据和挑战.
- 探索饮食干预措施在新CKD药物治疗中不断变化的作用.
- 突出需要新的试验设计,以建立最佳的饮食建议.
主要方法:
- 关于CKD中蛋白质和盐限制现有指导方针和证据的文献综述.
- 讨论遵守饮食和实施临床试验的挑战.
- 考虑新药疗法 (SGLT2抑制剂,MRA) 对营养管理的影响.
主要成果:
- 支持CKD中特定蛋白质或盐摄入门的证据仍然没有确定性.
- 长期患者坚持限制饮食是一个重大挑战.
- 限制饮食的必要性和增量益处在新的药物治疗中是不确定的.
结论:
- 个性化,多学科的护理对于在CKD中实施饮食干预措施至关重要.
- 需要进一步进行具有新设计的动力随机对照试验,以澄清CKD患者的最佳蛋白质和盐摄入门.
- 在先进的CKD药物治疗时代,饮食限制的作用可能需要重新评估.
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