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在CKD和ESKD中饮食和代谢健康
Adamasco Cupisti1, Domenico Giannese1, Mario Cozzolino2
1Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
概括
饮食酸盐 (P) 管理对于慢性病 (CKD) 患者来说至关重要,以减缓进展并降低心血管风险. 调节P摄入量对于CKD至关重要,但由于蛋白质需求,对透析患者来说具有挑战性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 营养科学 营养科学
背景情况:
- 食酸盐 (P) 显著促进慢性病 (CKD) 相关的矿物骨病.
- 慢性瘤中酸盐的保留会影响心血管健康,增加血压,化和高,从而增加死亡风险.
- 从加工食品和动物蛋白中摄入高酸盐是一个越来越令人担忧的问题,可能会加剧CKD的进展和心血管损伤.
研究的目的:
- 突出饮食酸盐管理在减缓CKD进展和改善患者结局方面的重要作用.
- 阐明酸盐过载对慢性病患者心血管系统的有害影响.
- 讨论在CKD中有效的食酸盐管理的挑战和策略,特别是对于透析患者.
主要方法:
- 对饮食中酸盐吸收,新陈代谢及其对CKD和心血管健康的影响现有文献的综述.
- 分析了饮食中酸盐摄入量,CKD进展和心血管并发症之间的关系.
- 探索在CKD患者,特别是透析患者中实施饮食酸盐限制的挑战.
主要成果:
- 肠道酸盐的吸收有所不同,无机来源的吸收比有机来源更容易.
- 饮食中酸盐摄入量增加与CKD进展和心血管损伤有关,尽管对一般人群的证据不太清楚.
- 调节酸盐摄入量是合理的,在非透析CKD患者中通过调整蛋白质摄入量来调节酸盐摄入量是合理的和可行的,但由于营养建议相互矛盾,对透析患者来说很困难.
结论:
- 饮食酸盐管理是治疗慢性病和降低心血管风险的基石.
- 虽然高酸盐摄入量对CKD患者构成风险,但对于一般人群缺乏具体建议.
- 在CKD中成功的食酸盐管理需要患者的教育,动机和坚持,特别注意透析患者面临的挑战.
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