在长期随访期间,低蛋白饮食的坚持和CKD进展
Isabela de Souza da Costa Brum1, Hugo de Luca Corrêa2, Thiago Santos Rosa2,3
1Graduate Program in Medical Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil.
概括
坚持低蛋白饮食 (LPD) 在早期慢性病 (CKD) 的巴西患者中显著减缓了功能下降. 这种饮食方法对保持脏健康和控制慢性脏病的进展充满希望.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 饮食科学 饮食科学
- 公共卫生 公共卫生
背景情况:
- 早期慢性病 (CKD) 管理通常涉及饮食干预.
- 低蛋白饮食 (LPD) 假设可以减少膜过和减缓CKD进展.
- 在像巴西这样的中等收入国家,关于LPD遵守的长期数据有限.
研究的目的:
- 评估遵守低蛋白饮食 (LPD) 对慢性病 (CKD) 进展的影响.
- 评估巴西患者队列中LPD坚持的长期影响.
- 调查饮食中的蛋白质摄入量与估计的淋巴细胞过率 (eGFR) 降低之间的关系.
主要方法:
- 一项队列研究,涉及438名巴西患者,在2010年至2024年期间患有早期CKD.
- 根据24小时的饮食回忆,患者被分为LPD坚持者 (<0.8g/kg/day) 和不坚持者 (>0.88g/kg/day) 组.
- 用线性混合模型分析的eGFR的年度下降率来衡量CKD的进展.
主要成果:
- 在坚持和不坚持的群体中,基线eGFR和年龄是可比的.
- 经过调整后的分析显示,与非坚持者 (-1.40 mL/min/1.73m2/year) 相比,LPD坚持者群体的年度EGFR下降明显较慢 (-0.29 mL/min/1.73m2/year).
- 在eGFR下降的绝对调整差异为1.10mL/min/1.73m2 (p=0.0048),表明LPD坚持的保护作用.
结论:
- 坚持低蛋白饮食表明,在早期CKD患者中具有脏保护作用.
- 饮食管理,特别是LPD的坚持,对于延长CKD功能至关重要.
- 研究结果支持将LPD纳入CKD治疗策略,特别是在各种医疗机构.
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