本文選題：慢性腎臟病 + 低蛋白飲食��； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：背景:一直以來,低蛋白飲食被認(rèn)為在慢性腎臟病(Chronic Kidney Disease,CKD)進(jìn)展中發(fā)揮著重要作用,而它對腎功能下降速率的影響卻仍存在爭議。目的:系統(tǒng)評價不同蛋白質(zhì)攝入對成人慢性腎臟病患者腎功能進(jìn)展速率及相關(guān)預(yù)后的影響。方法:在register網(wǎng)站注冊,并按照預(yù)先制定的檢索策略對Ovid MEDLINE,EMBASE,及Cochrane Library進(jìn)行檢索,篩選對比不同蛋白質(zhì)攝入對成人CKD患者影響的隨機(jī)對照試驗,隨訪時間大于24周。評價的結(jié)局包括腎衰竭事件、估測的腎小球濾過率(estimated glomerular filtration rate,eGFR)每年的下降速率、蛋白尿變化,血清磷濃度、血清白蛋白濃度及身體質(zhì)量指數(shù)(BMI)的變化。結(jié)果:共19項研究包括2492例患者被納入研究。分析結(jié)果顯示:限蛋白質(zhì)攝入能減少CKD患者腎衰竭及終末期腎病(end-stage renal disease,ESRD)發(fā)生的風(fēng)險(OR=0.59,OR=0.64),但不能降低全因死亡的發(fā)生。低蛋白飲食能明顯減慢eGFR下降速率(MD:1.85,P=0.001),并降低蛋白尿水平(MD:-0.44,P=0.02)。與對照組相比,限制蛋白質(zhì)的飲食干預(yù)能同時降低血磷水平,而不會引起營養(yǎng)不良。結(jié)論:低蛋白飲食降低了CKD患者腎功能下降速率以及腎衰竭的風(fēng)險,這些積極性作用在非糖尿病腎病患者中更顯著。低蛋白飲食是既有效又安全的CKD干預(yù)措施。
[Abstract]:Background: low protein diet has long been considered to play an important role in the progression of chronic kidney disease (Chronic Kidney diseaseate CKD), but its effect on the rate of renal function decline is still controversial. Objective: to evaluate the effects of different protein intake on renal function progression rate and prognosis in adult patients with chronic kidney disease. Methods: Ovid MEDLINE EMBASE and Cochrane Library were searched according to the pre-established search strategy on the register website. The randomized controlled trials were selected to compare the effects of different protein intake on adult CKD patients. The follow-up time was more than 24 weeks. The outcomes included events of renal failure, estimated annual rate of decline in glomerular filtration rate (GFR), changes in proteinuria, changes in serum phosphorus, serum albumin and body mass index (BMI). Results: a total of 19 studies, including 2492 patients were included in the study. The results showed that limited protein intake could reduce the risk of renal failure and end-stage renal disease in patients with CKD, but could not reduce the incidence of all-cause death. Low protein diet could significantly slow down the decrease rate of eGFR and reduce the level of protein urine. Compared with the control group, protein-restricted dietary intervention also reduced blood phosphorus levels without causing malnutrition. Conclusion: low protein diet reduces the rate of renal function decline and the risk of renal failure in CKD patients, and these positive effects are more significant in patients with non diabetic nephropathy. Low protein diet is an effective and safe intervention for CKD.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R692

【參考文獻(xiàn)】

相關(guān)期刊論文 前8條

1 楊悅;魏日胞;;慢性腎臟病胰島素抵抗發(fā)生的分子機(jī)制及干預(yù)研究[J];中國中西醫(yī)結(jié)合腎病雜志;2015年07期

2 谷立杰;董婷;王嘉琳;吳晶;黃艷茹;袁偉杰;陳靖;倪麗;嚴(yán)海東;張瑞青;汪年松;簡桂花;譚亞瓊;;酮酸聯(lián)合低蛋白飲食對2型糖尿病腎病患者腎臟局部RAS活性和足細(xì)胞脫落的影響[J];中華腎臟病雜志;2014年05期

3 邱紅渝;劉芳;趙黎君;黃頌敏;左川;鐘慧;陳鳳;;復(fù)方α-酮酸結(jié)合低蛋白飲食延緩2型糖尿病腎病進(jìn)展的前瞻隨機(jī)開放性試驗[J];四川大學(xué)學(xué)報(醫(yī)學(xué)版);2012年03期

4 陳孜瑾;陳楠;;從KDOQI到KDIGO指南解讀慢性腎臟病礦物質(zhì)和骨異常[J];中國實用內(nèi)科雜志;2011年12期

5 殷鶯;龍泉;尤莉;李海明;張力胤;顧勇;郝傳明;林善錟;陳靖;;低蛋白配伍α酮酸飲食可直接影響腎損傷大鼠系膜細(xì)胞腎素-血管緊張素系統(tǒng)表達(dá)[J];中華腎臟病雜志;2011年06期

6 劉燕萍;鄭法雷;劉建春;;低蛋白飲食加α-酮酸抑制CRF大鼠腎小管上皮間充質(zhì)轉(zhuǎn)化的作用及機(jī)制探討[J];北京醫(yī)學(xué);2011年02期

7 龍泉;李海明;張力胤;邱君思;顧勇;林善錟;陳靖;;低蛋白加α-酮酸飲食對5/6腎大部切除大鼠營養(yǎng)物質(zhì)代謝及殘腎組織硬化的影響[J];上海醫(yī)學(xué);2009年03期

8 諶衛(wèi);郭志勇;吳灝;孫莉靜;蔡莉莉;徐海燕;;復(fù)方α-酮酸配伍低蛋白飲食對長期腹膜透析患者微炎癥的影響及其與營養(yǎng)狀態(tài)關(guān)系的隨機(jī)對照研究[J];中西醫(yī)結(jié)合學(xué)報;2008年05期

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