Current Uses of Dietary Therapy for Patients with Far-Advanced CKD

Clinical journal of the American Society of Nephrology: CJASN

Norio Hanafusa¹ 

[1] *Department of Blood Purification, Kidney Center, Tokyo Women’s Medical University, Tokyo, Japan;†Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor–UCLA Medical Center, Torrance, California

关键词: chronic kidney disease;    uremia;    dialysis;    incremental dialysis;    low protein diet;    ketoacids;    essential amino acids;    Diet;    Protein-Restricted;    glomerular filtration rate;    Health Care Costs;    humans;    Nutritional Status;    quality of life;    renal dialysis;    Renal Insufficiency;    Chronic;    Renal Replacement Therapy;   

DOI  :  10.2215/CJN.09340916

学科分类：泌尿医学

来源: American Society of Nephrology

【 摘 要 】

For several decades, inquiry concerning dietary therapy for nondialyzed patients with CKD has focused mainly on its capability to retard progression of CKD. However, several studies published in recent years indicate that, independent of whether diet can delay progression of CKD, well designed low-protein diets may provide a number of benefits for people with advanced CKD who are close to requiring or actually in need of RRT. Dietary therapy may both maintain good nutritional status and safely delay the need for chronic dialysis in such patients, offering the possibility of improving quality of life and reducing health care costs. With the growing interest in incremental dialysis, dietary therapy may enable lower doses of dialysis to be safely and effectively used, even as GFR continues to decrease. Such combinations of dietary and incremental dialysis therapy might slow the rate of loss of residual GFR, possibly reduce mortality in patients with advanced CKD, improve quality of life, and also, reduce health care costs. The amount of evidence that supports these possibilities is limited, and more well designed, randomized clinical trials are clearly indicated.

【 授权许可】

CC BY