饮食疗法对改善慢性肾衰竭病人透析前症状的观察

[目的]观察以优质低蛋白饮食为主的综合治疗,对改善慢性肾衰竭(CRF)病人透析前临床状态的意义。[方法]将慢性肾衰竭非透析治疗住院病人90例随机分为治疗组(A组)和对照组(B组),A组实施以优质低蛋白饮食为主的综合内科治疗,B组不限制饮食;同时治疗18个月,观察两组肾功能、营养状态和并发症情况。[结果]A组肾功能较B组明显改善,血尿素氮(BUN)、血肌酐(Cr)较B组有明显下降,内生肌酐清除率(Ccr)较B组明显升高;A组血浆白蛋白(ALB)、血红蛋白(Hb)均较B组明显升高;急性心力衰竭、酸中毒、严重水电解质紊乱、高血钾等并发症发生率较B组明显下降。[结论]以优质低蛋白饮食为主的综合治疗,能改善CRF病人透析前的肾功能、营养状态及临床症状,延缓CRF的进展。

Observation on effect of diet therapy to improve pre-dialysis symptoms of chronic renal failure patients

To probe into the significance of combined therapy based on high-quality low protein diet on improvement of pre-dialysis clinical state of chronic renal failure patients. Method: A total of 90 cases of chronic renal failure (CRF) inpatients undergoing non-dialysis therapy were divided into both test (group A) and control group (group B) randomly. Patients of group A were given combined therapy based on high-quality low protein diet. While patients of group B were no diet limitation. Indexes including renal function, nutritional state, and complications of the two groups patients were observed after 18 months of therapy. Result: The renal functions of patients of group A had improved remarkably after the combined therapy compared to that of group B patients. Both blood urea nitrogen (BUN) and plasma creatinine (Cr) were decreased dramatically of group A patients after the combined therapy compared to that of group B. The endogenous creatinine clearance rate (Ccr) of group A patients lowered down obviously compared to that of group B patients. In terms of plasma albumin and hemoglobin, patients of group A were increased significantly than that of group B patients after the combined therapy. However, the incidences of complications including acute heart failure, acidosis, severe water-electrolytes disturbance and hyperkaliemia in patients of group A were lowered remarkably than that of group B patients. Conclusion: The combined therapy based on high-quality low protein diet could improve the renal function, nutritional state and clinical symptoms of CRF pre-dialysis patients and delay the progress of CRF.