饮食疗法对改善慢性肾衰竭病人透析前症状的观察

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

[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。

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.