慢性肾脏病患者蛋白质-能量消耗研究新进展

Research progress on protein-energy wasting in patients with chronic kidney disease

蛋白质-能量消耗在慢性肾脏病患者中发病率较高,临床上主要表现为饮食摄入、生化指标、体重指数、肌肉质量等方面的异常,其发病机制非常复杂,跟摄入不足、炎症、代谢性酸中毒、激素水平紊乱、透析相关因素等有关,严重影响透析患者的预后,因此早期发现、诊断和防治显得非常重要,将营养评估列入慢性肾脏病患者诊疗的日常工作当中,并对照诊断标准,及早诊断和采取各种措施防治蛋白质-能量消耗,最终提高慢性肾脏病患者的预后和生存率.本文对慢性肾脏病引起的蛋白质-能量消耗流行病学特点、发病机理、评估方式、治疗及干预措施等进行阐述.

Patients with chronic kidney disease often experience protein-energy wasting. The clinical manifestations performs include the abnormality of nutrient intake, biochemical index, body mass index, and muscle mass. Protein-energy wasting always results fiom decreased dietary intake, inflammation, metabolic acidosis, hormone level disorder, dialysis related factors, social psychological factors and so on, and seriously affects the prognosis and survival rates of patients with chronic kidney disease. Therefore, early detection, diagnosis and prevention and cure are very important. Nutritional evaluation should be included in daily diagnosis and treatment in patients with chronic kidney diseases. Contrasting diagnostic criteria, prevention and control of protein-energy wasting with early diagnosis and taking various measures will improve the prognosis and survival rate of patients with chronic kidney disease ultimately. Thus, the aim is to improve the patients＇ understanding of epidemiological characteristics, pathogenesis, assessment, treatment and intervention measures of protein-energy wasting in patients with chronic kidney disease.