老年慢性肾脏病合并糖尿病的营养治疗

Nutritional treatment for elderly chronic kidney disease patients with diabetes

营养治疗是慢性肾脏病(chronic kidney disease, CKD)治疗的重要组成部分,合并糖尿病的老年CKD的营养治疗存在着特殊性。低蛋白饮食作为营养治疗的核心,可以改善合并糖尿病的老年CKD患者的预后,但同时引发营养不良、血糖升高、心情低落的风险较年轻患者更高,因此适度的低蛋白饮食和及时的营养状态评估对于此类人群尤为重要,同时应提高老年患者饮食治疗的依从性从而保障低蛋白饮食的实施。需要特别注意的是合并糖尿病的老年CKD患者也常伴有心脑血管疾病等其他合并症,应该结合患者的营养状况,综合考虑制定个体化营养方案。

Nutritional treatment is of great importance for chronic kidney disease(CKD), with its particularity for elderly patients with diabetes. Low-protein diet, as the core of the nutritional treatment, is expected to improve the prognosis of elderly CKD patients with diabetes. However, considering its higher risk of malnutrition, blood glucose elevation and depression in these patients, appropriate protein limitation and in-time nutritional status assessment should be emphasized.Meanwhile, the weak compliance of low-protein diet in elderly patients should be improved. Since elderly CKD patients with diabetes are likely to suffer from many other complications, individual ized nutritional therapy should be prescribed according to the nutritional status of the patient.