中国成人糖尿病肾脏疾病医学营养治疗专家共识

Expert Consensus on Medical Nutrition Therapy for Adult Diabetic Kidney Diseases in China

糖尿病肾脏疾病(diabetic kidney disease,DKD)是糖尿病主要微血管并发症之一,表现为持续性尿白蛋白排泄率增加和(或)肾小球滤过率进行性下降,最终发展为终末期肾脏疾病(end stage renal disease,ESRD),严重影响患者健康及生活质量。营养不良在DKD中较为常见,可显著增加糖尿病患者全因死亡风险。医学营养治疗(medical nutrition therapy,MNT)可延缓DKD进展、降低ESRD比例,还可防治DKD导致的营养不良或蛋白质能量消耗。中华医学会内分泌学分会为制定符合中国DKD患者需求的MNT规范,组织专题讨论并制定本共识,旨在为临床工作者提供基于证据的DKD个体化MNT指导,进而延缓DKD进展、提高生存率。

Diabetic kidney disease(DKD),one of the most prevalent microvascular complications of diabetes mellitus,is characterized by increased persistent albuminuria and(or)progressive decrease of glomerular filtration rate.It would eventually develop into end-stage renal disease(ESRD),which leads to severely impaired patient health and quality of life.Malnutrition is relatively common in DKD and can significantly increase the risk of all-cause mortality in patients with diabetes.Medical nutrition therapy(MNT)can delay the progression to ESRD,and prevent malnutrition or protein-energy wasting.The Chinese Society of Endocrinology convened a task-force to develop evidence-based expert consensus to provide clear guidance for implementation of individualized MNT care to improve clinical outcomes of patient with DKD.