低蛋白饮食加α酮酸延缓慢性肾脏病进展的临床研究

摘要

Objective lo explore the clinical enicacy ot low protein diet plus compound a-keto acids on chronic kidney disease( CKD)lll-]V patients. Methods 101 cases of 111 -IV stage chronic kidney disease ( non-dialysis )were selected, among which 4 dropped out of the experiment later due to the aggravation of the disease,which reduced it to 97 cases at the end of the experiment. All patients were given the treatment with a low protein diet of 0.6 g/( kg ? D ),plus a-keto acid. During the 12 months follow-up,serum renal function and albumin before and after treatment were tested,and glomerular filtration rate( GFR )was calculated by MDRD method. Results Creatinine,urea,albumin,GFR were not statistically significantly different P >0. 05 )of the 97 CKD cases before and after treatment. Conclusion Treatment of CKD 111 -IV patients with low-protein diet plus a-keto acid can prevent the essential amino acid deficiency and improve metabolic disorders. And compound a-keto acid may have renoprotective effects in nature and play a role in effectively delaying the progression of CKD.%目的 探讨低蛋白饮食加复方α酮酸治疗慢性肾脏病(CKD)Ⅲ ～Ⅳ期患者的临床疗效.方法 选择CKD Ⅲ ～Ⅳ期患者(非透析治疗)101例,其中4例因病情加重退出实验,至实验结束时为97例,所有患者给予低蛋白饮食,控制蛋白摄入量为0.6 g/(kg·d),再加以复方α酮酸治疗.随访12个月,检测治疗前后血清肾功能和白蛋白,并以MDRD法测算肾小球滤过率(GFR).结果 97例CKD患者治疗前后肌酐、尿素、白蛋白、GFR差异无统计学意义(P＞0.05).结论 CKD Ⅲ ～Ⅳ期患者予以低蛋白饮食加α酮酸治疗,可防止必需氨基酸缺乏和改善代谢紊乱,且复方α酮酸可能在本质上具有肾脏保护作用,发挥有效延缓CKD进展的作用.