高龄男性慢性肾病3期患者饮食管理的回顾性研究OA

Objective To observe the implementation of low-protein diet(LPD)in elderly male patients with chronic kidney disease(CKD)and to explore the influence of LPD compliance on their nutritional status and the progression of renal function.Methods A retrospective observation which was 15 months was conducted on the dietary protein control in 139 elderly male patients with CKD stage 3.To evaluate the compliance of patients with LPD,the daily protein intake(eDPI)was estimated based on 24-hour urine urea nitrogen(UUN),and the subjects were categorized into four groups based on eDPI and supplementation with or without α-ketoacids(KA):LPD group,non-protein-restriction group,LPD+KA group,and non-protein-restriction+KA group.The changes in the nutritional status,calcium-phosphate metabolism,and renal function progression were compared at the end of follow-up.Results A total of 126 subjects were included in the final analysis,and 46.8%(59/126)of them effectively adhered to LPD.After the follow-up,the serum albumin level in the LPD group was significantly lower than the baseline(P<0.05),whereas the serum pre-albumin and serum calcium levels in the two KA-supplemented groups were significantly higher than those in the two non-KA groups(P<0.05).Notably,the LPD+KA group showed a slower decline in estimated glomerular filtration rate than the other three groups(P<0.05).Conclusions The compliance of the elderly male CKD patients with LPD is not high.LPD treatment alone may increase the risk of malnutrition in the elderly male patients,whereas supplementation with KA can maintain or even improve the nutritional sta-tus and blood calcium levels of CKD patients,and effectively delay CKD progression in this population.