Dietary protein restriction, blood pressure control, and the progression of polycystic kidney disease. Modification of Diet in Renal Disease Study Group.
Dietary protein restriction, blood pressure control, and the progression of polycystic kidney disease. Modification of Diet in Renal Disease Study Group.
复制标题
饮食蛋白质限制、血压控制和多囊肾病的进展。
DOI：
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发表时间：
1995
影响因子：
13.6
通讯作者：
Monica E. Yamamoto
中科院分区：
文献类型：
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作者：
S. Klahr;J. Breyer;G. Beck;V. W. Dennis;J. Hartman;David M. Roth;T. Steinman;Shin;Monica E. Yamamoto
在肾脏疾病饮食调整研究中，对200名常染色体显性多囊肾病（ADPKD）患者进行了随访（平均2.2年），以确定降低蛋白质摄入量和血压对GFR下降率的影响。ADPKD患者的下降速度比其他诊断的患者更快，部分反映了ADPKD组的疾病进展更快。预测ADPKD患者GFR下降速度更快的基线特征是更高的血清肌酐（独立于GFR）、更高的尿蛋白排泄、更高的平均动脉压（MAP）和更年轻。在初始GFR值在25至55 mL/min / 1.73 m2之间的患者中，分配到低蛋白饮食组和分配到低血压组都不能显著降低ADPKD参与者GFR下降的速度。同样，GFR的下降与达到的蛋白质摄入量或MAP无关。在GFR值在13至24 mL/min / 1.73 m2之间的参与者中，分配到低MAP组导致GFR下降更快。然而，更快速的GFR下降似乎不是由于低血压或用于达到低血压目标的降压药的有害影响。较低的蛋白质摄入量，而不是酮酸-氨基酸补充剂的处方，与肾脏疾病的缓慢进展略有相关。
In the Modification of Diet in Renal Disease Study, a follow-up (mean, 2.2 yr) of 200 study participants with autosomal dominant polycystic kidney disease (ADPKD) was conducted to determine the effect of lowering protein intake and blood pressure on the rate of decline in GFR. The rate of decline was faster in participants with ADPKD than in persons with other diagnoses, reflecting, in part, faster disease progression in the ADPKD group. Baseline characteristics that predicted a faster rate of decline in GFR in persons with ADPKD were greater serum creatinine (independent of GFR), greater urinary protein excretion, higher mean arterial pressure (MAP), and younger age. In patients with initial GFR values between 25 and 55 mL/min per 1.73 m2, neither assignment to a low-protein diet group nor assignment to a low blood pressure group significantly reduced the rate of decline of GFR in ADPKD participants. Similarly, the decline in GFR was not related to achieved protein intake or MAP. In participants with GFR values between 13 and 24 mL/min per 1.73 m2, assignment to the low MAP group led to a somewhat more rapid decline in GFR. However, the more rapid decline in GFR did not appear to be due to a detrimental effect of low blood pressure or the antihypertensive agents used to reach the low blood pressure goal. Lower protein intake, but not prescription of the keto acid-amino acid supplement, was marginally associated with a slower progression of renal disease.