Role of dietary factors in the progression of chronic renal disease.
Role of dietary factors in the progression of chronic renal disease.
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饮食因素在慢性肾病进展中的作用。
DOI：
10.1038/ki.1983.197
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发表时间：
1983
影响因子：
19.6
通讯作者：
Purkerson,ML
中科院分区：
文献类型：
--
作者：
Klahr,S;Buerkert,J;Purkerson,ML
在以不可逆转损伤为特征的肾脏疾病中，似乎一旦达到肾功能恶化的临界水平，即使最初的事件或状况得到解决或根除，进展到终末期疾病也总是会发生。免疫病理机制可能是人类大多数形式的原发肾小球疾病的原因。虽然免疫事件及其引起的肾小球损伤的介质可能是大多数肾小球疾病的始发因素，但某些临床和实验观察表明，这些疾病的进展速度受到几个非免疫因素的影响。在某些疾病中，如增殖性肾小球肾炎，肾功能的持续下降很可能是由于最初的潜在过程；在其他主要以间质瘢痕和肾小球硬化为特征的实体中，肾功能进行性丧失的原因不太明显。最近的实验证据表明，饮食控制，如减少蛋白质和/或磷的摄入量，可以阻止或减缓实验动物模型中慢性肾功能不全的进展。因此，存在一种令人兴奋的可能性，即某些肾脏疾病的自然病史可能会因饮食的变化而改变。我们回顾了有关控制饮食中蛋白质、磷或脂肪含量在慢性肾脏疾病进展中的作用的最新信息。大多数要回顾的实验观察都是在肾脏疾病的动物模型中进行的。关于饮食控制在患者肾脏疾病进展中的作用的文献有一定的局限性，这里不再强调。
In diseases of the kidney characterized by irreversible injury, it appears that once a critical level of renal functional deterioration is reached, progression to endstage disease invariably occurs even if the initiating event or condition is resolved or eradicated. Immunopathogenetic mechanisms probably account for most forms of primary glomerular disease in humans. Although immunologic events and the mediators of glomerular damage that they induce might be responsible for initiating most glomerular diseases, certain clinical and experimental observations suggest that the rate of progression of these diseases is influenced by several nonimmunologic factors. In certain diseases, such as proliferative glomerulonephritis, the relentless decrease in renal function is due very likely to the initial underlying process; in other entities characterized mainly by interstitial scarring and glomerular sclerosis, the cause of progressive loss of renal function is less apparent. Recent experimental evidence suggests that dietary manipulations, such as reductions in protein and/or phosphate intake, can halt or attenuate the progression of chronic renal insufficiency in experimental animal models. Therefore, the exciting possibility exists that the natural history of some renal diseases may be altered by changes in the diet. We review current information regarding the role of manipulations of dietary protein, phosphorus, or lipid content on the progression of chronic renal disease. Most of the experimental observations to be reviewed have been made in animal models of renal disease. The literature on the role of dietary manipulations on the progression of renal disease in patients is somewhat limited and will not be emphasized here.