Clinical results of long-term treatment with a low protein diet and a new amino acid preparation in patients with chronic uremia.
Clinical results of long-term treatment with a low protein diet and a new amino acid preparation in patients with chronic uremia.
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低蛋白饮食和新型氨基酸制剂长期治疗慢性尿毒症患者的临床结果。
作者：
A. Alvestrand;M. Ahlberg;P. Fürst;J. Bergström
15例重度尿毒症患者（平均血清肌酐浓度965，范围568-1383 mumoles/l），用限制性β-内酰胺酶蛋白治疗。（16-20克蛋白质/天）饮食和一种新的氨基酸制剂，其含有的必需氨基酸的比例不同于Rose为正常人推荐的比例，并且还含有组氨酸和酪氨酸，平均为224天（范围33-737天）。血浆尿素浓度下降，尿毒症症状消失。在平均治疗时间为151天后，对6例患者进行了10项氮平衡研究。平均氮平衡，总尿素库的变化校正，为+ 0.4 +/- 0.22 g N/天。在4例患者中，通过血清肌酐浓度的倒数与时间的曲线图评估了肾功能不全的进展，在方案制定后观察到进展延迟。结果表明，在长期治疗过程中，这种方案可以维持氮平衡，并表明，与正常人最佳比例的必需氨基酸相比，这种新的氨基酸制剂可以获得更好的氮利用率，并进一步表明，这种方案可以延缓肾功能不全的进展。
15 patients with severe uremia (mean serum creatinine concentration 965, range 568-1383 mumoles/l) were treated with an unselected protein restricted (16-20 g protein/day) diet and a new amino acid preparation, containing the essential amino acids in proportions which differed from those recommended by Rose for normal man and which contained in addition histidine and tyrosine, for an average period of 224 (range 33-737) days. Plasma urea concentration decreased and the uremic symptoms disappeared. Ten nitrogen balance studies were performed in 6 patients after a mean treatment time of 151 days. The mean nitrogen balance, corrected for changes in total urea pool, was + 0.4 +/- 0.22 g N/day. In 4 patients, in whom progression of the renal insufficiency was assessed by plots of the reciprocal of serum creatinine concentration versus time, retardation of progression was observed after institution of the regimen. The results show that nitrogen equilibrium can be maintained during long-term treatment with this regimen and suggest that better nitrogen utilization is achieved with the new amino acid preparation than when essential amino acids are given to uremic patients in the proportions considered optimal for normal man. It is further shown that the progression of renal insufficiency may be retarded by this regimen.