Progression of chronic renal failure in patients given ketoacids following amino acids.
Progression of chronic renal failure in patients given ketoacids following amino acids.
复制标题
在氨基酸之后给予酮酸的患者慢性肾衰竭的进展。
DOI：
10.1038/ki.1987.181
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发表时间：
1987
影响因子：
19.6
通讯作者：
VanDuyn,MA
中科院分区：
文献类型：
--
作者：
Walser,M;LaFrance,ND;Ward,L;VanDuyn,MA
氨基酸后给予酮酸的患者慢性肾功能衰竭的进展。12例慢性肾衰竭患者，尽管给予2至10个月的饮食（含0.3 g/kg理想体重的蛋白质和7至9 g/kg理想体重的磷，补充维生素、CaCO 3和10 g/天的必需氨基酸），但24小时肌酐清除率仍表现出进行性下降，改为主要含酮酸的补充剂。在转换时血清肌酐为7.5 mg/dl或更高的6例患者中，进展持续不减。在6例血清肌酐水平从6.6 mg/dl转换为7.4 mg/dl的患者中，1例患者不依从饮食并进展为透析。在其他五个，进展，衡量的变化率，每两个月的放射性同位素清除，已无法检测到在随后的一到两年。尿素外观、血压、磷酸盐尿或蛋白尿没有变化。营养得到了维持。因此，在一小群患者中，这种补充酮酸的方案明显阻止了中重度慢性肾衰竭的进展至少一年，在这些患者中，限制蛋白质和磷酸盐摄入而不使用酮酸未能阻止进展。在更严重的肾衰竭中，未观察到对进展的影响。
Progresion of chronic renal failure in patients given ketoacids following amino acids. Twelve patients with chronic renal failure who exhibited a progressive decline in 24-hour creatinine clearance, despite being given for 2 to 10 months a diet containing 0.3 g per kg ideal weight of protein and 7 to 9 g mg per kg ideal weight of phosphorus, supplemented with vitamins, CaCO3, and 10 g per day of essential amino acids, were changed to a supplement containing predominantly ketoacids. In six patients whose serum creatinine was 7.5 mg/dl or greater at changeover, progression continued unabated. In six patients with serum creatinine levels at changeover of 6.6 to 7.4 mg/dl, one was non-compliant with the diet and progressed to dialysis. In the other five, progression, measured as the rate of change of a bimonthly radioisotope clearance, has been undetectable during the ensuing one to two years. There has been no change in urea appearance, blood pressure, phosphaturia or proteinuria. Nutrition has been maintained. Thus this ketoacid supplemented regimen apparently halted the progression of moderately-severe chronic renal failure for at least a year in a small group of patients in whom restriction of protein and phosphate intake without ketoacids failed to halt progression. In more severe renal failure, no effect on progression was seen.