ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2015, Vol. 24 ›› Issue (4): 386-390.

• 论文 • 上一篇    下一篇

腹膜透析患者蛋白质能量消耗的病因和治疗对策

  

  • 出版日期:2015-08-28 发布日期:2015-09-01

Treatment of protein-energy wasting in chronic kidney disease patients undergoing peritoneal dialysis

  • Online:2015-08-28 Published:2015-09-01

摘要:

摘要:蛋白质能量消耗(protein-energy wasting, PEW)是由国际肾脏营养和代谢学会(International Society of Renal Nutrition and Metabolism,ISRNM)提出的一个新概念,指的是慢性肾脏病(chronic kidney disease, CKD)中发生的各种营养和代谢异常。PEW与CKD不良预后密切相关。导致PEW的病因是多方面的,除因食欲下降、饮食限制所致的营养不良外,微炎症状态、酸中毒、内分泌激素紊乱等所致的蛋白质消耗有着更重要的影响。腹膜透析(peritoneal dialysis, PD)患者PEW有其自身的特点。针对PEW的各种病因提出了各种治疗对策,包括营养补充、新型腹透液、生长激素、雄激素、运动以及一些新的治疗药物。现就PD患者PEW的病因及治疗对策做如下综述。

关键词: 蛋白质能量消耗, 慢性肾脏病, 腹膜透析

Abstract:

ABSTRACT: Protein-energy wasting (PEW), a term proposed by the International Society of Renal Nutrition and Metabolism (ISRNM), refers to the multiple nutritional and catabolic alterations that occur in chronic kidney disease (CKD) and is associated with morbidity and mortality. There are multiple factors related with PEW. Besides insufficient food intake (true under-nutrition) due to poor appetite and dietary restrictions, other factors such as inflammation, acidosis, endocrine disturbance are in charge of the more important problem, wasting. Because of unique dialysis mode, patients undergoing peritoneal dialysis have different characteristics of PEW. Multiple strategies are proposed to deal with PEW including nutrient supplement, modified PD dialysate, growth hormone, androgen, exercise and some new developed agents. This article reviews the etiology and treatment strategies of PEW in PD patients.

Key words: protein-energy wasting, chronic kidney disease, peritoneal dialysis