慢性腎臟病人的蛋白質－能量耗損－最新觀點與進展

Protein-Energy Wasting in CKD Patients-Latest Update

何立鈞(Li-Chun Ho) ； 洪士元(Shih-Yuan Hung)

《腎臟與透析》 29卷4期 (2017/12) Pp. 149-153

https://doi.org/10.6340/KD.2017.29(4).01

摘要

蛋白質－能量耗損是慢性腎臟病人營養與代謝失調的狀態。本文整理其最新發展，並著重尚未透析的慢性腎臟病人。診斷方面，現行診斷標準是否優於其他診斷工具仍需更多實證，而肌肉耗損所導致的衰弱，是漸受重視的功能性指標。治療方面，給與酮酸錠劑或不含蛋白質的熱量補充包，可避免低蛋白飲食惡化耗損，鹼化治療則可防止代謝性酸中毒所造成的耗損。總之，蛋白質－能量耗損的診斷及治療仍有待更多研究。

關鍵字

蛋白質－能量耗損 ； 慢性腎臟病 ； 衰弱

並列摘要

Protein-energy wasting (PEW) is a state of nutritional and metabolic derangements in patients with chronic kidney disease (CKD). This review summarizes the recent advances in understanding and management of PEW, focusing on non-dialysis CKD patients. For the diagnosis of PEW, there is still insufficient evidence to support the superiority of current diagnostic criteria proposed by the International Society of Renal Nutrition and Metabolism in comparison with other diagnostic tools. Frailty secondary to muscle wasting has drawn attentions since it represents the functional status of PEW patients. As for the therapy for PEW, alpha-Ketoanalogues or protein-free energy supplementation may prevent the potential wasting caused by low protein diet. Alkali therapy correcting metabolic acidosis is beneficial for nutritional status. In summary, the best diagnostic criteria and management for PEW still requires future studies.

並列關鍵字

protein-energy wasting ； chronic kidney disease ； frailty