酮基類似物在慢性腎臟病治療的角色

The Role of Ketoanalogue in the Management of Chronic Kidney Disease

陳清揚(Ching-Yang Chen) ； 洪士元(Shih-Yuan Hung)

《腎臟與透析》 29卷4期 (2017/12) Pp. 174-178

https://doi.org/10.6340/KD.2017.29(4).06

摘要

低蛋白飲食是慢性腎臟病治療很重要的一環，透過補充酮基類似物（ketoanalogue）可以將病人的蛋白攝 取限制到更低。酮基類似物可以經過轉胺作用在體內合成必需胺基酸，且減少尿毒素的產生，研究顯示可以改善腎功能惡化的速度，並延緩進入透析的時間。在密切的醫療及營養監測下，極低蛋白攝取合併酮基類似物並不會造成營養不良及死亡率上升。良好的飲食遵從性是低蛋白飲食是否可以成功的重要因素，這有賴於醫療端及病人共同努力，以改善慢性腎臟病人的預後。

關鍵字

慢性腎臟病 ； 低蛋白飲食 ； 酮基類似物 ； 透析

並列摘要

Low protein diet is an important part of management of chronic kidney disease. Supplementation of ketoanalogue allows further restriction of daily protein intake to a lower level. Ketoanalogue can be transformed to essential amino acid through transamination reaction and can also reduce uremic toxin formation. Studies demonstrate it can delay renal deterioration and the time of dialysis initiation. With closed medical and nutritional monitoring, very low protein diet accompanied with ketoanalogue is unlikely to cause malnutrition or increased mortality. Good dietary compliance is the key to success of low protein diet treatment. It depends on the efforts of both medical caregivers and patients to achieve a better outcome.

並列關鍵字

chronic kidney disease ； low protein diet ； ketoanalogue ； dialysis