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Том 2 №1,2 2000 год - Нефрология и диализ

Нутриционный статус больных на перитонеальном диализе


Земченков А.Ю. Райхельсон К.Л. Эйдельштейн В.А.

Аннотация: Больные, страдающие хронической почечной недостаточностью (ХПН), уже с ее ранних стадий начинают спонтанно ограничивать потребление белков. Это, в частности, было продемонстрировано в проспективном исследовании Ikizler и соавт. [31], основанном на наблюдении 90 пациентов. Авторы отметили, что при клубочковой фильтрации 50 мл/мин и более потребление белков составляет 1,0 г/кг веса/сут, но оно уменьшается до 0,54 г/кг веса/сут, если клубочковая филь-трация снижается до 10 мл/мин и ниже, причем этот эффект не провоцируется диетическими ограничениями. Подобные же результаты были представлены McCusker и соавт. [46]. В группе из 680 больных, наблюдавшихся в рамках совместного Канадско-Американского исследования, именуемого CAN-USA, показано, что при снижении клиренса креатинина с уровня, превышающего 50 мл/мин, до уровня ниже 25 мл/мин скорость катаболизма белка (СКБ), определенная по кинетике мочевины, уменьшается с 1,1 до 0,9 г/кг/сут.

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Ключевые слова: ХПН, лечение ПАПД, особенности питания, нутриционный статус, белково-энергетическая недостаточность, прогностическая значимость

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