腹膜透析患者蛋白质能量消耗的病因和治疗对策.pdfVIP

·386· ·腹膜透析· 腹膜透析患者蛋白质能量消耗的病因和治疗对策 周玉超综述俞雨生审校 摘要蛋白质能量消耗(PEW)是由国际肾脏营养和代谢学会(ISRNM)提出的一个新概念，指的是慢性肾 脏病(CKD)中发生的各种营养和代谢异常与CKD患者不良预后密切相关。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(PD)患者PEW有其自身的特点。针对PEW的病因提出了各种治疗对策，包括补充营养、新型透析 液、生长激素、雄激素、运动及一些新的治疗药物。现就PD患者PEW的病因及治疗对策作一综述。 关键词慢性肾脏病蛋白质能量消耗腹膜透析 Treatmentof inchronic disease peritoneal protein-energywasting kidney patientsundergoing dialysis ZHOU Yuchao，YUYusheng NationalClinicalResearchCenter School of ofKidneyDiseases，JinlingHospital，NanjingUnwenity Medicine，Nanjing 210016，China ABSTRACT term theInternationalofRenalNutritionand Protein—energywasting(PEW)aproposedby Society tothe nutritionalandcatabolicalterationsthatoccurinchronic disease Metabolism(ISRNM)，refersmultiple kidney isassociatedwith and ale factorsrelatedwithPEW．Besidesinsufficient (CKD)and morbiditymortality．Theremultiple as food to and factorssuch intake(trueunder—nutrition)due dietaryrestrictions，other inflammation，acidosis， poorappetite endocrinedisturbancearein ofthemore of charge importantproblem．Becauseuniquedialysismode，patientsundergoing havedifferentcharacteristicsof are todealwithPEW peritonealdialysis PEW．Multiplestrategiesproposed including nutrient PD andsomenew article supplement，modifieddialysate，growthhormone，androgen，exercisedevelopedagents．This reviewsthe andtreatment ofPEWinPD