Diet as a treatment for chronic kidney disease
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
The management of chronic kidney disease (CKD) includes nutritional interventions aimed at slowing disease progression and mitigating complications. This review examines various dietary approaches for CKD treatment, focusing on carbohydrate intake modulation, ketogenic diets, and plant-based diets. Standard guidelines recommend carbohydrate intake within 45% to 65% of total calories, but there is growing interest in reducing carbohydrate consumption to preserve kidney function. Low-carbohydrate diets (<25% of total calories) have shown benefits in glycemic control and weight reduction but may pose long-term adherence challenges. High-protein, low-carbohydrate diets are discouraged due to associations with hyperfiltration and CKD progression. Limiting fructose intake has been linked to reductions in blood pressure and uric acid levels. Intermittent fasting and ketogenic diets, which promote ketone body production and reduce inflammation, have shown promise in animal models and some human studies, particularly in autosomal dominant polycystic kidney disease, though more research is needed. Plantbased diets, such as the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets, offer cardiovascular benefits and may reduce CKD risk but require careful management of potassium intake. Overall, dietary interventions should be individualized, considering potential risks like hyperkalemia and ensuring nutritional adequacy.
Abstract
The management of chronic kidney disease (CKD) includes nutritional interventions aimed at slowing disease progression and mitigating complications. This review examines various dietary approaches for CKD treatment, focusing on carbohydrate intake modulation, ketogenic diets, and plant-based diets. Standard guidelines recommend carbohydrate intake within 45% to 65% of total calories, but there is growing interest in reducing carbohydrate consumption to preserve kidney function. Low-carbohydrate diets (<25% of total calories) have shown benefits in glycemic control and weight reduction but may pose long-term adherence challenges. High-protein, low-carbohydrate diets are discouraged due to associations with hyperfiltration and CKD progression. Limiting fructose intake has been linked to reductions in blood pressure and uric acid levels. Intermittent fasting and ketogenic diets, which promote ketone body production and reduce inflammation, have shown promise in animal models and some human studies, particularly in autosomal dominant polycystic kidney disease, though more research is needed. Plantbased diets, such as the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets, offer cardiovascular benefits and may reduce CKD risk but require careful management of potassium intake. Overall, dietary interventions should be individualized, considering potential risks like hyperkalemia and ensuring nutritional adequacy.
참고문헌 (16)
- KDOQI Work Group, "KDOQI clinical practice guideline for nutrition in children with CKD : 2008 update : executive summary", Am J Kidney Dis, 53(3 Suppl 2), pp.S11~104 (2009)
- Joshi S, "Risks and benefits of different dietary patterns in CKD", Am J Kidney Dis, 81, pp.352~360 (2023)
- Naude CE, "Low-carbohydrate versus balanced-carbohydrate diets for reducing weight and cardiovascular risk", Cochrane Database Syst Rev, 1, pp.CD013334~ (2022)
- Oyabu C, "Impact of low-carbohydrate diet on renal function : a meta-analysis of over 1000 individuals from nine randomised controlled trials", Br J Nutr, 116, pp.632~638 (2016)
- Farhadnejad H, "Low-carbohydrate high-protein diet is associated with increased risk of incident chronic kidney diseases among Tehranian adults", J Ren Nutr, 29, pp.343~349 (2019)
- Brymora A, "Low-fructose diet lowers blood pressure and inflammation in patients with chronic kidney disease", Nephrol Dial Transplant, 27, pp.608~612 (2012)
- Gershuni VM, "Nutritional ketosis for weight management and reversal of metabolic syndrome", Curr Nutr Rep, 7, pp.97~106 (2018)
- Kundu S, "Potentials of ketogenic diet against chronic kidney diseases : pharmacological insights and therapeutic prospects", Mol Biol Rep, 49, pp.9749~9758 (2022)
- Rowe I, "Defective glucose metabolism in polycystic kidney disease identifies a new therapeutic strategy", Nat Med, 19, pp.488~493 (2013)
- Kipp KR, "A mild reduction of food intake slows disease progression in an orthologous mouse model of polycystic kidney disease", Am J Physiol Renal Physiol, 310, pp.F726~31 (2016)
- Warner G, "food restriction ameliorates the development of polycystic kidney disease", J Am Soc Nephrol, 27, pp.1437~1447 (2016)
- Oehm S, "RESET-PKD : a pilot trial on short-term ketogenic interventions in autosomal dominant polycystic kidney disease", Nephrol Dial Transplant, 38, pp.1623~1635 (2023)
- Cukoski S, "Feasibility and impact of ketogenic dietary interventions in polycystic kidney disease : KETO-ADPKD-a randomized controlled trial", Cell Rep Med, 4, pp.101283~ (2023)
- Kontessis P, "Renal, metabolic and hormonal responses to ingestion of animal and vegetable proteins", Kidney Int, 38, pp.136~144 (1990)
- Hansrivijit P, "Mediterranean diet and the risk of chronic kidney disease : a systematic review and meta-analysis", Nephrology(Carlton), 25, pp.913~918 (2020)
- Podadera-Herreros A, "Longterm consumption of a mediterranean diet or a low-fat diet on kidney function in coronary heart disease patients : the CORDIOPREV randomized controlled trial", Clin Nutr, 41, pp.552~559 (2022)