DİYALİZ ÖNCESİ BESLENME

Yıl 2012, Cilt: 19 Sayı: 4, 156 - 161, 30.12.2012

Atila Altuntaş

Öz

Kronik böbrek yetmezliği olan hastalarda diyet hastalığın seyri açısından önemli bir yer tutmaktadır. Proteinler, yağ ve karbonhidratlar gibi depolanmazlar ve azot içeren ürünlere dönüşürler. Bu azotlu atık maddeler üremik semptomların oluşmasına neden olurlar. Ayrıca bu azotlu atık maddeler hiperkalemi, renal osteodistrofi ve metabolik asidozun da artmasına katkıda bulunurlar. Diyet içeriğinin düzenlenmesi ileride oluşabilecek elektrolit bozukluklarının düzeltilmesi ve kan basıncının kolaylıkla kontrol altına alınması açısından büyük öneme sahiptir. Bununla birlikte beslenmedeki yetersizlik artmış morbidite ve mortalite ile ilişkilidir. Son dönem böbrek yetmezliği evresine ulaşmadan, kronik böbrek yetmezlikli hastaların diyet uyumu yakın takip edilmelidir. Bu yakın diyet takibi sonucunda böbrek yetmezliğinin progresyon hızının azaltılması ve ileride gelişebilecek komplikasyonların kontrol altına alınması daha kolay olacaktır.

Anahtar Kelimeler

Diyet, kronik böbrek yetmezliði, prediyaliz

Kaynakça

• Aparicio M, Fouque D, Chauveau P. Effect of a very low-protein diet on long-term outcomes. 2009 Jul;54(1):183.
• Slinin Y, Guo H, Gilbertson DT, Mau LW, Ensrud K, Collins AJ et al. Prehemodialysis care by dietitians and first-year mortality after initiation of hemodialysis. Am J Kidney Dis. 2011 Jun 28.
• Teixeira Nunes F, de Campos G, Xavier de Paula SM, Merhi VA, Portero-McLellan KC, da Motta DG et al. Dialysis adequacy and nutritional status of hemodialysis patients. Hemodial Int. 2008 Jan;12(1):45-51.
• Kaysen GA, Dubin JA, Müller HG, Mitch WE, Rosales LM, Levin NW. Relationships among inflammation nutrition and physiologic mechanisms establishing albumin levels in hemodialysis patients. Kidney Int. 2002 Jun;61(6):2240-9.
• Mitch WE Dietary protein restriction in chronic renal failure: nutritional efficacy, compliance, and progression of renal insufficiency. J Am Soc Nephrol. 1991;2(4):823.
• Maroni BJ, Steinman TI, Mitch WE. A method for estimating nitrogen intake of patients with chronic renal failure. Kidney Int. 1985;27(1):58.
• Masud T, Manatunga A, Cotsonis G, Mitch WE. The precision of estimating protein intake of patients with chronic renal failure. Kidney Int. 2002 Nov;62(5):1750- 6.
• Fouque D, Pelletier S, Guebre-Egziabher F. Have recommended protein and phosphate intake recently changed in maintenance hemodialysis? J Ren Nutr. 2011 Jan;21(1):35-8
• Bellizzi V, Bedogni G, Quintaliani G. [Compliance with low-protein diet in patients with chronic kidney disease]. G Ital Nefrol. 2008 Sep-Oct;25 Suppl 42:S45- 9
• Mitch WE, Remuzzi G. Diets for patients with chronic kidney disease, still worth prescribing. J Am Soc Nephrol. 2004 Jan;15(1):234-7
• Cuppari L, Ikizler TA. Energy balance in advanced chronic kidney disease and end-stage renal disease. Semin Dial. 2010 Jul-Aug;23(4):373-7.
• Brunori G, Viola BF, Parrinello G, De Biase V, Como G, Franco V et al. Efficacy and safety of a very-low- protein diet when postponing dialysis in the elderly: a prospective randomized multicenter controlled study. Am J Kidney Dis. 2007;49(5):569.
• Glabska D, Narojek L, Wardak J, Rojek-Trebicka J. [Analysis of the food rations of predialysis patients with chronic renal failure receiving essential amino acid ketoanalogues]. Rocz Panstw Zakl Hig. 2009;60(3):285-8.
• Bross R, Noori N, Kovesdy CP, Murali SB, Benner D, Block G et al.Dietary assessment of individuals with chronic kidney disease. Semin Dial. 2010 Jul- Aug;23(4):359-64.
• Dukkipati R, Noori N, Feroze U, Kopple JD. Dietary protein intake in patients with advanced chronic kidney disease and on dialysis. Semin Dial. 2010Jul- Aug;23(4):365-72.
• Chauveau P, Aparicio M. Benefits in nutritional interventions in patients with CKD stage 3-4. J Ren Nutr. 2011 Jan;21(1):20-2
• Delmez JA, Slatopolsky E. Hyperphosphatemia: its consequences and treatment in patients with chronic renal disease. Am J Kidney Dis. 1992;19(4):303.
• Pupim LB, Cuppari L, Ikizler TA. Nutrition and metabolism in kidney disease. Semin Nephrol. 2006 Mar;26(2):134-57.
• Shirai S, Kimura K. Lifestyle modification and diet therapy for nephrotic syndrome. Nihon Rinsho. 2004 Oct;62(10):1885-91.
• Calleja Fernández A, López Gómez JJ, Vidal Casariego A, Cano Rodríguez I, Ballesteros Pomar MD. [Effectiveness of dietetic treatment in nephrotic syndrome]. Nutr Hosp. 2009 Nov-Dec;24(6):744-7
• Ranich T, Bhathena SJ, Velasquez MT. Protective effects of dietary phytoestrogens in chronic renal disease. J Ren Nutr. 2001 Oct;11(4):183-93
• Schmieder RE, Ruilope LM, Barnett AH. Renal protection with angiotensin receptor blockers: where do we stand. J Nephrol. 2011 Sep-Oct;24(5):569-80
• Lin J, Judd S, Le A, Ard J, Newsome BB, Howard G et al. Associations of dietary fat with albuminuria and kidney dysfunction. Am J Clin Nutr. 2010 Oct;92(4):897-904.