Nefrologia Dialisi

The high estimated prevalence of chronic kidney disease (CKD) forcefully supports the need for collaboration among nephrologists, cardiologists, diabetologists and general practitioners, to reduce the cardiovascular risk of CKD patients and delay the start of dialysis. Many studies confirm that reducing the dietary intake of proteins improves uremia as well as acid-base and phosphorus disorders without exposing the CKD patient to the risk of malnutrition. The possibility of delaying renal death and the start of dialysis by almost one to two years is also recognized, thanks in part to the antiproteinuric effect of low-protein diets supplemented with keto acids and essential amino acids. Reducing the dietary protein intake delays the start of dialysis independently of the effect of renin-angiotensin system (RAS)-active antihypertensive drugs. Reduction of the dietary protein intake is indicated in patients with a glomerular filtration rate <25 mL/min (CKD stages 4 and 5). Some situ...

Riassunto La restrizione del contenuto proteico della dieta nasce agli albori della nefrolo- gia come trattamento sintomatico dell'uremia, ma diventa di uso comune negli anni '80 come provvedimento mirato ad un rallentamento della progressione della malattia renale cronica (CKD). Da allora sono stati effettuati numerosi studi sull'argomento. Lo studio Modification of Diet in Renal Disease (MDRD), che rappresenta uno dei