Cov neeg mob raum puas xav txo qis cov protein? Tsis Txhob Paub ARB!
May 10, 2024
Kev tswj cov urinary protein yog ib qho ntawm cov tswv yim tseem ceeb los ncua kev loj hlob ntawm cov kab mob raum
Feem ntau hais lus, ib qho 24- teev cov zis protein ntau tsawg dua 150 mg yog nyob rau hauv ib txwm muaj. Hauv cov neeg mob uas muaj kab mob raum, qhov 24- teev cov zis protein ntau yuav tsum tau tswj qis dua 500 mg. Tam sim no, nyob rau hauv kev kho mob, cov tshuaj regimens rau txo cov zis protein feem ntau muaj xws li cov hauv qab no:
Nyem rau Cistanche rau mob raum
kev kho mob
①ACEI/ARB
ACEI / ARB (cov tshuaj primer thiab sartan) tsis tuaj yeem txo cov ntshav siab xwb, tab sis kuj txo qis intraglomerular siab, txo cov urinary protein, thiab ncua kev ua haujlwm ntawm lub raum. Rau cov neeg mob CKD uas muaj proteinuria hnyav uas tsis tau txais kev lim ntshav, nws raug nquahu kom siv ACEI lossis ARB kho; Rau cov neeg mob uas muaj cov proteinuria nruab nrab thiab ntshav qab zib mellitus, nws raug nquahu kom siv ACEI lossis ARB kev kho mob.
② SGLT2i
Txawm hais tias SGLT2i yog cov tshuaj hypoglycemic, nws tuaj yeem tiv thaiv lub raum ua haujlwm los ntawm ntau lub tswv yim xws li kho "tubuloglomerular tawm tswv yim", txhim kho glomerular hyperfiltration, txo qis intraglomerular siab, txhim kho hypoxia hauv zos, thiab txo cov tubular load. , txo cov zis protein.
Txawm hais tias cov neeg mob CKD muaj ntshav qab zib los yog tsis, SGLT2i tuaj yeem siv rau kev kho mob. Cov tshuaj tseem ceeb yog dapagliflozin thiab empagliflozin.
Dapagliflozin thiab empagliflozin 10 mg, ib hnub ib zaug, noj lub plab khoob lossis tom qab noj mov. Cov lus pom zoo noj rau cov neeg mob lub raum tsis zoo yog raws li hauv qab no:
③ Mineralocorticoid receptor antagonist (MRA)
MRA tiv thaiv lub raum los ntawm antagonizing mineralocorticoids thiab lawv cov receptors kom txo oxidative kev nyuaj siab, inflammatory teb, thiab pro-fibrotic cuam tshuam los ntawm kev ua kom ntau dhau ntawm mineralocorticoid receptors.
Rau cov neeg mob CKD uas muaj ntshav qab zib thiab proteinuria uas tau txais kev kho mob siab tshaj plaws ntawm ACEI / ARB thiab / lossis SGLT2i, MRA tuaj yeem muab ntxiv raws li qhov tsim nyog, thiab nws raug pom zoo tias tsis yog steroidal MRA (fenelidone) yog qhov tseem ceeb.
Qhov pib koob tshuaj ntawm fenelidone yuav tsum tau txiav txim siab raws li eGFR thiab cov qib poov tshuaj hauv cov ntshav:
If serum potassium is >5. 0mmol/L lossis eGFR yog<25ml/(min·1.73m2), fenelidone is not recommended;
Thaum cov ntshav cov poov tshuaj tsawg dua lossis sib npaug rau 5.
Thaum cov piam thaj hauv cov ntshav tsawg dua lossis sib npaug rau 5.<60 ml/(min·1.73m2), it is recommended to start with 10mg/d.
Cov qib poov tshuaj thiab eGFR yuav tsum tau saib xyuas tsis pub dhau 4 lub lis piam ntawm kev pib kho fenelidone:
Yog tias cov piam thaj hauv ntshav tsawg dua lossis sib npaug li 4.8 mmol / L thiab eGFR txo qis dua los yog sib npaug li 30% piv nrog qhov kev sim zaum kawg, cov koob tshuaj tuaj yeem nce mus rau 20 mg / d lossis khaws cia ntawm 20 mg / d;
If the serum potassium is 4.8~5.5 mmol/L or the eGFR decreases by >30%.
If serum potassium is >5.5 mmol / L, kev kho fenelidone yuav tsum raug ncua.
Tib lub sijhawm nrog kev kho tshuaj, kev noj zaub mov ntawm cov neeg mob raum tsis tuaj yeem tsis quav ntsej.
Cov khoom noj muaj protein tsawg tsawg
Protein tseem ceeb heev rau kev tswj lub cev cov ntaub so ntswg rov ua dua tshiab thiab lub cev ua haujlwm. Feem ntau cov neeg mob uas mob raum mob raug kev txom nyem los ntawm kev poob protein. Kev noj cov protein ntau ntau yuav ua rau lub nra ntawm lub raum ntawm cov neeg mob uas muaj kab mob raum ntev thiab ua kom cov kab mob loj zuj zus ntxiv. Yog li ntawd, hom thiab tus nqi ntawm cov protein nyob rau hauv cov zaub mov noj ntawm cov neeg mob uas mob raum kab mob yuav tsum tau xaiv raws li lawv cov kab mob theem. Cov protein zoo yuav tsum suav rau ntau dua 50% ntawm tag nrho cov protein. Cov protein uas muaj txiaj ntsig zoo feem ntau yog cov khoom noj tsiaj thiab taum pauv. .
Kev noj cov protein ntau ntawm cov neeg mob nrog CKD theem 1 ~ 2 yuav tsum tau tswj ntawm 0.8 ~ 1.0g/(kg·d); Cov neeg mob uas tsis yog lim ntshav uas muaj cov metabolism hauv ruaj khov hauv CKD theem 3 ~ 5 yuav tsum txwv tsis pub noj cov protein ntau hauv lawv cov zaub mov, thiab qhov feem pua ntawm cov khoom noj muaj protein ntau tuaj yeem nce ntxiv. , kom ncua kev kis kab mob.
Noj tsawg ntsev thiab tswj roj
"Food thiab Nutrition Guidelines for Adults with Chronic Kidney Disease (2024 Edition)" Kev tswj cov ntsev kom tsawg hauv cov zaub mov yuav pab txhim kho ntshav siab thiab txo cov proteinuria thiab edema hauv cov neeg mob raum mob. Nws raug pom zoo tias cov neeg mob uas mob raum mob yuav tsum tau noj ntsev txhua hnub tsis pub ntau tshaj 5g; Rau cov neeg mob raum mob ntev nrog edema, kev noj zaub mov tsawg yuav tsum tau siv thiab kev noj ntsev txhua hnub yuav tsum tsis pub tshaj 3g.
Tsis txhob noj haus luam yeeb, barbecued, pickled thiab lwm yam khoom noj dhau lawm, txwv tsis pub noj cov kua ntses, monosodium glutamate, nqaij qaib, ntau cov kua ntses thiab lwm yam khoom noj, thiab sim xaiv cov khoom qab zib xws li hawthorn, txiv qaub, kua txob, Sichuan peppercorns, vinegar, lwm yam.
Cov neeg mob lub raum yuav tsum sim txiav luam yeeb
Kev haus luam yeeb yog ib qho kev pheej hmoo ywj pheej rau cov neeg mob CKD. Cov kev tshawb fawb tau pom tias cov neeg haus luam yeeb muaj kev pheej hmoo siab ntawm albuminuria dua li cov neeg tsis haus luam yeeb. Yog li, nws raug pom zoo kom cov neeg mob CKD txiav luam yeeb kom txo qis albuminuria thiab ncua kev kis kab mob.
Cistanche kho mob raum li cas?
Cistancheyog ib hom tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho ntau yam mob, suav nrog kab mob raum. Nws yog muab los ntawm qhuav stems ntawmCistanchedeserticola, ib tsob nroj nyob rau hauv cov suab puam ntawm Tuam Tshoj thiab Mongolia. Lub ntsiab active Cheebtsam ntawm cistanche yogphenylethanoidglycosides, echinacoside cov tshuaj, thiabacteoside, uas tau pom tias muaj txiaj ntsig zoo rauraumnoj qab haus huv.
Kab mob raum, tseem hu ua kab mob raum, hais txog ib yam mob uas lub raum ua haujlwm tsis zoo. Qhov no tuaj yeem ua rau muaj cov khoom pov tseg thiab cov co toxins hauv lub cev, ua rau muaj ntau yam tsos mob thiab teeb meem. Cistanche tuaj yeem pab kho mob raum ase los ntawm ntau lub tshuab.
Ua ntej, cistanche tau pom tias muaj cov nyhuv diuretic, txhais tau tias nws tuaj yeem ua rau cov zis ntau ntxiv thiab pab tshem tawm cov khoom pov tseg ntawm lub cev. Qhov no tuaj yeem pab txo lub nra ntawm lub raum thiab tiv thaiv kev tsim cov co toxins. Los ntawm kev txhawb nqa diuresis, cistanche kuj tseem tuaj yeem pab txo qis ntshav siab, ib qho teeb meem ntawm cov kab mob raum.
Ntxiv mus, cistanche tau pom tias muaj cov teebmeem antioxidant. Kev ntxhov siab oxidative, tshwm sim los ntawm qhov tsis sib xws ntawm kev tsim cov dawb radicals thiab lub cev tiv thaiv antioxidant, ua lub luag haujlwm tseem ceeb hauv kev mob raum. ies pab neutralize dawb radicals thiab txo Oxidative kev nyuaj siab, yog li tiv thaiv lub raum los ntawm kev puas tsuaj. Cov phenylethanoid glycosides pom hauv cistanche tau tshwj xeeb hauv kev tshem tawm cov dawb radicals thiab inhibiting lipid peroxidation.
Tsis tas li ntawd, cistanche tau pom tias muaj cov nyhuv anti-inflammatory. Kev mob yog lwm yam tseem ceeb hauv kev loj hlob thiab kev loj hlob ntawm cov kab mob raum. Cistanche's anti-inflammatory zog pab txo cov zus tau tej cov pro-inflammatory cytokines thiab inhibit qhov ua kom o yuav tsum tau txoj kev, yog li alleviating o nyob rau hauv lub raum.
Tsis tas li ntawd, cistanche tau pom tias muaj cov teebmeem immunomodulatory. Hauv kab mob raum, lub cev tiv thaiv kab mob tuaj yeem ua rau tsis zoo, ua rau muaj kev mob ntau dhau thiab cov ntaub so ntswg puas. Cistanche pab tswj lub cev tiv thaiv kab mob los ntawm kev hloov kho kev tsim khoom thiab kev ua haujlwm ntawm lub cev tiv thaiv kab mob, xws li T hlwb thiab macrophages. Txoj cai tiv thaiv kab mob no pab txo qhov mob thiab tiv thaiv kev puas tsuaj ntxiv rau lub raum.
Ntxiv mus, cistanche tau pom los txhim kho lub raum kev ua haujlwm los ntawm kev txhawb nqa kev tsim kho ntawm lub raum hlab nrog cov hlwb. Lub raum tubular epithelial hlwb ua lub luag haujlwm tseem ceeb hauv kev pom thiab rov nqus cov khoom pov tseg thiab electrolytes. Hauv kab mob raum, cov hlwb no tuaj yeem raug puas tsuaj, ua rau lub raum ua haujlwm puas. Cistanche lub peev xwm los txhawb kev tsim kho ntawm cov hlwb no pab kho lub raum kom zoo thiab txhim kho lub raum tag nrho.
Ntxiv nrog rau cov kev cuam tshuam ncaj qha rau lub raum, cistanche tau pom tias muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev hauv lub cev. Txoj hauv kev zoo rau kev noj qab haus huv no tseem ceeb tshwj xeeb hauv cov kab mob raum, vim tias tus mob feem ntau cuam tshuam rau ntau lub cev thiab lub cev. che tau pom tias muaj kev tiv thaiv rau lub siab, lub plawv, thiab cov hlab ntsha, uas feem ntau cuam tshuam los ntawm kab mob raum. Los ntawm kev txhawb nqa kev noj qab haus huv ntawm cov kabmob no, cistanche pab txhim kho lub raum tag nrho thiab tiv thaiv kev mob ntxiv.
Hauv kev xaus, cistanche yog cov tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho mob raum. Nws cov active Cheebtsam muaj diuretic, antioxidant, anti-inflammatory, immunomodulatory, thiab regenerative teebmeem, uas pab txhim kho lub raum ua haujlwm thiab tiv thaiv ob lub raum los ntawm kev puas tsuaj ntxiv. , cistanche muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev, ua rau nws txoj hauv kev zoo rau kev kho mob raum.
