Nutrition treatment and health management practice of low protein diet in patients with chronic kidney disease
慢性肾病患者低蛋白饮食的营养治疗与卫生管理实践

摘要

目的 探讨低蛋白饮食联合规范化卫生管理在社区慢性肾病（CKD）患者中的应用效果。方法 采用整群抽样法选取2024年1月—2024年5月我辖区内建档管理的CKD患者100例。依据CKD分期分为1-2期组（n=43）、3期组（n=34）、4-5期组（n=23）。所有患者均实施基于低蛋白饮食营养治疗与“筛查-干预-监测-教育”一体化卫生管理，干预周期6个月。比较干预前后各组营养指标、肾功能指标及饮食依从性、营养不良发生率差异。结果 干预6个月后，三组患者血清白蛋白、前白蛋白、血红蛋白均显著升高，且1-2期组优于3期组及4-5期组；血肌酐、尿素氮降低，eGFR下降减缓。整体饮食总依从率较高，1-2期组依从性最优，营养不良发生率较干预前显著降低。结论 基于指南的低蛋白饮食营养治疗结合疾控主导的规范化卫生管理，可有效改善社区CKD患者营养状况，延缓肾功能进展。

Abstract

Objective To explore the effect of low-protein diet combined with standardized health management in community patients with chronic kidney disease (CKD).
Methods A total of 100 patients with CKD who were on file management in our hospital from January 2024 to May 2024 were selected from cluster sampling method. According to the CKD stage, the rats were divided into stage 1–2 groups (n=43), stage 3 group (n=34), and stage 4–5 group (n=23). All patients were treated with nutrition therapy based on low-protein diet and integrated health management of "screening-intervention-monitoring-education". The intervention cycle was six months. The differences in nutritional indicators, renal function indicators, dietary compliance, and the incidence of malnutrition before and after intervention were compared among different groups.
Results After six months of intervention, serum albumin, prealbumin and hemoglobin were significantly increased in the three groups, and the effects in the stage 1–2 groups were better than those in the stage 3 and stage 4–5 groups. Serum creatinine and urea nitrogen decreased, and eGFR decreased slowly. The overall compliance rate of diet was higher, and the compliance in Phase 1-2 groups was the best. The incidence of malnutrition was significantly lower than that before intervention.
Conclusion   The low-protein diet nutritional therapy based on the guidelines combined with standardized health management led by disease control and prevention can effectively improve the nutritional status of CKD patients in the community and delay the progression of renal function.