Author: Leo
Keywords: nephritis
Chronic nephritis patients with hypoproteinemia, should be strictly concerned about the supply of protein in the diet to be appropriate. In ensuring the total daily calorie intake of patients (per kilogram of body weight 125.5 to 146.1 kJ, or 30 to 35 kcal) under the premise of attention to the amount and quality of dietary protein. Because the high protein diet will make renal blood flow and glomerular filtration rate increased, so that glomerular capillaries in a state of high pressure, while a large number of protein intake also increased urinary protein, can accelerate the glomerular sclerosis.
Chronic nephritis patients can be seen in the symptoms of hypoproteinemia, straightforward is that in the late stage of chronic nephritis, due to a large number of patients in the body lost from the urine, into the body and liver synthesis of protein is not enough to compensate for its loss, will lead to blood Protein is reduced to form hypoproteinemia. The reason for the emergence of urinary protein is due to kidney filtration barrier damage, mainly damage the charge barrier leading to renal filtration dysfunction, causing protein leakage.
Because the loss of protein in urine is mainly albumin, it is mainly characterized by lower albumin, that is, low albuminemia, serum albumin levels below 30 grams per liter. But the two are not completely parallel, because the plasma albumin value is the result of albumin synthesis and catabolic balance.
Patients with chronic nephritis due to the loss of a large number of proteins lead to hypoproteinemia, while sustained protein leakage will increase the glomerular and renal tubular damage.
Hypoglycemia influencing factors
① renal tubular decomposition of albumin capacity increased. Normal liver synthesis of albumin 10% in the renal tubular metabolism, in chronic nephritis nephrotic syndrome, due to proximal tubule uptake and decomposition of filtration protein increased significantly, renal metabolism can be increased to 16% to 30%;
② severe edema, gastrointestinal absorption capacity decreased, chronic nephritis patients often negative nitrogen balance;
③ age, duration, chronic liver disease, malnutrition can affect plasma albumin levels;
④ intake of high protein protein in patients with chronic nephritis and nephrotic syndrome can lead to increased proteinuria, and plasma albumin did not increase or increase, but rarely, and in severe malnutrition, if the same time taking angiotensin converting enzyme inhibitors Reduce the glomerular hyperfiltration), the high protein diet can increase the plasma albumin concentration. If the limit of protein intake, the urine protein will be reduced, and plasma albumin levels have not changed or even though little.
Chronic nephritis patients with hypoproteinemia, should be strictly concerned about the supply of protein in the diet to be appropriate. In ensuring the total daily calorie intake of patients (per kilogram of body weight 125.5 to 146.1 kJ, or 30 to 35 kcal) under the premise of attention to the amount and quality of dietary protein. Because the high protein diet will make renal blood flow and glomerular filtration rate increased, so that glomerular capillaries in a state of high pressure, while a large number of protein intake also increased urinary protein, can accelerate the glomerular sclerosis.
Currently advocates daily protein intake to 0.8 to 1.0 g / kg is appropriate. In addition, patients with hypoproteinemia due to the body of metal-binding proteins and endocrine binding protein with the loss of urine, resulting in the body iron, zinc, copper trace elements and vitamin D deficiency, which should also be treated by diet and drug supplement, which took 25 - hydroxyaprostyl alcohol treatment of active vitamin D deficiency and hypocalcemia is better. Patients with hypoproteinemia should control salt intake, so as to avoid excessive accumulation of sodium in the body, increased edema. Can be used water salt (daily salt content of not more than 2 to 3 grams) or salt-free diet.
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