Лечебное питание при хронической болезни почек: смещение приоритетов в сторону растительной диеты

В последние годы появляется все больше данных о пользе растительной диеты для профилактики и лечения большинства соматических заболеваний, в том числе и хронической болезни почек (ХБП). Улучшение питательных свойств употребляемых пациентами продуктов за счет увеличения доли растительных ингредиентов при одновременном снижении общего количества потребляемых белков животного происхождения может снизить потребность в нефропротекторных препаратах, уменьшить осложнения при почечных заболеваниях и, возможно, благоприятно повлиять на прогрессирование заболевания и выживаемость пациентов. В этой статье мы анализируем имеющиеся в мировой литературе данные о диете с преобладанием растительных продуктов, которая положительно влияет н предупреждение почечной патологии, частоту возникновения и прогрессирования ХБП, метаболический ацидоз, гиперфосфатемию, артериальную гипертензию, уремическую токсичность, потребность в заместительной почечной терапии и качество жизни. Также уделено внимание проблемам гиперкалиемии и дефицита витамина В12, которые часто связаны с растительным питанием, но при правильной организации процесса с участием врача-диетолога эти риски могут быть значительно минимизированы. Поэтому при учете соотношения риска и пользы парадигма лечебного питания при ХБП уверенно смещается в сторону более широкого применения растительных продуктов.

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