Lifestyle Modifications and Nutritional and Therapeutic Interventions in Delaying the Progression of Chronic Kidney Disease: A Review

被引：18

作者：

Alkhatib, Lean ^{[1
]}

Diaz, Lorena A. Velez ^{[2
]}

Varma, Samyukta ^{[3
]}

Chowdhary, Arsh ^{[4
]}

Bapat, Prachi ^{[5
]}

Pan, Hai ^{[6
]}

Kukreja, Geetika ^{[7
]}

Palabindela, Prasannalaxmi ^{[8
]}

Selvam, Sri Abirami ^{[9
]}

Kalra, Kartik ^{[10
]}

机构：

[1] Royal Med Serv, Internal Med, Amman, Jordan

[2] Univ Guayaquil, Med, Guayaquil, Ecuador

[3] Madurai Med Coll, Internal Med, Madurai, India

[4] Smt Kashibai Navale Med Coll & Gen Hosp, Nephrol, Pune, India

[5] Smt Kashibai Navale Med Coll & Gen Hosp, Gen Med, Pune, India

[6] Tianjin Univ Chinese Med, Pathol, Tianjin, Peoples R China

[7] Henry Ford Hlth Syst, Internal Med & Hematol Oncol, Clinton Township, MI USA

[8] Jennie Stuart Hlth, Internal Med, Hopkinsville, KY USA

[9] St Mary Hosp, Internal Med, Langhorne, PA USA

[10] Geisinger Med Ctr, Nephrol, Danville, VA USA

来源：

CUREUS JOURNAL OF MEDICAL SCIENCE | 2023年 / 15卷 / 02期

关键词：

treatment options for diabetic nephropathy; diabetic kidney disease (dkd); chronic kidney disease (ckd); ckd progression; ckd management; CARDIOVASCULAR RISK; SGLT2; INHIBITORS; HYPERTENSION; ASSOCIATION; FINERENONE; MANAGEMENT; OUTCOMES;

D O I：

10.7759/cureus.34572

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Chronic kidney disease (CKD) is a debilitating progressive illness that affects more than 10% of the world's population. In this literature review, we discussed the roles of nutritional interventions, lifestyle modifications, hypertension (HTN) and diabetes mellitus (DM) control, and medications in delaying the progression of CKD. Walking, weight loss, low-protein diet (LPD), adherence to the alternate Mediterranean (aMed) diet, and Alternative Healthy Eating Index (AHEI)-2010 slow the progression of CKD. However, smoking and binge alcohol drinking increase the risk of CKD progression. In addition, hyperglycemia, altered lipid metabolism, low-grade inflammation, over-activation of the renin-angiotensin-aldosterone system (RAAS), and overhydration (OH) increase diabetic CKD progression. The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend blood pressure (BP) control of <140/90 mmHg in patients without albuminuria and <130/80 mmHg in patients with albuminuria to prevent CKD progression. Medical therapies aim to target epigenetic alterations, fibrosis, and inflammation. Currently, RAAS blockade, sodium-glucose cotransporter-2 (SGLT2) inhibitors, pentoxifylline, and finerenone are approved for managing CKD. In addition, according to the completed Study of Diabetic Nephropathy with Atrasentan (SONAR), atrasentan, an endothelin receptor antagonist (ERA), decreased the risk of renal events in diabetic CKD patients. However, ongoing trials are studying the role of other agents in slowing the progression of CKD.

引用

页数：10