spbmedicalrecordsНовые Санкт-Петербургские врачебные ведомостиNew St. Petersburg Medical Records1609-2201Первый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова10.24884/1609-2201-2024-103-3-11-24spbmedicalrecords-28Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSЛечебное питание при хронической болезни почек: смещение приоритетов в сторону растительной диетыTherapeutic nutrition in chronic kidney disease: prioritizing a plant-based diethttps://orcid.org/0000-0002-5616-3488КучерА. Г.KucherA. G.

Кучер Анатолий Григорьевич, доктор медицинских наук, профессор, профессор кафедры пропедевтики внутренних болезней с клиникой им. акад. М. Д. Тушинского

197022, Санкт-Петербург, улица Льва Толстого, д. 6-8

Anatoliy G. Kucher, Dr. of Sci. (Med.), Professor, Professor of the Department of Propaedeutics of Internal Diseases with clinic named after acad. M. D. Tushinksy

Saint-Petersburg

6–8, L’va Tolstogo str., Saint Petersburg, 197022

 

prof.kucher@yandex.ruПервый Санкт-Петербургский государственный медицинский университет им. акад. И. П. ПавловаРоссияPavlov UniversityRussian Federation202427012025031124Copyright © Кучер А.Г., 20252025Кучер А.Г.Kucher A.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.docved.ru/jour/article/view/28

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.

In recent years, there has been increasing evidence of the benefits of a plant-based diet for the prevention and treatment of most somatic diseases, including chronic kidney disease (CKD). Improving the nutritional properties of foods by increasing the proportion of plant ingredients while reducing the total amount of animal proteins can reduce the need for nephroprotective drugs, complications of renal diseases and may favorably affect disease progression and patient survival. In this article, we analyze the data available in the world literature on a diet with a predominance of plant products, which has a positive effect on the prevention of renal pathology, the incidence and CKD progression, metabolic acidosis, hyperphosphatemia, arterial hypertension, uremic toxicity, the need for renal replacement therapy and quality of life. Attention is also paid to hyperkalemia and vitamin B12 deficiency, which are often associated with plant-based nutrition, but with the participation of a nutritionist, these risks can be significantly minimized. Therefore, taking into account the risk-benefit ratio, the approach to therapeutic nutrition for CKD is confidently shifting to the plant-based diet.

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The authors declare that there are no conflicts of interest present.