特集名 | 小児期の腎不全対策 | |
---|---|---|
題名 | 腎不全進行遅延の試み -- 食事療法,ACEI, 吸着剤 | |
発刊年月 | 1999年 04月 | |
著者 | 吉田 義幸 | 吉田こどもクリニック |
【 要旨 】 | 慢性腎不全進行遅延の試みとして,糸球体高血圧,糸球体肥大,上皮細胞障害,メサンギウム基質の増加,尿毒症物質等の糸球体硬化進展因子の抑制が期待される治療が行われている.高血圧の治療となる塩分制限に加えて,低たんぱく食療法は慢性腎不全の治療の基礎となるが,エネルギー不足とならぬようにコンプライアンスが保てるような工夫が必要である.アンギオテンシン変換酵素阻害剤は,高血圧の患児や糸球体肥大を認める巣状糸球体硬化症(FGS)の患児には積極的に使用するが,腎機能に注意する.また,尿毒症物質を吸着する経口吸着剤は,低たんぱく食療法に加えて,慢性腎不全早期から使用することによりその進行遅延が期待される. |
Theme | Strategy for the Treatment of Chronic Renal Failure in Children | |
---|---|---|
Title | Trial for the delay of the progression in chronic renal failure -- Diet therapy, ACEI and renal adsorbent | |
Author | Yoshiyuki Yoshida | Yoshida Children's Clinic |
[ Summary ] | As a test of the ability to delay the of progression of chronic renal failure (CRF), we have been performing therapy to promote the inhibition of some factors in the progression of glomerular sclerosis. These factors are glomerular hypertension, glomerular hypertrophy, epithelial damage, increase in the mesangial matrix and uremic toxins. In addition to the limitation of NaCl, related to hypertension, low protein diet therapy is one of the most important treatments for CRF. It is necessary to maintain compliance in order to preserve adequate patient energy levels. Angiotensin II converting enzyme inhibitor is useful for the patients with CRF and hypertension, and patients with FGS with glomerular hypertrophy. Careful observation of renal function is important. In addition to low protein diet therapy, oral adsorbents for uremic toxins are required produce inhibitory effects in the progression of CRF, even in its early stages. |