| Theme |
New Nutritional Assesment for Dialysis Patients |
| Title |
Diet therapy for patients with ADPKD |
| Author |
Yoshifumi Ubara |
Kidney Center, Toranomon Hospital |
| Author |
Tetsuo Tagami |
Kidney Center, Toranomon Hospital |
| Author |
Junichi Hoshino |
Kidney Center, Toranomon Hospital |
| Author |
Kenmei Takaichi |
Kidney Center, Toranomon Hospital |
| Author |
Tamio Yamaguchi |
Department of Nephrology, University of Kansas |
| [ Summary ] |
The kidneys of patients with autosomal dominant polycystic kidney disease (ADPKD) usually continue to increase in size even after patients begin dialysis, and this increased mass may lead to severe complications. On the basis of a questionnaire survey of 131 ADPKD patients, upper digestive tract symptoms such as heartburn, nausea and vomiting (71.4%),loss of appetite (69%) and early satiety (69.8%); intestinal symptoms such as severe constipation (55.5%) and odd bit-shaped feces(56.3%), along with nutritional problems such as thinness of legs and chest (69%) were shown. We attempted renal contraction therapy in ADPKD patients with renal transcatheter arterial embolization (TAE) using intravascular coils. Almost all patients experienced relief of symptoms. Appetite became good. Insulin-like growth factor-I (IGF-1), as an index of nutritional status, increased significantly. In serum albumin and total cholesterol levels, significant increases were observed. Nephromegaly was thought to be the cause of these symptoms. From these observations, most patients with ADPKD on dialysis should receive adequate diets to prevent malnutrition. On the other hand, with pre-dialysis patients, low protein diet therapy should be performed, based on careful nutritional monitoring. The restriction of salt should be under taken to prevent hypertension. The effects of soy protein diets and genistein were shown in mice and rats with polycystic kidney disease. Applications for human patients with ADPKD maybe expected. Attention should be payed to caffeine consumption by patients with ADPKD. |