已知，肥胖的个体因常伴有高血压、糖尿病等，故易患慢性肾病。因此，某些肥胖的个体一经确诊为慢性肾病，医生常常建议他或她采取相应的措施以减肥而有助于延缓慢性肾病的进展等。通常减肥套餐最主要的原则是“增加蛋白质的摄入和减少糖与脂肪的摄入”，并且非常有效，但考虑到慢性肾病的患者不宜进食过多的蛋白质（注：过多的摄入蛋白质可以恶化肾功能），故该膳食减肥的原则肯定不适合于慢性肾病之患者减肥。为此，美国克里夫兰诊疗中心（Cleveland Clinic）的专家建议“肥胖伴慢性肾病”的患者，拟采用“低蛋白、低热量＋适量运动”的方式以减轻自己的体重。

Dieting Can Prove Dangerous for Kidney Disease Patients

Certain weight-loss methods can lead to organ damage, study says

FRIDAY, Feb. 24 (HealthDay News) -- Overweight or obese people with chronic kidney disease may suffer further kidney damage if they use certain weight-loss methods, a new study warns.

Cleveland Clinic researchers analyzed the eating and lifestyle habits of nearly 11,000 overweight or obese adults who took part in the U.S. National Health and Nutrition Examination Survey.

Of those with chronic kidney disease, 50 percent said they had tried to lose weight in the past year, and 8 percent said they used medications as part of their weight-loss program. Some also used weight-loss methods that promoted high-protein diets that called for up to 1.9 grams per kilogram of body weight per day, considerably more than the amount recommended by the National Kidney Foundation.

Patients with chronic kidney disease are advised to consume 0.6 grams to 0.75 grams of protein per kilogram of body weight per day. The typical American adult consumes about 1.2 grams of protein per kilogram of body weight per day. (To convert body weight into kilograms, divide weight in pounds by 2.2.)

Weight-loss medications and high-protein diets are not recommended for people with chronic kidney disease because these methods may lead to further kidney damage, the researchers said in the study, published online recently in the International Journal of Obesity.

"People who are overweight or obese are at higher risk for chronic kidney disease, and there is a great need to define what the appropriate lifestyle changes and weight loss modalities are for protecting kidney function," lead author Dr. Sankar Navaneethan, a nephrologist in the Glickman Urological and Kidney Institute at Cleveland Clinic, said in a clinic news release.

"Rather than using fad diets or diet pills, overweight and obese people with kidney disease may adopt a weight loss plan that incorporates a low-protein, low-calorie diet, regular physical activity and close follow-up by their physicians," Navaneethan added.

The researchers called for further studies to identify safe weight-loss strategies for overweight or obese adults with chronic kidney disease, a condition in which kidney function progressively worsens.

More than 10 percent of adults 20 and older in the United States have chronic kidney disease, according to the U.S. Centers for Disease Control and Prevention.

SOURCE: Cleveland Clinic, news release, Feb. 21, 2012