OSOBITOSTI PREHRANE BOLESNIKA S KRONIČNOM BUBREŽNOM BOLESTI

Zbog sve većeg broja, bubrežne bolesti su postale značajan javno zdravstveni problem. Slabljenjem funkcije bubrega potrebno je postupno uvoditi promjene u prehrani. Cilj rada je istražiti odgovarajući pristup u prehrani bolesnika oboljelih od kronične bubrežne bolesti (KBB) unutar zadnjih 10 godina koji bi mogao pridonijeti usporenju progresije bolesti. Preporuke prehrane su individualne za svakog bolesnika, a razlikuju se i u istog bolesnika ovisno o fazi bubrežne bolesti. Posebnu pozornost treba obratiti pravilnom unosu makronutrijenata (proteina, ugljikohidrata i masnoća), mikronutrijenata (natrija, kalija, kalcija, fosfora, cinka, selena, različitih vitamina), te vode. U novootkrivenih bolesnika neophodno je učiniti procjenu statusa uhranjenosti i energetskih potreba. Proteinsko energetska pothranjenost, gubitak muskulature i kaheksija snažni su prediktori mortaliteta u kroničnoj bubrežnoj bolesti. Usporedbom različitih prehrambenih pristupa u svakodnevnom životu oboljelog od KBB najučinkovitijim se pokazao mediteranski način prehrane, koji ima važan preventivni utjecaj na bubrežnu funkciju i smanjenje progresije same bolesti. Zaključujemo da preventivnim mjerama, pravilnim prepoznavanjem i ranom intervencijom možemo povećati preživljavanje bolesnika i poboljšati kvalitetu života. Mediteranska prehrana prilagođena pojedinim fazama KBB potvrdila se kao najbolji izbor u pristupu oboljelom od KBB.
Because of the increasing number of patients, chronic kidney disease (CKD) has become a signifi cant public health problem. As kidney function decreases, it is necessary to introduce certain dietary modifi cations. The aim was to investigate what is the appropriate approach to diet of CKD patients, which could contribute to slowing down progression of the disease. Dietary recommendations are individual for each patient, but also vary in the same patient depending on the stage of disease progression because special attention must be paid to appropriate intake of macronutrients (protein, carbohydrates and fats), micronutrients (sodium, potassium, calcium, phosphorus, zinc, selenium, various vitamins), and water. In newly diagnosed patients, it is necessary to assess their nutritional status and energy requirements. It has been shown that protein-energy malnutrition, muscle loss and cachexia are strong predictors of mortality in CKD. Comparing different dietary approaches in everyday life of patients suffering from CKD, it was found that the most effective diet is Mediterranean food style. Studies confi rm that Mediterranean diet has a preventive effect on renal function and reduces progression of the disease. Preventive measures, correct identifi cation and early intervention can increase survival of patients and improve their quality of life. Mediterranean diet tailored to individual stages of CKD has been confi rmed as the best choice in CKD patients.