— 生理適應 · EASY · MCQ —
一位慢性腎臟病病人肌酸酐數值為 4.2 mg/dL，哪項飲食調整最恰當？
A client with chronic kidney disease (CKD) has a serum creatinine of 4.2 mg/dL. Which dietary modification is most appropriate?
- AIncrease protein intake to 1.5 g/kg/day增加蛋白質攝取至 1.5 g/kg/day
- BIncrease sodium intake to improve appetite增加鈉攝取以改善食慾
- CEncourage consumption of high-potassium fruits鼓勵食用高鉀水果
- DRestrict phosphorus intake✓ 正解限制磷攝取
— Explanation · 中文詳解 —
CKD 腎功能受損時，無法有效排泄磷酸鹽，導致高磷血症，因此限制磷攝取是延緩骨病變與繼發性副甲狀腺機能亢進的關鍵。高蛋白會增加腎臟負擔，高鈉會加重高血壓與水腫，高鉀在腎功能不全時可能引發致命性心律不整。
In chronic kidney disease (CKD), impaired renal function prevents effective excretion of phosphate, leading to hyperphosphatemia; therefore, restricting phosphorus intake is key to delaying renal bone disease and secondary hyperparathyroidism. High protein intake increases the renal workload, high sodium worsens hypertension and edema, and high potassium intake may precipitate lethal cardiac dysrhythmias in the setting of renal impairment.
✦ 台美臨床差異
台美對於 CKD 的營養衛教皆極為重視，台灣通常會會診專責腎臟營養師進行個別化菜單設計。