Zusammenfassung
Eine chronische Niereninsuffizienz ist auch schon bei milder Ausprägung mit einer
deutlichen Steigerung von Morbidität und Mortalität assoziiert. Leider ist eine kausale
Therapie einer chronischen Niereninsuffizienz nicht immer möglich. In diesen Fällen
tritt die so genannten »supportive Therapie« in den Vordergrund. Eine besondere Bedeutung
hat dabei die antihypertensive und antiproteinurische Therapie. Insbesondere Medikamente
mit einer hemmenden Wirkung auf das Renin-Angiotensin-System haben nephroprotektive
und antiproteinurische Wirkungen. Einen wichtigen Baustein der »supportiven Therapie«
stellen auch diätetische Maßnahmen dar (Restriktion der Phosphat-, Kochsalz- und Proteinzufuhr
u.a.).
Summary
Chronic renal failure: Therapeutic principles to retard progression with special regard
to dietetic measures
Even mild chronic kidney failure is associated with a significant increase in morbidity
and mortality. Unfortunately, a causal therapy is not always available and the so-called
supportive therapy comes into the focus of interest. Antihypertensive and antiproteinuric
treatment strategies are of outstanding importance. Medical treatment should especially
aim at a blockade of the renin-angiotensin system to achieve renoprotective and antiproteinuric
effects. Among others dietary salt, phosphate, and protein restriction are important
elements of supportive renal therapy.
Schlüsselwörter
Arterielle Hypertonie - Diabetes mellitus - supportive Therapie - Nierenversagen -
Progression
Key words
Arterial hypertension - Diabetes mellitus - renal failure - progression - nutrition
- review
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Prof. Dr. med. Jürgen Floege
Medizinische Klinik II, Universitätsklinikum der RWTH Aachen
Pauwelsstraße 30
52074 Aachen
Email: Vincent.Brandenburg@post.rwth-aachen.de
Nach einem Vortrag anlässlich der 12. Aachener Diätetik Fortbildung (2004).
Das Literaturverzeichnis ist in der online-Ausgabe der Zeitschrift unter www.thieme-onnect.de
enthalten. Es wird auf Anfrage auch gern vom Autor und vom Verlag zugeschickt.