The 2024 Edition Of Chinese Consensus On Clinical Management Of Diabetes And Chronic Kidney Disease Was Released! Check Out The 5 Key Points Of Lifestyle Management
Jul 05, 2024
According to clinical diagnostic criteria, when a diabetic patient has at least two urine albumin/creatinine ratio (UACR) tests exceeding 30 mg/g within three to six months, or the estimated glomerular filtration rate (eGFR) is continuously below 60 mL/min/1.73m^2 for more than three months, and after excluding other possible interfering factors such as infection, he or she can be diagnosed with diabetes and CKD.
Comprehensive management is emphasized for patients with diabetes and CKD, among which lifestyle management is a crucial cornerstone.
Click to Cistanche for kidney disease
So, what aspects should be taken into consideration for lifestyle management?
On June 25, 2024, the "Chinese Consensus on Clinical Management of Diabetes and Chronic Kidney Disease" written by experts from the Endocrinology Branch of the Chinese Medical Association and the Chinese Endocrine and Metabolic Disease Specialty Alliance was published in the "Chinese Journal of Endocrinology and Metabolism". This consensus provides comprehensive guidance and suggestions for the lifestyle management of patients with diabetes and CKD.
➤ It is recommended to develop an individualized nutrition plan for patients with diabetes and CKD, with a total daily energy intake of 30 to 35 kcal/kg.
➤ It is recommended that non-dialysis patients should take 0.8 g/kg/d of protein for the G1-G2 stage 0.6-0.8 g/kg/d for the G3-G5 stage, and 1.0-1.2 g/kg/d for dialysis patients.
➤ It is recommended that daily sodium intake be 1.2-2.0 g (3.0-5.0 g of salt). Patients at risk of hyperkalemia should strictly limit dietary potassium intake.
➤ It is recommended that patients with diabetes and CKD exercise regularly and control their weight.
➤ It is recommended that patients with diabetes and CKD quit smoking and limit alcohol.
1. Daily calorie intake - 30-35 kcal/kg is recommended
Diabetes and CKD are prone to malnutrition. Nutritional assessment should be conducted for all patients with diabetes and CKD, and individualized nutrition plans should be formulated. It is recommended that the total daily energy intake be 30-35 kcal/kg, which can be adjusted individually according to age, weight, specific activity intensity, and time.
2. Daily protein intake - individualized recommendation, appropriate relaxation for dialysis patients
Restricting protein intake can reduce proteinuria in patients with diabetes and CKD and improve renal function, but too low intake (<0.8 g/kg/d) is associated with an increased risk of death. Recommended protein intake:
➤0.8 g/kg/d for non-dialysis patients in G1-G2 stages;
➤0.6-0.8 g/kg/d for non-dialysis patients in G3-G5 stages, and supplementation of compound α-keto acid preparations at 0.12 g/kg/d can be considered;
➤The protein intake of dialysis patients can be relaxed to 1.0-1.2 g/kg/d (because protein energy consumption is more likely to occur).
3. Daily sodium salt intake - 3-5 g is appropriate
The recommended daily sodium intake is 1.2-2.0 g (3.0-5.0 g salt), and those at risk of hyperkalemia should strictly limit their dietary potassium intake. At the same time, the patient's electrolyte level should be monitored regularly.
4. Regular exercise and weight control - aiming for a BMI of 23kg/m^2
Patients with diabetes and CKD should exercise at least 150 minutes per week (e.g. 5 times a week, 30 minutes each time) in a way that matches their cardiopulmonary function, and adjust according to their own situation; it is also recommended to keep the body mass index below 23 kg/m^2.
5. Quit smoking and limit alcohol consumption - delay the progression of kidney disease
Quitting smoking can significantly reduce the eGFR and urinary albumin levels in patients with type 2 diabetes and delay the progression of kidney disease.
At present, there is still controversy over whether to drink alcohol and the amount of alcohol consumed daily. Adult patients who are accustomed to drinking alcohol should strictly limit their alcohol intake to no more than 15 g of alcohol (1 alcohol unit) per day.
How Does Cistanche Treat Kidney Disease?
Cistanche is a traditional Chinese herbal medicine used for centuries to treat various health conditions, including kidney disease. It is derived from the dried stems of Cistanche deserticola, a plant native to the deserts of China and Mongolia. The main active components of cistanche are phenylethanoid glycosides, echinacoside, and acteoside, which have been found to have beneficial effects on kidney health.
Kidney disease, also known as renal disease, refers to a condition in which the kidneys are not functioning properly. This can result in a buildup of waste products and toxins in the body, leading to various symptoms and complications. Cistanche may help treat kidney disease ase through several mechanisms.
Firstly, cistanche has been found to have diuretic properties, meaning it can increase urine production and help eliminate waste products from the body. This can help relieve the burden on the kidneys and prevent the buildup of toxins. By promoting diuresis, cistanche may also help Reduce high blood pressure, a common complication of kidney disease.
Moreover, cistanche has been shown to have antioxidant effects. Oxidative stress, caused by an imbalance between the production of free radicals and the body's antioxidant defenses, plays a key role in the progression of kidney disease. ies help neutralize free radicals and reduce Oxidative stress, thereby protecting the kidneys from damage. The phenylethanoid glycosides found in cistanche have been particularly effective in scavenging free radicals and inhibiting lipid peroxidation.
Additionally, cistanche has been found to have anti-inflammatory effects. Inflammation is another key factor in the development and progression of kidney disease. Cistanche's anti-inflammatory properties help reduce the production of pro-inflammatory cytokines and inhibit the activation of inflammation mandatory pathways, thus alleviating inflammation in the kidneys.
Furthermore, cistanche has been shown to have immunomodulatory effects. In kidney disease, the immune system can be dysregulated, leading to excessive inflammation and tissue damage. Cistanche helps regulate the immune response by modulating the production and activity of immune cells, such as T cells and macrophages. This immune regulation helps reduce inflammation and prevent further damage to the kidneys.
Moreover, cistanche has been found to improve renal function by promoting the regeneration of renal tubes with cells. Renal tubular epithelial cells play a crucial role in the filtration and reabsorption of waste products and electrolytes. In kidney disease, these cells can be damaged, leading to damaged renal function. Cistanche's ability to promote the regeneration of these cells helps restore proper renal function and improve overall kidney health.
In addition to these direct effects on the kidneys, cistanche has been found to have beneficial effects on other organs and systems in the body. This holistic approach to health is particularly important in kidney disease, as the condition often affects multiple organs and systems. che has been shown to have protective effects on the liver, heart, and blood vessels, which are commonly affected by kidney disease. By promoting the health of these organs, cistanche helps improve overall kidney function and prevent further complications.
In conclusion, cistanche is a traditional Chinese herbal medicine used for centuries to treat kidney disease. Its active components have diuretic, antioxidant, anti-inflammatory, immunomodulatory, and regenerative effects, which help improve renal function and protect the kidneys from further damage. , cistanche has beneficial effects on other organs and systems, making it a holistic approach to treating kidney disease.
