nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2025-29-3-8-30HDGDBYnefr-2450Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESЛечебное питание пожилых людей при заболеваниях почекTherapeutic nutrition of elderly people with kidney diseaseshttps://orcid.org/0000-0001-9134-931XБарановскийА. Ю.BaranovskyA. Yu.

Проф. Барановский Андрей Юрьевич, д-р мед. наук. Медицинский институт, кафедра гастроэнтерологии и диетологии, заведующий кафедрой

199106, Санкт-Петербург, 21-я линия В.О., д. 8а

Тел.: +7921937097

Prof. Andrey Yu. Baranovsky, MD, PhD, DMedSci. Medical Institute, Head of the Department of Gastroenterology and Dietetics

199106, St. Petersburg, 21st line V. O., 8a

Phone: +7921937097

baranovsky46@mail.ruhttps://orcid.org/0000-0002-1915-2237МазуренкоС. О.MazurenkoS. O.

Проф. Мазуренко Сергей Олегович, д-р мед. наук. Медицинский институт, кафедра пропедевтики внутренних болезней, заведующий кафедрой

199106, Санкт-Петербург, 21-я линия В.О., д. 8а

Тел.: +79117942845

Prof. Sergey O. Mazurenko, MD, PhD, DMedSci. Medical Institute, , Department of Propaedeutics of Internal Diseases, Head of the Department

199106, St. Petersburg, 21st line V. O., 8a

Tel.: +79117942845

dr_mazurenko@mail.ruСанкт-Петербургский государственный университетРоссияSt. Petersburg State UniversityRussian Federation202503092025293830Copyright © Барановский А.Ю., Мазуренко С.О., 20252025Барановский А.Ю., Мазуренко С.О.Baranovsky A.Y., Mazurenko S.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/2450

Заболевания почек относятся к распространенной категории патологии в пожилом и старческом возрасте, при которой диетотерапия занимает одно из центральных мест в комплексном лечении. Оценка нарушений обмена веществ в организме пожилых людей с заболеваниями мочевыделительной системы является важнейшим условием проведения диетотерапии. Она должна основываться на комплексном подходе, включающем антропометрические данные о пациенте, биохимическую информацию о состоянии водно-электролитного, белково-энергетического, жирового, углеводного, витаминно-минерального обмена. Задача осуществления нутритивной поддержки пожилых людей с различными нефрологическими патологиями включает в себя нозологически адекватное и персонализированное определение диетической стратегии при выборе питания пациента, диетических ритмов, диетических программ и рационов питания. В лекции представлены методы, рекомендованные российским и международным консенсусом для количественного составления рационов питания, учитывающие характер и тяжесть метаболических нарушений, а также патогенетические особенности имеющейся патологии почек и выраженность инволюционных процессов в организме пожилых людей. Представлены алгоритмы подбора индивидуально обоснованных диет при различных заболеваниях почек, их тяжести и формировании осложнений с учетом реализации различных программ терапии, включая варианты фармакотерапии и обоснованные виды диализа. Описаны возможности влияния определенных пищевых продуктов и их сочетаний на снижение интенсивности механизмов развития и прогрессирования почечной патологии. Геронтодиетологию в клинической нефрологии следует рассматривать как важнейшую составляющую комплексной программы лечения, индивидуализация которой должна основываться на тщательном изучении метаболических особенностей пациента, понимании патогенетических особенностей возникновения и хронизации патологии почек, понимании сути инволюционных процессов у наблюдаемого пациента и других факторов. используя обширные знания творческого и эрудированного врача, чтобы блокировать эти выявленные соматические особенности. индивидуальная диета.

Kidney diseases belong to a common category of pathology in the elderly and senile age, in which diet therapy occupies one of the central places in complex treatment. Assessment of metabolic disorders in the body of older people with diseases of the urinary system is the most important condition for diet therapy. It should be based on an integrated approach, including anthropometric data on the patient, biochemical information on the state of water-electrolyte, protein-energy, fat, carbohydrate, vitamin-mineral metabolism. The task of implementing nutritional support for the elderly with various nephrological pathologies includes a nosologically appropriate and personalized definition of dietary strategy in choosing patient nutrition, dietary rhythms, dietary programs and diets. The lecture presents methods recommended in Russian and international consensus for the quantitative formulation of diets that take into account the nature and severity of metabolic disorders and pathogenetic features of existing kidney pathology and the severity of involution processes in the body of the elderly and elderly. Algorithms for choosing individually justified diets for various kidney diseases, their severity, and the formation of complications are presented, taking into account the implementation of various therapy programs, including pharmacotherapy options and reasonable types of dialysis. The possibilities of the influence of certain foods and their combinations on reducing the intensity of the mechanisms of development and progression of renal pathology are described. Gerontodietology in clinical nephrology should be considered as the most important component of a comprehensive treatment program, the individualization of which should be based on a thorough study of the patient's metabolic features, understanding the pathogenetic features of the occurrence and chronization of kidney pathology, understanding the essence of involutional processes in the supervised patient and using the extensive knowledge of a creative and erudite doctor to block these identified somatic features. an individualized diet.

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The authors declare that there are no conflicts of interest present.