| Abstract | Bubrezi su organi mokraćnog sustava sa važnom ulogom u glavnim životnim funkcijama. Oni
filtracijom krvi i stvaranjem mokraće imaju središnju ulogu u homeostazi. Osim održavanja
homeostatske ravnoteže, imaju i endokrinu funkciju koji očituju lučenjem hormona i
posljedičnom regulacijom krvnog tlaka i sastava krvi. Primarno mjesto u patologiji bubrežnih
bolesti zauzima akutno zatajenje bubrega i kronična bolest bubrega. Akutno zatajenje je bolest
koja nastaje naglo, te je potencijalno reverzibilne prirode. Kronična je bolest pak ireverzibilna,
te nastaje kroz dulji vremenski period. Istraživanja su pokazala, da neovisno o kojoj se bolesti
radi, osim medikamentozne terapije, za oporavak pacijenta ključna je i prehrambena potpora.
Kod akutne bolesti, primarna uloga prehrane je smanjenje negativne energetske ravnoteže i
kataboličkih procesa. Navedeno se javlja zbog gubitka energije i bjelančevina, pa se pažnja
posvećuje njihovom nadomještanju. Ostale preporuke odnose se na ograničen unos kalija i
fosfora kako bi se spriječila njihova akumulacija i posljedični neželjeni učinci. U teškim
stadijima bolesti, kod uremičnih pasa, često se javlja odbijanje hrane i nedovoljan unos energije.
Takvo stanje je indikacija za enteralno hranjenje putem hranidbenih sondi, a ukoliko je i ono
neuspješno, indicirana je parenteralna prehrana. Nadalje, kod kronične bolesti, prehrambena
potpora je usmjerena ka rješavanju etiopatogenetskih mehanizama. Ključno je povećanje unosa
vode i energije, zatim ograničenje unosa bjelančevina, te smanjenje količine fosfora i natrija u
hrani. Osim navedenog, u obrocima treba povećati količinu omega – 3 masnih kiselina i
antioksidansa, te oralnom suplementacijom nadomjestiti kalij. Kako kronična bolest ima četiri
poznata stadija, promjene u prehrani u II i III stadiju usmjerene su ka usporavanju napredovanja
bolesti, dok je u IV stadiju najvažnije ublažiti simptome uremije. Navedeno su općenite
preporuke, a plan prehrane treba prilagoditi individualnim potrebama oboljele životinje. Na
kraju, obje bolesti su dinamične, sa značajnim napredovanjem, pa se prvotno prepisana
prehrana, u određenim vremenskim razmacima, mora modificirati prema nalazima kliničkih i
laboratorijskih pretraga, a kao odgovor na promjene zdravstvenog stanja pacijenta. |
| Abstract (english) | The kidneys are organs of the urinary system that have an important role in the fundamental
life processes. They play a central role in homeostasis by filtering blood and creating urine. In
addition to maintaining homeostatic balance, they also have an endocrine function, consisting
of hormone secretion and the consequent regulation of blood pressure and blood composition.
In renal pathology, the two primary diseases include acute kidney disease and chronic kidney
disease. Acute failure is a disease that occurs suddenly and may be reversible. In contrast,
chronic disease develops over a long period of time and is irreversible. Research has shown
that, in addition to drug therapy, nutritional management is crucial for the patient's recovery,
regardless of the disease. In the case of acute disease, the primary role of nutrition is to reduce
negative energy balance and catabolic processes. This occurs due to a loss of energy and protein,
which then need to be compensated for. Moreover, it is recommended to limit potassium and
phosphorus intake in order to prevent their accumulation and subsequent unwanted effects.
Dogs with severe uremia often refuse food and do not have sufficient energy intake. Such a
condition is an indication of enteral nutrition through feeding tubes, and, if there are no
improvements, it is indicated to administer parenteral nutrition. Furthermore, in the case of
chronic disease, nutritional management is aimed at tackling etiopathogenetic mechanisms. It
is essential to increase water and energy intake as well as to limit protein intake and reduce the
amount of phosphorus and sodium in food. In addition, the amount of omega – 3 fatty acids and
antioxidants should be increased in meals, while potassium should be replaced by oral
supplementation. As the chronic disease has four known stages, dietary alterations in stages II
and III are aimed at halting the progression of the disease, while in stage IV the principal goal
is to alleviate the symptoms of uremia. These are only general recommendations, and the diet
plan should be adapted to the individual needs of the affected animal. After all, both diseases
are dynamic, with significant progression, thus the originally prescribed diet must be modified
at certain time intervals according to the findings of clinical and laboratory tests as a response
to changes in the patient's condition. |
