Seminars in nephrology最新文献_第8页

Management of Heart Failure With Reduced Ejection Fraction in Patients With Diabetes Mellitus and Chronic Kidney Disease 糖尿病和慢性肾脏病患者射血分数降低治疗心力衰竭。

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-05-01 DOI: 10.1016/j.semnephrol.2023.151429

Muhammad Shahzeb Khan MD, MSc , Ahmed Mustafa Rashid MBBS , Tariq Shafi MD, MHS , Joao Pedro Ferreira MD , Javed Butler MD, MPH, MBA

{"title":"Management of Heart Failure With Reduced Ejection Fraction in Patients With Diabetes Mellitus and Chronic Kidney Disease","authors":"Muhammad Shahzeb Khan MD, MSc , Ahmed Mustafa Rashid MBBS , Tariq Shafi MD, MHS , Joao Pedro Ferreira MD , Javed Butler MD, MPH, MBA","doi":"10.1016/j.semnephrol.2023.151429","DOIUrl":"10.1016/j.semnephrol.2023.151429","url":null,"abstract":"<div><p><span>Heart failure (HF), diabetes, and chronic kidney disease (CKD) frequently coexist, with one comorbidity worsening the prognosis of another. β-blockers, angiotensin-receptor–neprilysin inhibitors, renin-angiotensin-aldosterone system inhibitors, mineralocorticoid-receptor antagonists, and sodium-glucose cotransporter-2 inhibitors all have been shown to reduce mortality </span>in patients<span> with HF with reduced ejection fraction. However, their uptake in real-world clinical practice remains low, especially among patients who have multiple other comorbidities such as CKD and diabetes. The management of HF in patients with diabetes and CKD can be especially challenging because these patients typically are older, frail, and have multiple other comorbidities, and guideline-directed medical therapy used in HF potentially can affect renal function acutely and chronically. In this article, we discuss the available evidence for each of the foundational HF therapies in patients with diabetes and CKD, emphasizing the current challenges and outlining future directions to optimize the management of HF among these high-risk patients.</span></p></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49692288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Precision Medicine and/or Biomarker Based Therapy in T2DM: Ready for Prime Time? 精准医学和/或基于生物标志物的T2DM治疗：准备好进入黄金时段了吗？

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-05-01 DOI: 10.1016/j.semnephrol.2023.151430

Peter Rossing MD , Marie Frimodt-Møller MD , Frederik Persson MD

引用次数: 0

Is There a Need to “Modernize” and “Simplify” the Diagnostic Criteria of Protein-Energy Wasting? 是否需要“现代化”和“简化”蛋白质能量消耗的诊断标准？

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-03-01 DOI: 10.1016/j.semnephrol.2023.151403

Laetitia Koppe , Robert H. Mak

{"title":"Is There a Need to “Modernize” and “Simplify” the Diagnostic Criteria of Protein-Energy Wasting?","authors":"Laetitia Koppe , Robert H. Mak","doi":"10.1016/j.semnephrol.2023.151403","DOIUrl":"10.1016/j.semnephrol.2023.151403","url":null,"abstract":"<div><p><em>Protein energy wasting</em>(PEW) is a term that most nephrologists used to define nutritional disorders in patients with acute kidney injury and chronic kidney disease. Although this nomenclature is well implemented in the field of nephrology, the use of other terms such as <em>cachexia</em> or <em>malnutrition</em>in the majority of chronic diseases can induce confusion regarding the definition and interpretation of these terms. There is ample evidence in the literature that the pathways involved in cachexia/malnutrition and PEW are common. However, in kidney diseases, there are pathophysiological conditions such as accumulation of uremic toxins, and the use of dialysis, which may induce a phenotypic specificity justifying the original term PEW. In light of the latest epidemiologic studies, the criteria for PEW used in 2008 probably need to be updated. The objective of this review is to summarize the main mechanisms involved in cachexia/malnutrition and PEW. We discuss the need to modernize and simplify the current definition and diagnostic criteria of PEW. We consider the interest of proposing a specific nomenclature of PEW for children and elderly patients with kidney diseases.</p></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9940051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Organ Crosstalk Contributes to Muscle Wasting in Chronic Kidney Disease 器官串扰导致慢性肾脏疾病肌肉消耗

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-03-01 DOI: 10.1016/j.semnephrol.2023.151409

Xiaonan H. Wang MD , S. Russ Price PhD

引用次数: 1

Nutrition Education Models for Patients With Chronic Kidney Disease 慢性肾脏病患者的营养教育模式

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-03-01 DOI: 10.1016/j.semnephrol.2023.151404

Ban-Hock Khor PhD , Keiichi Sumida MD, MPH, PhD , Nicole Scholes-Robertson PhD , Maria Chan PhD , Kelly Lambert PhD , Holly Kramer MD, MPH , Siu-Fai Lui MD , Angela Yee-Moon Wang MD, PhD

{"title":"Nutrition Education Models for Patients With Chronic Kidney Disease","authors":"Ban-Hock Khor PhD , Keiichi Sumida MD, MPH, PhD , Nicole Scholes-Robertson PhD , Maria Chan PhD , Kelly Lambert PhD , Holly Kramer MD, MPH , Siu-Fai Lui MD , Angela Yee-Moon Wang MD, PhD","doi":"10.1016/j.semnephrol.2023.151404","DOIUrl":"10.1016/j.semnephrol.2023.151404","url":null,"abstract":"<div><p>Nutrition is an integral component in the management of chronic kidney disease (CKD), and kidney health professionals play a crucial role in educating patients on dietary interventions for CKD. Several dietary modifications are indicated for CKD that require frequent adaptations with CKD progression and with underlying metabolic disturbances. However, poor adherence to dietary interventions is not uncommon among patients with CKD. An effective education program on nutrition intervention consists of providing knowledge and developing skills that are necessary to support behavioral change. The application of theoretical models of behavioral change such as social cognitive theory and the transtheoretical model in nutrition intervention has been reported to be effective in promoting changes in dietary habits. This review summarizes the evidence supporting the application of theoretical models as strategies to enhance nutrition education for patients with CKD. In addition, digital technologies are gaining interest in empowering patients and facilitating nutrition management in patients with CKD. This review also examines the applications of the latest digital technologies guided by behavioral theory in facilitating patients’ changes in dietary intake patterns and lifestyle habits.</p></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10406285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The Role of Dietary Potassium in the Cardiovascular Protective Effects of Plant-Based Diets 膳食钾在植物性膳食心血管保护作用中的作用

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-03-01 DOI: 10.1016/j.semnephrol.2023.151406

Olgert Bardhi MD , Deborah J. Clegg PhD , Biff F. Palmer MD

{"title":"The Role of Dietary Potassium in the Cardiovascular Protective Effects of Plant-Based Diets","authors":"Olgert Bardhi MD , Deborah J. Clegg PhD , Biff F. Palmer MD","doi":"10.1016/j.semnephrol.2023.151406","DOIUrl":"10.1016/j.semnephrol.2023.151406","url":null,"abstract":"<div><p><strong><em>Summary:</em></strong> Dietary intervention is an essential factor in managing a multitude of chronic health conditions such as cardiovascular and chronic kidney disease. In recent decades, there has been a host of research suggesting the potential benefit of plant-based diets in mitigating the health outcomes of these conditions. Plant-based diets are rich in vegetables and fruits, while limiting processed food and animal protein sources. The underlying physiological mechanism involves the interaction of several macronutrients and micronutrients such as plant protein, carbohydrates, and dietary potassium. Specifically, plant-based foods rich in potassium provide cardiorenal protective effects to include urinary alkalization and increased sodium excretion. These diets induce adaptive physiologic responses that improve kidney and cardiovascular hemodynamics and improve overall metabolic health. A shift toward consuming plant-based diets even in subjects with cardiorenal decrements may reduce their morbidity and mortality. Nonetheless, randomized controlled trials are needed to confirm the clinical benefits of plant-based diets.</p></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9937386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Diet and Polycystic Kidney Disease: Nutrients, Foods, Dietary Patterns, and Implications for Practice 饮食与多囊肾病：营养、食物、饮食模式和实践意义

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-03-01 DOI: 10.1016/j.semnephrol.2023.151405

Kelly Lambert PhD, RD, Adv APD , Robert Gardos BSc (Appl) , Helen Coolican BA, Dip Ed MA , Lauren Pickel BSc (Biol) , Hoon-Ki Sung PhD , Angela Yee-Moon Wang MD, PhD , Albert CM Ong DM, MA, FRCP

引用次数: 1

Gut Microbiota-Targeted Interventions in the Management of Chronic Kidney Disease 肠道微生物群靶向干预治疗慢性肾脏疾病

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-03-01 DOI: 10.1016/j.semnephrol.2023.151408

Keiichi Sumida MD, MPH, PhD , Joseph F. Pierre PhD , Melana Yuzefpolskaya MD , Paolo C. Colombo MD , Ryan T. Demmer MPH, PhD , Csaba P. Kovesdy MD

{"title":"Gut Microbiota-Targeted Interventions in the Management of Chronic Kidney Disease","authors":"Keiichi Sumida MD, MPH, PhD , Joseph F. Pierre PhD , Melana Yuzefpolskaya MD , Paolo C. Colombo MD , Ryan T. Demmer MPH, PhD , Csaba P. Kovesdy MD","doi":"10.1016/j.semnephrol.2023.151408","DOIUrl":"10.1016/j.semnephrol.2023.151408","url":null,"abstract":"<div><p><strong><em>Summary:</em></strong> Recent advances in microbiome research have informed the potential role of the gut microbiota in the regulation of metabolic, cardiovascular, and renal systems, and, when altered, in the pathogenesis of various cardiometabolic disorders, including chronic kidney disease (CKD). The improved understanding of gut dysbiosis in cardiometabolic pathologies in turn has led to a vigorous quest for developing therapeutic strategies. These therapeutic strategies aim to investigate whether interventions targeting gut dysbiosis can shift the microbiota toward eubiosis and if these shifts, in turn, translate into improvements in (or prevention of) CKD and its related complications, such as premature cardiovascular disease. Existing evidence suggests that multiple interventions (eg, plant-based diets; prebiotic, probiotic, and synbiotic supplementation; constipation treatment; fecal microbiota transplantation; and intestinal dialysis) might result in favorable modulation of the gut microbiota in patients with CKD, and thereby potentially contribute to improving clinical outcomes in these patients. In this review, we summarize the current understanding of the characteristics and roles of the gut microbiota in CKD and discuss the potential of emerging gut microbiota–targeted interventions in the management of CKD.</p></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10123548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Diet and Metabolism in CKD-Related Metabolic Acidosis CKD相关代谢性酸中毒的饮食和代谢。

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-03-01 DOI: 10.1016/j.semnephrol.2023.151425

Anita Vincent-Johnson MD , Brenda Davy PhD, RDN , Julia J. Scialla MD, MHS

{"title":"Diet and Metabolism in CKD-Related Metabolic Acidosis","authors":"Anita Vincent-Johnson MD , Brenda Davy PhD, RDN , Julia J. Scialla MD, MHS","doi":"10.1016/j.semnephrol.2023.151425","DOIUrl":"10.1016/j.semnephrol.2023.151425","url":null,"abstract":"<div><p>Metabolic acidosis is a common complication in patients with chronic kidney disease that occurs when the daily nonvolatile acid load produced in metabolism cannot be excreted fully by the kidney. A reduction in urine net acid excretion coupled with a high nonvolatile acid load may play a role in its pathogenesis. Diet is important in generation of the nonvolatile acid load. Acids are produced from metabolism of dietary protein and from the endogenous production of organic anions from neutral precursors. Acids can be balanced by alkali precursors ingested in the diet in the form of combustible organic anions. These typically are reflected indirectly by the excess of mineral cations to mineral anions in a food or diet. These principles underscore widely used methods to estimate the nonvolatile acid load from dietary intake using formulas such as the net endogenous acid production equation and the potential renal acid load equation. Empiric data largely validate these paradigms with high net endogenous acid production and potential renal acid load contributed by foods such as protein, grains, and dairy, and low net endogenous acid production and potential renal acid load contributed by fruits and vegetables along with corresponding dietary patterns. Although further studies are needed to understand the health benefits of altering nonvolatile acid load via diet, this review provides a detailed assessment on our current understanding of the role of diet in chronic kidney disease–related acidosis, providing an updated resource for researchers and clinicians.</p></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0270929523001353/pdfft?md5=6c9f55d977ac23987a08aea39e573f5c&pid=1-s2.0-S0270929523001353-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66784282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Personalized Low-Protein Diet Prescription in CKD Population: Merging Evidence From Randomized Trials With Observational Data CKD人群的个性化低蛋白饮食处方：将随机试验的证据与观察数据相结合

IF 3.3 3区医学

Seminars in nephrology Pub Date : 2023-03-01 DOI: 10.1016/j.semnephrol.2023.151402

Massimo Torreggiani , Angela Yee-Moon Wang , Antioco Fois , Giorgina Barbara Piccoli

{"title":"Personalized Low-Protein Diet Prescription in CKD Population: Merging Evidence From Randomized Trials With Observational Data","authors":"Massimo Torreggiani , Angela Yee-Moon Wang , Antioco Fois , Giorgina Barbara Piccoli","doi":"10.1016/j.semnephrol.2023.151402","DOIUrl":"10.1016/j.semnephrol.2023.151402","url":null,"abstract":"<div><p>Nutritional therapy is a cornerstone of the clinical management of chronic kidney disease (CKD). Nevertheless, randomized controlled trials often have failed to show a relevant benefit of low-protein diets in nonselected CKD populations in terms of slowing the progression of kidney disease and need for dialysis. The more the target population is selected, the less the results can be generalizable to implement in clinical practice. On the contrary, observational studies, especially if performed with patient-centered, flexible approaches, point toward an extensive implementation of dietary protein restriction in different and unselected CKD populations. The observational evidence cannot be disregarded anymore. The most recent guidelines advise implementing low-protein diets or even very-low-protein diets in all CKD patients as early as stage 3. However, the lack of data from large randomized controlled trials on unselected CKD populations as well as on specific subpopulations, such as diabetic or obese patients, which nowadays comprise the majority of CKD subjects, reduces the generalizability of the recommendations. For some patient populations, such as those encompassing very old, nephrotic, or pregnant patients, the literature is even more limited because of the lower prevalence of these conditions and diffused prejudices against reducing protein intake. This pragmatic review discusses the need for integrating information derived from randomized trials with evidence derived from observational studies to guide feasible strategies for more successful implementation of low-protein diets in the treatment of all segments of the CKD population.</p></div>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9988122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2