Journal of Renal Nutrition最新文献

{"title":"Urine Albumin-creatinine Ratio Accurately Reflects Daily Albuminuria in Nonobese Patients but Requires Body Weight Correction in Obese.","authors":"Liang-Chun Chen, Zih-Kai Kao, Chih-Yu Yang, Der-Cherng Tarng","doi":"10.1053/j.jrn.2025.05.004","DOIUrl":"10.1053/j.jrn.2025.05.004","url":null,"abstract":"<p><strong>Objective: </strong>Urine albumin-creatinine ratio (UACR) is widely used to estimate daily albuminuria. Despite efforts to improve the accuracy of the estimated albumin excretion rate, the individual contributions of age, sex, and body weight remain unexplored.</p><p><strong>Methods: </strong>This hospital-based cohort study examined the explanatory power of various factors and compared total R² values across different sets of factors to determine the optimal estimated albumin excretion rate model.</p><p><strong>Results: </strong>An analysis of 304 24-hour urine samples revealed a median value of 0.538 g (interquartile range: 0.091-2.080 g), identifying UACR and body weight as significant factors with high partial R² values in estimating daily albuminuria. A novel model using only UACR and body weight demonstrated performance comparable to previous models that included additional variables (total R² values: ours 0.922 vs. 0.923, P = .893; ours 0.922 vs. 0.925, P = .727), and outperformed the model that excluded body weight (total R² values: ours 0.922 vs. 0.855, P < .001). Receiver operating characteristic analysis identified 78.1 kg (body mass index [BMI] of 28.5 kg/m²) as the optimal cutoff for predicting underestimation of daily albuminuria by UACR in the heavier half of our patient cohort (area under the curve: 0.865). For individuals with body weight less than 78.1 kg (0th-75.4th percentile), daily albuminuria (g) could be estimated as: 0.033 + 0.999 × UACR (mg/mg) (total R²: 0.966). Conversely, for those weighing ≥78.1 kg (75.5th-100th percentile), the estimation formula was as follows: -3.885 + 1.538 × UACR (mg/mg) + 0.045 × body weight (kg) (total R²: 0.942).</p><p><strong>Conclusions: </strong>For individuals with a BMI below 28.5 kg/m², the UACR alone provides sufficient accuracy for estimating daily albuminuria (using the formula: daily albuminuria (g) = 0.033 + 0.999 × UACR (mg/mg)). However, for those with a BMI of 28.5 kg/m² or higher, adding body weight as a single correction factor to UACR sufficiently improves the explanatory power, simplifying clinical practice by eliminating the need for age and sex as additional factors.</p>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081798","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}

{"title":"Perceptions of Food and Nutrition Security Among Adults With chronic kidney disease, Nondialysis: A Mixed Method Study.","authors":"Jeanette M Andrade, Katherine Mullis, Pablo Lamino","doi":"10.1053/j.jrn.2025.05.003","DOIUrl":"10.1053/j.jrn.2025.05.003","url":null,"abstract":"<p><strong>Objective: </strong>Food and nutrition insecurity may contribute to the progression of chronic kidney disease (CKD). Current metrics to measure food and nutrition security (FANS) status may not capture the nuances associated with these concepts. The purpose of this mixed method study was to examine perceptions of FANS of adults with CKD, nondialysis.</p><p><strong>Methods: </strong>A sequential explanatory mixed-method study was conducted from March to August 2024. Participants (n = 60) completed a survey that focused on the dimensions of FANS and diet quality. A sub-section of participants (n = 23) completed an interview that explored FANS. Frequencies and descriptives were analyzed using Statistical Package for Social Science (v28). Interviews were transcribed, and deductive and inductive coding was used to determine themes using NVivo (v14).</p><p><strong>Results: </strong>Many participants (77%) were in stage 3 of CKD based on self-reported estimated Glomerular Filtration Rate, were considered Black (47.5%) or Hispanic/Latino (45.9%), did not receive any food/government assistance (55.7%), and self-reported annual household income of $50,000 or more (70.5%). The median diet quality score was 35.5 out of 60. The themes from the interviews focused on specific aspects of food security dimensions, such as availability and accessibility, with other themes present, such as affordability, health, and support.</p><p><strong>Conclusion: </strong>Affordability of food, health, and support were of concern for adults with CKD, regardless of income level. Traditional food security instruments need to expand to include more in-depth questions about the food and nutrition dimensions in alleviating any potential burdens that adults with CKD face in obtaining and consuming foods.</p>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081797","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}

{"title":"Centers for Nutritional Care: A Further Step to Improve Health-care Quality in Patients With Chronic Kidney Disease.","authors":"Giacomo Garibotto, Linda W Moore","doi":"10.1053/j.jrn.2025.05.001","DOIUrl":"10.1053/j.jrn.2025.05.001","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081796","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}

{"title":"A Guide to Filipino Foods While on Dialysis.","authors":"Melissa Prest, Alanna Marder","doi":"10.1053/j.jrn.2025.04.004","DOIUrl":"10.1053/j.jrn.2025.04.004","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030522","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}

{"title":"Response to Letter to the Editor: Predictors of Skeletal Muscle Index for Patients Treated With Hemodialysis.","authors":"Laura Byham-Gray, Glenn Brietzke, Rebecca Brody, Joachim Sackey","doi":"10.1053/j.jrn.2025.03.010","DOIUrl":"10.1053/j.jrn.2025.03.010","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041707","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}

{"title":"CRN - Message from the Chair.","authors":"Jill Hoyt","doi":"10.1053/j.jrn.2025.04.003","DOIUrl":"https://doi.org/10.1053/j.jrn.2025.04.003","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029820","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}

{"title":"Predictors of Skeletal Muscle Index for Patients Treated With Hemodialysis.","authors":"Wei-Ti Wang, Min-Sheng Lu, Wei-Yang Lee, Ping-Chen Wang, Chih-Chung Shiao","doi":"10.1053/j.jrn.2024.12.010","DOIUrl":"10.1053/j.jrn.2024.12.010","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025041","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}

{"title":"Declining Serum Albumin With Stable Body Mass Index: A Mortality Indicator in Predialysis Chronic Kidney Disease.","authors":"Menaka Sarav, Prabin Shrestha, Adnan Naseer, Fridtjof Thomas, Keiichi Sumida, Kamyar Kalantar-Zadeh, Csaba P Kovesdy","doi":"10.1053/j.jrn.2025.04.005","DOIUrl":"10.1053/j.jrn.2025.04.005","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate changes in nutritional markers in patients with predialysis chronic kidney disease (CKD) and stable body mass index (BMI).</p><p><strong>Methods: </strong>We analyzed data from a nationwide cohort of US Veterans with advanced CKD who transitioned to kidney replacement therapy from October 1, 2007, through March 31, 2015. We identified 20,164 U.S. veterans with stable BMI and multiple serum albumin measurements. We calculated intraindividual slopes of serum albumin using mixed effects models for 3 years preceding dialysis. We examined the association of serum albumin slope with mortality after dialysis initiation using Cox proportional hazards models adjusted for demographic characteristics, comorbidities, and baseline estimated glomerular filtration rate and serum albumin.</p><p><strong>Results: </strong>The cohort had a mean age of 64 years, with 98.3% male and 30% African American participants. Despite maintaining stable BMI, 81% of patients displayed a decline in serum albumin levels in the predialysis period (median slope: -0.09 g/dL/year, 25th and 75th percentile: -0.17, -0.02). A steeper decline in serum albumin over time was associated with significantly higher postdialysis mortality (multivariable-adjusted hazard ratio associated with -1 g/dL/year decline in serum albumin: 1.86, 95% confidence interval: 1.65-2.10, P < .001).</p><p><strong>Conclusion: </strong>A large proportion of patients with advanced CKD display a clinically relevant decline in serum albumin despite maintaining a stable BMI. Our study highlights the limitations of stable BMI as a marker of nutritional adequacy in advanced CKD, emphasizing the need for more comprehensive nutritional assessments in CKD management.</p>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993899","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}

{"title":"Correlation of Nutritional Risk Indicators and Cognitive Function on Mexican Hemodialysis Patients: Cross-Sectional Study.","authors":"García-Cruz María Fernanda, Rios-Rios Brenda Daniela, Cárdenas Yolitzy, Ríos-Silva Mónica, Trujillo Xóchitl, Huerta Miguel, Bermúdez-Aceves Luis Antonio, Sánchez-Meza Karmina, Bricio-Barrios Jaime Alberto","doi":"10.1053/j.jrn.2025.04.006","DOIUrl":"10.1053/j.jrn.2025.04.006","url":null,"abstract":"<p><strong>Objective: </strong>Deterioration of cognitive status and malnutrition are very common in patients with hemodialysis; these patients usually have a greater decline in their cognitive performance than individuals of the same age in the general population. The objective of the study was to correlate cognitive function with nutritional risk indicators in adults receiving hemodialysis treatment in the state of Colima, Mexico.</p><p><strong>Methods: </strong>Analytical, cross-sectional study, which included 63 people (aged >18 years) of both sexes, who attended the Colima State Hemodialysis Center. Each patient who agreed to participate signed an informed consent. Nutritional risk was measured with the Nutritional Control Scale. To evaluate cognitive status, the Brief Neuropsychological Test in Spanish was used.</p><p><strong>Results: </strong>Overall, 38.1% of the participants were women and 61.9% were men, with a median age of 52 (interquartile range 24.5) years. In addition, 58.7% of the participants presented cognitive impairment, and 14.3% were at nutritional risk. Albumin presented a positive correlation with the recall and encoding domains, the latter being stronger in the group of patients with moderate to severe nutritional risk, and lymphocytes were strongly and negatively correlated with the encoding domain.</p><p><strong>Conclusion: </strong>No association was found between cognitive status and nutritional status in this study. However, a positive correlation of albumin and lymphocytes with some domains of cognitive function was found, especially in patients with nutritional risk.</p>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044769","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}

{"title":"Diet Quality Components and Gut Microbiota of Patients on Peritoneal Dialysis","authors":"Christiane Ishikawa Ramos PhD ,&nbsp;Laila Santos de Andrade PhD ,&nbsp;Renata Rodrigues Teixeira MD ,&nbsp;Natália Barros Ferreira Pereira MD ,&nbsp;Fabiana da Silva Lima PhD ,&nbsp;Christian Hoffmann PhD ,&nbsp;Lilian Cuppari PhD","doi":"10.1053/j.jrn.2025.01.001","DOIUrl":"10.1053/j.jrn.2025.01.001","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the associations between the quality of the diet and its components and microbial diversity and composition in peritoneal dialysis (PD) patients.</div></div><div><h3>Design and Methods</h3><div>This cross-sectional study included PD patients for at least 3 months, aged 18-75 years and clinically stable. The Diet Quality Index (DQI), validated for the Brazilian population, is based on the energy density of 11 components (“sugar and sweets;” “beef, pork, and processed meat;” “refined grains and breads;” “animal fat;” “poultry, fish, and eggs;” “whole cereals, tubers, and roots;” “fruits”; “nonstarch vegetables;” “legumes and nuts;” “milk and dairy products;” and “vegetable oil”). A proportional score—based on the adequacy of the intake to Brazilian dietary guidelines—is calculated, and a final score ranged from 0 (worse) to 100 (better) is obtained. Fecal samples were collected at home, in a sterile material, kept refrigerated, and delivered to the clinic within 12 hours; α-diversity indices (Observed operational taxonomic units, Chao-1, Shannon’s, Gini-Simpson’s, Pielou eveness, and Faith phylogenetics) and microbial profile were determined by 16S ribosomal DNA with polymerase chain reaction-amplification and sequenced on an Illumina MiSeq platform.</div></div><div><h3>Results</h3><div>Forty-three participants were included (53.5% men, 52.4 ± 14.1 years, body mass index: 25.9 ± 4.1 kg/m², 30.2% had diabetes mellitus). DQI score was 50.5 (41.9-54.9). The lowest energy density was for the components “animal fat” and “whole cereals and breads, tubers, and roots,” and the highest were for “refined grains and bread” and “beef, pork, and processed meat.” Diversity indices and <em>Enterorhabdus</em> genus were directly associated with the energy density of the components “whole cereals and breads, tubers, and roots” and inversely with “refined grains and bread,” after adjustments for age and diabetes.</div></div><div><h3>Conclusions</h3><div>Even low, the intake of whole cereals, tubers, and roots has the potential to positively influence the microbiota profile in PD patients.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 3","pages":"Pages 454-462"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048760","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}