Journal of Renal Nutrition最新文献

{"title":"UACR Accurately Reflects Daily Albuminuria in Non-Obese 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":"https://doi.org/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 (eAER), 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 eAER model.</p><p><strong>Results: </strong>An analysis of 304 24-hour urine samples revealed a median value of 0.538 g (IQR: 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 = 0.893; ours 0.922 vs. 0.925, p = 0.727), and outperformed the model that excluded body weight (total R² values: ours 0.922 vs. 0.855, p < 0.001). 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 (AUC: 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: -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 CKD, non-dialysis: A mixed method study.","authors":"Jeanette M Andrade, Katherine Mullis, Pablo Lamino","doi":"10.1053/j.jrn.2025.05.003","DOIUrl":"https://doi.org/10.1053/j.jrn.2025.05.003","url":null,"abstract":"<p><strong>Background: </strong>Food and nutrition insecurity may contribute to the progression of chronic kidney disease (CKD). Current metrics to measure food and nutrition security status may not capture the nuances associated with these concepts. The purpose of this mixed method study was to examine perceptions of food and nutrition security of adults with chronic kidney disease, non-dialysis.</p><p><strong>Methods: </strong>A sequential explanatory mixed-method study was conducted from March - August 2024. Participants (n=60) completed a survey that focused on the dimensions of food and nutrition security and diet quality. A sub-section of participants (n=23) completed an interview that explored food and nutrition security. Frequencies and descriptives were analyzed using SPSS 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 eGFR, 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 healthcare quality in patients with chronic renal disease.","authors":"Giacomo Garibotto, Linda W Moore","doi":"10.1053/j.jrn.2025.05.001","DOIUrl":"https://doi.org/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":"https://doi.org/10.1053/j.jrn.2025.04.004","url":null,"abstract":"<p><p>This handout, Filipino Food Guide for Dialysis, was developed to provide culturally relevant nutrition education for Filipino patients undergoing hemodialysis. Given the high prevalence of chronic kidney disease (CKD) in the Filipino population, and the unique dietary patterns rooted in traditional Filipino cuisine, this resource offers practical, easy-to-follow guidance tailored to their needs. The guide outlines key dietary restrictions associated with dialysis-specifically for phosphorus, potassium, sodium, and fluid intake-and presents alternatives using familiar Filipino foods. It encourages moderation of common high-phosphorus and high-sodium items such as dried fish, soy sauce, and processed goods, while promoting the use of fresh herbs, vegetables, and natural seasonings like calamansi and ginger. Culturally relevant substitutions and preparation methods, such as boiling vegetables to reduce potassium levels and using low-sodium versions of popular dishes, are emphasized. Additionally, the guide includes a 3-day meal plan with balanced meals and snacks that align with dialysis dietary recommendations, making it practical for daily use. By reflecting the cultural food preferences and traditions of the Filipino community, this tool aims to improve dietary adherence, support better health outcomes, and empower patients with kidney disease to make informed food choices while maintaining cultural identity.</p>","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":"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":"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":"https://doi.org/10.1053/j.jrn.2025.03.010","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-07","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":"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":"https://doi.org/10.1053/j.jrn.2025.04.006","url":null,"abstract":"<p><strong>Introduction: </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.</p><p><strong>Objective: </strong>The objective of the study was to correlate cognitive function with nutritional risk indicators in adults receiving hemodialysis treatment in the state of XXXX, Mexico.</p><p><strong>Methods: </strong>Analytical, cross-sectional study which included 63 people (>18 years) of both sexes, who attended the XXX State Hemodialysis Center. Each patient who agreed to participate signed an informed consent. Nutritional risk was measured with the Nutritional Control Scale (CONUT). To evaluate cognitive status, the Brief Neuropsychological Test in Spanish (NEUROPSI) was used.</p><p><strong>Results: </strong>Thirty-eight point one percent of the participants were women and 61.9% were men, with a median age of 52 (IQR 24.5) years. Fifty-eight point seven percent 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":"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":"Computed Tomography-based Abdominal Myosteatosis Indicators and Handgrip Strength in Hemodialyzed Patients.","authors":"Takahiro Yajima, Maiko Arao","doi":"10.1053/j.jrn.2025.04.001","DOIUrl":"10.1053/j.jrn.2025.04.001","url":null,"abstract":"<p><strong>Objective: </strong>The relationship between myosteatosis and muscle quality in hemodialyzed patients remains unknown. This study aimed to investigate the relationship between computed tomography (CT)-based abdominal myosteatosis indicators and handgrip strength (HGS) in these patients.</p><p><strong>Methods: </strong>This study enrolled 128 hemodialyzed patients who underwent CT, bioimpedance analysis (BIA), and HGS measurement. CT-based abdominal myosteatosis indicators were measured, including psoas muscle density (PMD), paraspinous muscle density (PSMD), and abdominal skeletal muscle density (ASMD), defined as the mean CT value of each muscle at the third lumbar vertebral level. The association between these indicators and HGS was analyzed, and the diagnostic abilities of these indicators to detect low muscle strength, as defined by HGS cutoff values (male, <28 kg; female, <18 kg), were investigated.</p><p><strong>Results: </strong>The PMD, PSMD, and ASMD were independently correlated with HGS (β = 0.310, P = .0041; β = 0.210, P = .033; and β = 0.252, P = .011, respectively), but not with BIA-estimated skeletal muscle index. Sixty-two (48.4%) patients had low HGS. After adjusting for confounding factors, the adjusted C-statistics of PMD, PSMD, and ASMD for detecting low HGS were 0.845 (reference), 0.836 (P = .56), and 0.837 (P = .50), respectively. Moreover, an increase in the PMD alone was independently associated with a decrease in the risk of low HGS (adjusted odds ratio: 0.912 (95% confidence interval 0.841-0.982), P = .015).</p><p><strong>Conclusions: </strong>CT-based abdominal myosteatosis indicators were independently associated with HGS, but not with BIA-estimated skeletal muscle index, and may aid in detecting clinically acceptable low HGS in hemodialyzed patients. The PMD may be the most recommended myosteatosis indicator for assessing muscle quality in this population.</p>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025199","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}