Journal of Renal Nutrition最新文献

{"title":"Hyperphosphatemia-Related Mortality Is Modified by Serum Albumin and Creatinine Levels in Hemodialysis Patients: The Q-Cohort Study","authors":"Shunsuke Yamada MD, PhD, Hokuto Arase MD, PhD, Masanori Tokumoto MD, PhD, Masatomo Taniguchi MD, PhD, Kazuhiko Tsuruya MD, PhD, Toshiaki Nakano MD, PhD, Tetsuro Ago MD, PhD","doi":"10.1053/j.jrn.2026.04.012","DOIUrl":"10.1053/j.jrn.2026.04.012","url":null,"abstract":"<div><h3>Objective</h3><div>Hyperphosphatemia is a well-established predictor of mortality in hemodialysis patients. However, its impact may vary depending on clinical conditions. We examined whether serum albumin and creatinine (Cr) levels modify the association between hyperphosphatemia and mortality.</div></div><div>Hyperphosphatemia is a well-established predictor of mortality in hemodialysis patients. However, its impact may vary depending on clinical conditions. We examined whether serum albumin and creatinine (Cr) levels modify the association between hyperphosphatemia and mortality.</div><div><h3>Design and Methods</h3><div>We conducted a prospective, multicenter cohort study involving 3,050 patients on maintenance hemodialysis, followed for up to 4 years. The primary outcomes were all-cause and cardiovascular mortality. Serum phosphorus levels were the main exposure; serum albumin and Cr levels were evaluated as potential effect modifiers. Sensitivity analyses were performed using the Geriatric Nutritional Risk Index and modified creatinine index. Cox proportional hazards models were used to assess mortality risk.</div></div><div>We conducted a prospective, multicenter cohort study involving 3,050 patients on maintenance hemodialysis, followed for up to 4 years. The primary outcomes were all-cause and cardiovascular mortality. Serum phosphorus levels were the main exposure; serum albumin and Cr levels were evaluated as potential effect modifiers. Sensitivity analyses were performed using the Geriatric Nutritional Risk Index and modified creatinine index. Cox proportional hazards models were used to assess mortality risk.</div><div><h3>Results</h3><div>Over a median follow-up of 3.5 years, 639 patients died, including 227 from cardiovascular causes. In multivariable-adjusted models, hyperphosphatemia was significantly associated with higher risks of both all-cause and cardiovascular mortality. Stratified analyses revealed that this association was significant only in patients with higher serum albumin or lower Cr levels. Among patients with lower albumin or higher Cr, the association was not significant. Significant interaction effects were observed between serum phosphorus and both albumin and Cr, highlighting a potential modifying role of nutritional and muscular status in phosphate-related mortality risk. In sensitivity analyses, similar patterns were observed, with the association between hyperphosphatemia and mortality being more evident among patients with higher Geriatric Nutritional Risk Index and lower modified creatinine index.</div></div><div>Over a median follow-up of 3.5 years, 639 patients died, including 227 from cardiovascular causes. In multivariable-adjusted models, hyperphosphatemia was significantly associated with higher risks of both all-cause and cardiovascular mortality. Stratified analyses revealed that this association was significant only in patients with higher serum albumin or lower Cr levels. Among patients w","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 5","pages":"Pages 775-783"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937158","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":"Association of C-Reactive Protein–Triglyceride Glucose Index With Chronic Kidney Disease and Reduction of Renal Function","authors":"Wenjing Wang MSc, Yuhan Huang MSc, Xiaohua Wang MSc, Wenli Gan MSc, Shihao Zhao MSc, Lina Jin PhD, Yuchun Tao MSc","doi":"10.1053/j.jrn.2026.03.003","DOIUrl":"10.1053/j.jrn.2026.03.003","url":null,"abstract":"<div><h3>Objectives</h3><div>The C-reactive protein–triglyceride glucose index (CTI) is a novel biomarker integrating insulin resistance and systemic inflammation, both of which are implicated in the pathogenesis of chronic kidney disease (CKD). This study aimed to investigate the association of CTI with CKD and the reduction of renal function.</div></div><div>The C-reactive protein–triglyceride glucose index (CTI) is a novel biomarker integrating insulin resistance and systemic inflammation, both of which are implicated in the pathogenesis of chronic kidney disease (CKD). This study aimed to investigate the association of CTI with CKD and the reduction of renal function.</div><div><h3>Methods</h3><div>This study used China Health and Retirement Longitudinal Study data from 2011 to 2015. The 2011 and 2015 cross-sectional studies included 5,242 and 8,056 participants aged ≥45 years, respectively. A total of 3,435 eligible subjects participated in the longitudinal cohort study. Logistic regression, linear regression, and restricted cubic splines were used to assess the association of CTI with CKD, estimated glomerular filtration rate, and reduction of renal function, with subgroup and interaction analyses performed.</div></div><div>This study used China Health and Retirement Longitudinal Study data from 2011 to 2015. The 2011 and 2015 cross-sectional studies included 5,242 and 8,056 participants aged ≥45 years, respectively. A total of 3,435 eligible subjects participated in the longitudinal cohort study. Logistic regression, linear regression, and restricted cubic splines were used to assess the association of CTI with CKD, estimated glomerular filtration rate, and reduction of renal function, with subgroup and interaction analyses performed.</div><div><h3>Results</h3><div>The study demonstrated a positive association between CTI and CKD in both 2011 (odds ratio [OR] = 1.30, 95% confidence interval [CI]: 1.21, 1.41; <em>P</em> < .001) and 2015 (OR = 1.44, 95% CI: 1.34, 1.56; <em>P</em> < .001) cross-sectional studies, with inverse associations observed with estimated glomerular filtration rate. In the longitudinal cohort study, there was a positive association of CTI with the incidence of new-onset CKD (OR = 1.26, 95% CI: 1.08, 1.47; <em>P</em> = .003) and reduction of renal function with CKD (OR = 1.71, 95% CI: 1.31, 2.25; <em>P</em> < .001).</div></div><div>The study demonstrated a positive association between CTI and CKD in both 2011 (odds ratio [OR] = 1.30, 95% confidence interval [CI]: 1.21, 1.41; <em>P</em> < .001) and 2015 (OR = 1.44, 95% CI: 1.34, 1.56; <em>P</em> < .001) cross-sectional studies, with inverse associations observed with estimated glomerular filtration rate. In the longitudinal cohort study, there was a positive association of CTI with the incidence of new-onset CKD (OR = 1.26, 95% CI: 1.08, 1.47; <em>P</em> = .003) and reduction of renal function with CKD (OR = 1.71, 95% CI: 1.31, 2.25; <em>P</em> < .001).","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 5","pages":"Pages 748-757"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518293","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 the Letter to the Editor Regarding “Ultraviolet Spectrophotometric Analysis of Phosphate Content in Plant-Based Milk Alternatives in Relation to Advanced Chronic Kidney Disease”","authors":"Alison L. Lyles BSc(hons) Pharmacology, MSc Dietetics","doi":"10.1053/j.jrn.2026.04.014","DOIUrl":"10.1053/j.jrn.2026.04.014","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 5","pages":"Pages 815-816"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059497","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":"Joint International Society of Renal Nutrition and Metabolism (ISRNM) and International Society for Peritoneal Dialysis (ISPD) Practice Recommendation on Nutrition Management in Peritoneal Dialysis","authors":"Angela Yee-Moon Wang, Carla Maria Avesani, Deepa Kariyawasam, Kelly Lambert, Christine Nash, Fabiana Nerbass, Alice Sabatino, Ammar Alobaidi, Sharon Devi Naraine, Maria Chan, Josephine SF. Chow, Jie Dong, Zarina Ebrahim, Ana E. Figueiredo, Scott E. Liebman, Connie Rhee, Maryanne Zilli Canedo Silva, David W. Johnson","doi":"10.1053/j.jrn.2026.08.002","DOIUrl":"10.1053/j.jrn.2026.08.002","url":null,"abstract":"<div><div>Nutrition is a key management issue in individuals receiving peritoneal dialysis (PD) and those who develop complications during PD. However, globally, there is no unified practice consensus to guide nephrologists, dietitians and other allied health professionals in managing various nutrition issues for individuals receiving PD. The International Society of Renal Nutrition and Metabolism (ISRNM) and International Society for Peritoneal Dialysis (ISPD) joined forces to develop an inaugural practice recommendation on nutrition management in individuals receiving PD. The practice recommendation was developed by a globally representative group of nephrologists, dietitians, and dialysis nurses. It aims to provide comprehensive clinical guidance on nutrition management to nephrologists, non-nephrologists physicians, dietitians, nurses and multidisciplinary care team for implementation in individuals receiving PD to optimize their nutrition status, prevent and manage protein-energy wasting (PEW), promote a healthy dietary pattern, improve patient-centred outcomes, enabling them to live well on PD. A multidisciplinary education approach is promoted to improve patients’ health, nutrition and food literacy in order for them to adopt a healthy dietary pattern and promote more individuals’ engagement in self-managing their diets and nutrition. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was used to evaluate the quality of evidence and grade practice recommendations. Practice points are developed based on expert consensus of health professionals. The practice recommendation covers 5 key themed topics: nutrition screening and assessment and monitoring of nutrition status, dietary recommendations for individuals receiving PD, nutrition interventions for individuals who develop complications while receiving PD, nutrition supplementation and nutrition education.</div></div><div>Nutrition is a key management issue in individuals receiving peritoneal dialysis (PD) and those who develop complications during PD. However, globally, there is no unified practice consensus to guide nephrologists, dietitians and other allied health professionals in managing various nutrition issues for individuals receiving PD. The International Society of Renal Nutrition and Metabolism (ISRNM) and International Society for Peritoneal Dialysis (ISPD) joined forces to develop an inaugural practice recommendation on nutrition management in individuals receiving PD. The practice recommendation was developed by a globally representative group of nephrologists, dietitians, and dialysis nurses. It aims to provide comprehensive clinical guidance on nutrition management to nephrologists, non-nephrologists physicians, dietitians, nurses and multidisciplinary care team for implementation in individuals receiving PD to optimize their nutrition status, prevent and manage protein-energy wasting (PEW), promote a healthy dietary pattern, improve pat","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 5","pages":"Pages 654-713"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149033277","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":"Changes in Nutritional Category After the First Year of Dialysis and Their Association With Survival and Hospitalization","authors":"Sara Blumberg Benyamini PhD, Relu Cernes MD, Anna Katkov MD, Anat Levi MSc, Ze'ev Katzir MD, Leonid Feldman MD","doi":"10.1053/j.jrn.2026.05.003","DOIUrl":"10.1053/j.jrn.2026.05.003","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine nutritional category reclassification at 1 year after hemodialysis initiation and its associations with later survival and hospitalization.</div></div><div>To examine nutritional category reclassification at 1 year after hemodialysis initiation and its associations with later survival and hospitalization.</div><div><h3>Methods</h3><div>A total of 297 patients who started dialysis from March 2009 to March 2019 were enrolled. Nutritional status was assessed at dialysis commencement and 1 year later using the Integrative Clinical Nutrition Dialysis Score along with the slope of 3 successive monthly scores. Patients were classified into four nutritional categories, with category 1 representing the best nutritional status and category 4 the poorest. The Cox proportional hazard model was used to analyze the associations between the nutritional categories at the beginning of the second year on hemodialysis and all-cause mortality. The Kruskal-Wallis rank sum test was used to analyze hospitalization frequency and hospital length of stay (LOS).</div></div><div>A total of 297 patients who started dialysis from March 2009 to March 2019 were enrolled. Nutritional status was assessed at dialysis commencement and 1 year later using the Integrative Clinical Nutrition Dialysis Score along with the slope of 3 successive monthly scores. Patients were classified into four nutritional categories, with category 1 representing the best nutritional status and category 4 the poorest. The Cox proportional hazard model was used to analyze the associations between the nutritional categories at the beginning of the second year on hemodialysis and all-cause mortality. The Kruskal-Wallis rank sum test was used to analyze hospitalization frequency and hospital length of stay (LOS).</div><div><h3>Results</h3><div>Reclassification to different nutritional categories was observed at 1 year after dialysis initiation. Three years after dialysis initiation, death odds of patients allocated to categories 3 and 4 combined were significantly increased compared to category 1 (HR: 2.71, 95% confidence interval: 1.45-5.07, <em>P</em> = .002). The median LOS of patients in category 1 at 1 year after dialysis start was 1.3 days, (interquartile range (IQR): 0.0-4.7) significantly shorter than that for categories 3 and 4 combined (median 5.0 days, IQR: 3.0-6.0, <em>P</em> = .028). The median number of hospitalizations was lower in category 1 (median 1, IQR: 0-2), compared with categories 3 and 4 combined (median 3, IQR:1-3, <em>P</em> = .009).</div></div><div>Reclassification to different nutritional categories was observed at 1 year after dialysis initiation. Three years after dialysis initiation, death odds of patients allocated to categories 3 and 4 combined were significantly increased compared to category 1 (HR: 2.71, 95% confidence interval: 1.45-5.07, <em>P</em> = .002). The median LOS of patients in category 1 at 1 year after dialysis start was ","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 5","pages":"Pages 784-793"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059462","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":"Fruit, but Not Vegetable, Intake Is Positively Associated With Lean Mass, Handgrip Strength, and 4-m Walking Speed in Kidney Transplant Patients","authors":"Rafaela Nehme, Larissa S. Limirio, Débora M. Morais, Maria Eduarda F. Mendonça, Breno Batista-da-Silva, Erick P. de Oliveira","doi":"10.1053/j.jrn.2026.04.005","DOIUrl":"10.1053/j.jrn.2026.04.005","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the association between fruit and vegetable intake and lean mass, muscle strength, and functional capacity in kidney transplant patients (KTPs).</div></div><div>To investigate the association between fruit and vegetable intake and lean mass, muscle strength, and functional capacity in kidney transplant patients (KTPs).</div><div><h3>Methods</h3><div>We conducted a cross-sectional study including 123 KTPs aged 18 years or older who had received a kidney transplant at least 3 months prior to study inclusion. Lean mass was assessed by bioelectrical impedance analysis. Muscle strength was evaluated using handgrip strength and the five times sit-to-stand test. Functional capacity was assessed using the 4-m walking speed. Fruit and vegetable intake was estimated based on two 24-hour dietary recalls collected using the five-step multiple-pass method. Linear regression analysis was performed to examine the association between fruit and vegetable intake and muscle-related outcomes, with adjustments for potential confounding variables.</div></div><div>We conducted a cross-sectional study including 123 KTPs aged 18 years or older who had received a kidney transplant at least 3 months prior to study inclusion. Lean mass was assessed by bioelectrical impedance analysis. Muscle strength was evaluated using handgrip strength and the five times sit-to-stand test. Functional capacity was assessed using the 4-m walking speed. Fruit and vegetable intake was estimated based on two 24-hour dietary recalls collected using the five-step multiple-pass method. Linear regression analysis was performed to examine the association between fruit and vegetable intake and muscle-related outcomes, with adjustments for potential confounding variables.</div><div><h3>Results</h3><div>Fruit intake (servings) was positively associated with lean mass (kg) (β = 0.522; <em>P</em> = .024), handgrip strength (kg) (β = 0.874; <em>P</em> = .012), and walking speed (m/s) (β = 0.021; <em>P</em> = .014). However, no significant association was observed between fruit intake and performance on the five times sit-to-stand test. Vegetable intake was not significantly associated with any of the muscle-related parameters evaluated.</div></div><div>Fruit intake (servings) was positively associated with lean mass (kg) (β = 0.522; <em>P</em> = .024), handgrip strength (kg) (β = 0.874; <em>P</em> = .012), and walking speed (m/s) (β = 0.021; <em>P</em> = .014). However, no significant association was observed between fruit intake and performance on the five times sit-to-stand test. Vegetable intake was not significantly associated with any of the muscle-related parameters evaluated.</div><div><h3>Conclusions</h3><div>Fruit, but not vegetable, intake was positively associated with lean mass, handgrip strength, and 4-m walking speed in KTPs.</div></div><div>Fruit, but not vegetable, intake was positively associated with lean mass, handgrip strength, and 4-m walki","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 5","pages":"Pages 794-801"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794629","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}

{"title":"Clinical Relevance of Malnutrition-Inflammation Score in Detecting Peritoneal Sclerosis Among Long-Term Peritoneal Dialysis Patients","authors":"Ning Weng MD, Fangyu Yi MD, Haiyang Liao MD, Hongyu Chen PhD, Meijuan Zhang MD, Yue Sun MD, Yongsheng Zhang MD, Yue Ren MD, Jiazhen Yin PhD","doi":"10.1053/j.jrn.2026.05.001","DOIUrl":"10.1053/j.jrn.2026.05.001","url":null,"abstract":"<div><h3>Objectives</h3><div>The malnutrition-inflammation score (MIS) is a composite indicator widely used in dialysis populations to evaluate nutritional deficiency and chronic inflammation. However, its association with structural peritoneal alterations remains unclear. This study aimed to investigate the relationship between MIS and the peritoneal sclerosis index (PSI) in long-term peritoneal dialysis (PD) patients.</div></div><div>The malnutrition-inflammation score (MIS) is a composite indicator widely used in dialysis populations to evaluate nutritional deficiency and chronic inflammation. However, its association with structural peritoneal alterations remains unclear. This study aimed to investigate the relationship between MIS and the peritoneal sclerosis index (PSI) in long-term peritoneal dialysis (PD) patients.</div><div><h3>Methods</h3><div>This single-center cross-sectional study included 191 PD patients with dialysis duration≥3 years. MIS was assessed using a standardized scoring system, and PSI was quantified based on structural abnormalities identified on abdominal computed tomography (CT). In response to the reviewer comment, beta2-microglobulin was additionally incorporated into the comparative analysis together with dialysis vintage, age, peritoneal equilibration test score, and dialysis adequacy. The association between MIS and CT-defined peritoneal sclerosis was evaluated using Spearman correlation, multivariate linear regression, and logistic regression analyses, and an exploratory screening of other candidate clinical indicators associated with PSI was also performed.</div></div><div>This single-center cross-sectional study included 191 PD patients with dialysis duration≥3 years. MIS was assessed using a standardized scoring system, and PSI was quantified based on structural abnormalities identified on abdominal computed tomography (CT). In response to the reviewer comment, beta2-microglobulin was additionally incorporated into the comparative analysis together with dialysis vintage, age, peritoneal equilibration test score, and dialysis adequacy. The association between MIS and CT-defined peritoneal sclerosis was evaluated using Spearman correlation, multivariate linear regression, and logistic regression analyses, and an exploratory screening of other candidate clinical indicators associated with PSI was also performed.</div><div><h3>Results</h3><div>When PSI was used as the CT-based marker of peritoneal sclerosis, dialysis vintage showed the strongest correlation with PSI (r = 0.333, <em>P</em> < .001). MIS showed only a weak correlation with PSI (r = 0.114, <em>P</em> = .116), whereas beta2-microglobulin was also weakly correlated (r = 0.154, <em>P</em> = .034). In univariate logistic analysis, MIS was associated with clinically significant peritoneal sclerosis (PSI≥5; odds ratio 1.13, <em>P</em> = .017), but this association was attenuated after adjustment for dialysis vintage, age, peritoneal equilibration test sc","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 5","pages":"Pages 802-813"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045446","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}

{"title":"Structured Appetite Assessment in Children With Chronic Kidney Disease","authors":"Matthew J. Harmer BSc(Hons), BM, PGCert, PhD, MRCPCH,&nbsp;Steve Wootton BSc(Hons), PhD,&nbsp;Rodney D. Gilbert MA, MMed(Paed), FRCPCH, DCH,&nbsp;Caroline Anderson BSc(Hons), RD, PhD","doi":"10.1053/j.jrn.2026.01.003","DOIUrl":"10.1053/j.jrn.2026.01.003","url":null,"abstract":"<div><h3>Objectives</h3><div>Appetite disturbances are common in children with chronic kidney disease (CKD). Although appetite assessment is recommended in clinical practice, no validated tools exist for structured evaluation. This study explores appetite in pediatric CKD and validates a simplified, user-friendly assessment tool.</div></div><div>Appetite disturbances are common in children with chronic kidney disease (CKD). Although appetite assessment is recommended in clinical practice, no validated tools exist for structured evaluation. This study explores appetite in pediatric CKD and validates a simplified, user-friendly assessment tool.</div><div><h3>Methods</h3><div>Following its construction, the ModSNAQ tool was assessed for content validity and employed in an observational cross-sectional study of children with CKD to validate it against dietary intake. The ModSNAQ scores were used to explore relationships of appetite and clinical data, including follow-up outcomes of growth and renal function at 12 months.</div></div><div>Following its construction, the ModSNAQ tool was assessed for content validity and employed in an observational cross-sectional study of children with CKD to validate it against dietary intake. The ModSNAQ scores were used to explore relationships of appetite and clinical data, including follow-up outcomes of growth and renal function at 12 months.</div><div><h3>Results</h3><div>The tool showed excellent content validity. In the cohort of children with CKD (mean glomerular filtration rate = 52 mL/minute/1.73 m²), almost a quarter rated their appetite as poor/very poor. Although not correlating with renal function, ModSNAQ scores predicted meeting energy and protein intake and correlated with height. Change in height and renal function at 12 months did not correspond with ModSNAQ scores, but those with poor appetite had an increase in body mass index.</div></div><div>The tool showed excellent content validity. In the cohort of children with CKD (mean glomerular filtration rate = 52 mL/minute/1.73 m²), almost a quarter rated their appetite as poor/very poor. Although not correlating with renal function, ModSNAQ scores predicted meeting energy and protein intake and correlated with height. Change in height and renal function at 12 months did not correspond with ModSNAQ scores, but those with poor appetite had an increase in body mass index.</div><div><h3>Conclusions</h3><div>The ModSNAQ is validated against dietary intake and offers a structured approach to appetite assessment. Using this tool, low appetite is more common than previously reported in CKD and does not correlate with degree of renal impairment.</div></div><div>The ModSNAQ is validated against dietary intake and offers a structured approach to appetite assessment. Using this tool, low appetite is more common than previously reported in CKD and does not correlate with degree of renal impairment.</div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 5","pages":"Pages 725-729"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129220","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}

{"title":"Response to Comment on ‘‘Higher Renal Net Acid but Not Higher Phosphate Excretion During Growth Associates With Lower Adult Circulating Uromodulin”","authors":"Thomas Remer PhD,&nbsp;Seyedeh-Masomeh Derakhshandeh-Rishehri PhD,&nbsp;Luciana Peixoto Franco PhD,&nbsp;Hermann Kalhoff MD,&nbsp;Stefan A. Wudy MD","doi":"10.1053/j.jrn.2026.05.004","DOIUrl":"10.1053/j.jrn.2026.05.004","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 5","pages":"Pages 819-821"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059480","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":"Longitudinal Trajectories of Serum Prealbumin and Their Association With Mortality in Maintenance Hemodialysis Patients","authors":"Jiaxin Li PhD,&nbsp;Xiaoqin Zhang BSN,&nbsp;Honghong Lv BSN","doi":"10.1053/j.jrn.2026.04.011","DOIUrl":"10.1053/j.jrn.2026.04.011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;Protein-energy wasting is a leading driver of mortality in maintenance hemodialysis (MHD) patients. Current nutritional assessment relies heavily on serum albumin, a lagging indicator that often masks active nutritional deterioration until stores are significantly depleted. While serum prealbumin offers higher sensitivity, it is frequently dismissed as merely a surrogate for systemic inflammation. It remains unclear whether the longitudinal velocity of prealbumin decline provides prognostic information beyond static markers, average concentration levels, and the acute phase response.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Protein-energy wasting is a leading driver of mortality in maintenance hemodialysis (MHD) patients. Current nutritional assessment relies heavily on serum albumin, a lagging indicator that often masks active nutritional deterioration until stores are significantly depleted. While serum prealbumin offers higher sensitivity, it is frequently dismissed as merely a surrogate for systemic inflammation. It remains unclear whether the longitudinal velocity of prealbumin decline provides prognostic information beyond static markers, average concentration levels, and the acute phase response.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a retrospective cohort study of 326 prevalent MHD patients with 3,137 serial prealbumin measurements (median follow-up 2.25 years; average 9.62 measurements per patient). Longitudinal trajectories were identified using a two-stage approach combining linear mixed-effects modeling and K-means clustering. Associations were assessed using sequential multivariable Cox proportional hazards models adjusted for demographics, diabetes mellitus, cardiovascular disease, baseline serum albumin, high-sensitivity C-reactive protein, hemoglobin, phosphate, urea reduction ratio, and time-average prealbumin. Multiple imputation by chained equations was employed to handle missing covariates, ensuring the inclusion of the full cohort (N = 326) in all multivariable models.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;We conducted a retrospective cohort study of 326 prevalent MHD patients with 3,137 serial prealbumin measurements (median follow-up 2.25 years; average 9.62 measurements per patient). Longitudinal trajectories were identified using a two-stage approach combining linear mixed-effects modeling and K-means clustering. Associations were assessed using sequential multivariable Cox proportional hazards models adjusted for demographics, diabetes mellitus, cardiovascular disease, baseline serum albumin, high-sensitivity C-reactive protein, hemoglobin, phosphate, urea reduction ratio, and time-average prealbumin. Multiple imputation by chained equations was employed to handle missing covariates, ensuring the inclusion of the full cohort (N = 326) in all multivariable models.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Three distinct trajectory phenotypes were identified: rapid decline (16.6%), moderate decline (66.0%), and stable/up (17.5%). Notably, patien","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 5","pages":"Pages 767-774"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937214","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}