Journal of Renal Nutrition最新文献

{"title":"Dietary needs, barriers, and facilitators among patients on hemodialysis and their caregivers: The GoodRENal Project in Spain.","authors":"Marina Padial, Carla Maria Avesani, Alicia García-Testal, Alicia Cana-Poyatos, Bengt Lindholm, Eva Segura-Ortí","doi":"10.1053/j.jrn.2024.08.005","DOIUrl":"https://doi.org/10.1053/j.jrn.2024.08.005","url":null,"abstract":"<p><strong>Objective: </strong>Dietary restrictions are common in patients undergoing hemodialysis (HD). These restrictions result in a complex diet that becomes difficult for patients to understand and to follow. Therefore, we aimed to identify dietary needs, and barriers and facilitators that influence the adherence to dietary recommendations as perceived by patients on HD and their caregivers.</p><p><strong>Methods: </strong>Seventy-two Spanish patients on HD and fifty-seven caregivers participated in this explorative study by replying a questionnaire consisting of 20 and 10 questions respectively. The responses were assessed using a Likert scale varying from 1 to 5 (strongly agree, agree, neither disagree or disagree, disagree, strongly disagree, respectively) to evaluate the perception of patients and caregivers regarding dietary needs, barriers and facilitators to adhere to the recommended diet. For analysis purposes, the responses were grouped in three categories (agree, neither agree or disagree, disagree).</p><p><strong>Results: </strong>Seventy percent of the patients agreed that knowing the food sources of potassium, protein and phosphate was a need for them to know to be able to adhere to the dietary recommendations. Moreover, patients stated that not being able to eat what they liked, and feeling thirsty, were important barriers. For caregivers, the support of a renal dietitian was mentioned as an important facilitator to assist those they cared for to adhere to the diet.</p><p><strong>Conclusions: </strong>Knowing food sources of potassium, phosphate, and protein, exploring foods patients like to eat and adjusting fluid intake to avoid feeling thirsty were identified as important by the patients. These findings can be used to develop strategies and educational material to improve the dietary adherence in patients undergoing HD. Moreover, the presence of a renal dietitian was identified as an important resource by the caregivers.</p>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141650","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":"Gauging the Diagnosis of Sarcopenia: A Side Note for Nephrologists","authors":"","doi":"10.1053/j.jrn.2024.01.001","DOIUrl":"10.1053/j.jrn.2024.01.001","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571815","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":"Associations Between Dietary Patterns and Kidney Health Assessed in the Population-Based CHRIS Study Using Reduced Rank Regression","authors":"","doi":"10.1053/j.jrn.2024.03.003","DOIUrl":"10.1053/j.jrn.2024.03.003","url":null,"abstract":"<div><h3>Objective</h3><p>While diet plays a key role in chronic kidney disease (CKD) management, the potential for diet to impact CKD prevention in the general population is less clear. Using a priori knowledge, we derived disease-related dietary patterns (DPs) through reduced rank regression (RRR) and investigated associations with kidney function, separately focusing on generally healthy individuals and those with self-reported kidney diseases, hypertension, or diabetes mellitus.</p></div><div><h3>Methods</h3><p>Eight thousand six hundred eighty-six participants from the population-based Cooperative Health Research in South Tyrol study were split into a group free of kidney disease, hypertension and diabetes (n = 6,133) and a group with any of the 3 conditions (n = 2,553). Diet was assessed through the self-administered Global Allergy and Asthma Network of Excellence food frequency questionnaire and DPs were derived through RRR selecting food frequency questionnaire–derived sodium, potassium, phosphorus, and protein intake as mediators. Outcomes were creatinine-based estimated glomerular filtration rate, urinary albumin-to-creatinine ratio, CKD and microalbuminuria. Multiple linear and logistic models were used to assess associations between RRR-based DPs and kidney outcomes separately in the 2 analytic groups.</p></div><div><h3>Results</h3><p>We identified 3 DPs, where high adherence reflected high levels of all nutrients (DP1), high potassium–phosphorus and low protein–sodium levels (DP2), and low potassium–sodium and high protein–phosphorus levels (DP3), respectively. We observed heterogeneous associations with kidney outcomes, varying by analytic group and sex. Kidney outcomes were much more strongly associated with DPs than with single nutrients.</p></div><div><h3>Conclusion</h3><p>RRR is a feasible approach to estimate disease-related DPs and explore the combined effects of nutrients on kidney health. Heterogeneous associations across kidney outcomes suggest possible specificity to kidney function or damage. In individuals reporting kidney disease, hypertension or diabetes, specific dietary habits were associated with better kidney health, indicating that disease-specific dietary interventions can be effective for disease control.</p></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1051227624000517/pdfft?md5=a1c763ba28a43b7ff63726532765955c&pid=1-s2.0-S1051227624000517-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194963","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":"Predictors of Skeletal Muscle Index for Patients Treated With Hemodialysis","authors":"","doi":"10.1053/j.jrn.2024.03.004","DOIUrl":"10.1053/j.jrn.2024.03.004","url":null,"abstract":"<div><h3>Objective</h3><p>There is an increased risk of skeletal muscle mass (SMM) loss among patients with stage 5 chronic kidney disease treated with maintenance hemodialysis (MHD). The reduced SMM considerably influences the development of protein-energy wasting (PEW). Patients who develop PEW have higher hospitalization and mortality rates than those without PEW. This study determined if key variables could predict SMM Index (SMM adjusted for height) in patients receiving MHD.</p></div><div><h3>Methods</h3><p>We conducted a secondary analysis of cross-sectional data obtained from the Rutgers Nutrition and Kidney Database (n = 178). Data were used to calculate both SMM and SMM Index. Univariate and multiple linear regression models explored the relationship between SMM Index and the following variables: serum albumin, urea clearance normalized treatment ratio, normalized protein catabolic rate, serum creatinine, and urea reduction ratio (URR).</p></div><div><h3>Results</h3><p>Most participants were Black/African American (82.9%), male (59.1%), and obese (39%), with a mean age of 55.9 ± 11.9 years. The median Subjective Global Assessment score was 5, indicating a lower risk of malnutrition. Participants had a mean SMM of 26.4 kg and a median SMM Index of 8.9 kg/m². Univariate regression modeling found URR to be a significant predictor of SMM Index, with increases in the percentage of URR predicting lower SMM Index values. The adjusted regression modeling found similar results, with increases in URR percentage predicting declines in SMM Index.</p></div><div><h3>Conclusion</h3><p>This study found that URR was a predictor of SMM Index in patients receiving MHD. Further research is required to explore these relationships and provide clinicians with a more extensive array of tools to recognize early signs of SMM loss to prevent the progression of PEW.</p></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1051227624000529/pdfft?md5=cb25d6ebea08b339cfdcb99bd7784ab6&pid=1-s2.0-S1051227624000529-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190299","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":"Message From the Chair","authors":"","doi":"10.1053/j.jrn.2024.07.011","DOIUrl":"10.1053/j.jrn.2024.07.011","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S105122762400164X/pdfft?md5=c491b11eaeab60ff6ef196f73546aec3&pid=1-s2.0-S105122762400164X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735473","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":"Changes in Bone Mineral Density in Patients With Non-dialysis-Dependent Chronic Kidney Disease Are Associated With Body Composition","authors":"","doi":"10.1053/j.jrn.2024.03.011","DOIUrl":"10.1053/j.jrn.2024.03.011","url":null,"abstract":"<div><h3>Objective</h3><p>Chronic kidney disease (CKD) and low bone mineral density (BMD) are highly prevalent and can co-exist. Parameters of mineral metabolism are associated with BMD in CKD, but other contributing factors may contribute. The aim of this study was to assess changes in BMD and its determinants in patients with nondialysis-dependent CKD (NDD-CKD).</p></div><div><h3>Methods</h3><p>Body composition and biochemical profiles were assessed in a retrospective hospital-based cohort study of patients with NDD-CKD. BMD, lean soft tissue (LST), appendicular LST (ALST), and percentage fat mass were assessed by dual-energy X-ray absorptiometry. The ALST index (ALSTI, ALST/height²) and load-capacity index (LCI, fat mass/LST) were calculated. Low BMD was defined as T-score ≤ −1.0.</p></div><div><h3>Results</h3><p>The mean time between assessments was 2.8 ± 1.3 years; 46 patients were included. A reduction in renal function was observed. Changes in body composition included reductions in ALST (<em>P</em> = .031), ALSTI (<em>P</em> = .021), a trend for BMD (<em>P</em> = .053), and an increase in percentage fat mass (<em>P</em> = .044) and LCI (<em>P</em> = .032). Females had a reduction in BMD (<em>P</em> = .034), ALST (<em>P</em> = .026), and ALSTI (<em>P</em> = .037). Patients with low BMD at baseline had lower LST (<em>P</em> = .013), ALST (<em>P</em> = .023), and percentage fat mass (<em>P</em> = .037) than those with normal BMD. Additionally, reductions in LST (<em>P</em> = .041), ALST (<em>P</em> = .006), and ALSTI (<em>P</em> = .008) were observed in patients who had low BMD at baseline, while no significant changes in body composition were observed in those with normal BMD at baseline. The following body composition parameters at baseline were determinants of BMD status at follow-up: LST (odds ratio [OR]: 0.899, 95% confidence interval [CI]: 0.829-0.976, <em>P</em> = .010), ALST (OR: 0.825, 95% CI: 0.704-0.967, <em>P</em> = .017), and ALSTI (OR: 0.586, 95% CI: 0.354-0.968, <em>P</em> = .037), independent of fat mass and LCI.</p></div><div><h3>Conclusions</h3><p>Detrimental body composition changes were observed without changes in body weight; these were more significant in females. Moreover, this is the first longitudinal study showing a protective effect of LST against BMD loss in patients with NDD-CKD.</p></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1051227624000633/pdfft?md5=8e6e1240a29b6cc293fee5bf4c93fb1e&pid=1-s2.0-S1051227624000633-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862980","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":"Role of Peritoneal Equilibration Test in Assessing Folate Transport During Peritoneal Dialysis","authors":"","doi":"10.1053/j.jrn.2024.02.003","DOIUrl":"10.1053/j.jrn.2024.02.003","url":null,"abstract":"<div><h3>Objectives</h3><p>Low plasma folate levels have been reported in patients undergoing hemodialysis and peritoneal dialysis (PD) in clinical studies. However, folate transport has never been mentioned as a factor contributing to low plasma folate levels in patients undergoing PD. The peritoneal equilibrium test (PET) assesses the plasma creatinine level and glucose transport abilities. This study aimed to evaluate the association between plasma folate levels and folate transport during PD based on PET grades.</p></div><div><h3>Methods</h3><p>This study recruited 50 patients who underwent PD for ≥3 months and were categorized according to PET grades. Data regarding plasma folate levels and dialysate folate were collected. The primary outcomes were the relationship between the PET grade and plasma folate level and between the PET grade and dialysate-to-plasma folate concentration ratio (D/P folate). Furthermore, the difference in the plasma folate level and D/P folate between men and women was assessed.</p></div><div><h3>Results</h3><p>The plasma folate level and the D/P folate significantly differed among the 4 PET groups (both <em>P</em> &lt; .001). PET grade was significantly negatively correlated with plasma folate levels (r = −0.56, <em>P</em> &lt; .001) and positively correlated with D/P folate (r = 0.686, <em>P</em> &lt; .001). In subgroup analysis, neither the plasma folate level nor the D/P folate significantly differed between men and women.</p></div><div><h3>Conclusions</h3><p>Our study provides clinical evidence that the PET grade is associated with the plasma folate level and D/P folate, regardless of sex. Larger cohort studies are warranted to assess the importance of folate supplementation during PD based on PET grades.</p></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1051227624000347/pdfft?md5=603d3591cffb554d3363cb7dfda9753e&pid=1-s2.0-S1051227624000347-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137417","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":"Reflecting on Remarkable Years at the Journal of Renal Nutrition: Innovation in Dietary and Nutritional Interventions in Kidney Health and Disease","authors":"","doi":"10.1053/j.jrn.2024.07.002","DOIUrl":"10.1053/j.jrn.2024.07.002","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1051227624001547/pdfft?md5=06fa9824a2a6a82c1bde9efc868e7c32&pid=1-s2.0-S1051227624001547-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560221","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":"Dysgeusia and Chronic Kidney Disease: A Scoping Review","authors":"","doi":"10.1053/j.jrn.2024.04.005","DOIUrl":"10.1053/j.jrn.2024.04.005","url":null,"abstract":"<div><p>Dysgeusia is a common altered taste perception in chronic kidney disease patients. The study aims to identify available treatments for educating, screening, and clinically managing dysgeusia in this population. A scoping review was conducted following the protocol of Arksey and O'Malley, incorporating the Joanna Briggs Institute methodology, and adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Among the 424 identified records, 13 studies were included. Screening methodologies, educational strategies, particularly a hospital-based program focusing on salt reduction, showed a significant improvement in dysgeusia (<em>P</em> &lt; .001). The identified clinical treatments exclusively included oral zinc supplementation, with dosages ranging from 50 to 220 mg, reporting heterogeneous results not consistent across different studies. The personalized management of dysgeusia associated with chronic kidney disease is crucial, requiring targeted education and treatment protocols to prevent and address nutritional complications such as malnutrition.</p></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1051227624000670/pdfft?md5=64e7ddbb062f46f9281e3ab5a643f8f3&pid=1-s2.0-S1051227624000670-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140905216","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":"The Effect of Niacinamide Supplementation on Phosphate Concentrations in Dutch Dialysis Patients: A Randomized Crossover Trial","authors":"","doi":"10.1053/j.jrn.2024.02.005","DOIUrl":"10.1053/j.jrn.2024.02.005","url":null,"abstract":"<div><h3>Objective</h3><p>Hyperphosphatemia is a common complication in patients with kidney failure, despite the use of phosphate binders. Vitamin B3, either in the form of niacin or niacinamide (NAM), shows potential as “add-on” treatment to reduce serum phosphate concentrations in this population. NAM seems to lack many of the side effects that are observed with niacin. The aim of this study was to investigate whether NAM is an effective and acceptable treatment in reducing serum phosphate concentrations in patients with kidney failure.</p></div><div><h3>Methods</h3><p>DiaNia was a double-blind placebo-controlled randomized crossover trial, comparing NAM (250-500 mg/day) to placebo as “add-on” treatment to an individual treatment with approved phosphate binders for 12 weeks in patients receiving hemodialysis. The primary outcome was serum phosphate concentrations, and the secondary outcomes were platelet counts as well as drop-outs due to side effects. Data were analyzed using both per-protocol and intention-to-treat analyses.</p></div><div><h3>Results</h3><p>Mean age of the per-protocol population (n = 26) was 63.6 ± 17.2 years and 53.8% were men. NAM treatment significantly reduced serum phosphate with 0.59 mg/dL (p = .03). Linear mixed-effects models demonstrated superiority of 12 weeks NAM over 12 weeks placebo with a between-treatment difference of 0.77 mg/dL (95% CI 0.010, 1.43; <em>P</em> = .03). Similar results, although not significant, were found in the intention-to-treat population. We found no between-treatment differences in platelet counts and during the NAM treatment we observed 3 drop-outs due to side effects (8.6%).</p></div><div><h3>Conclusion</h3><p>NAM is effective in reducing serum phosphate concentrations in patients with kidney failure receiving hemodialysis. In addition, NAM is well-tolerated and seems not to increase the risk of thrombocytopenia. Thus, NAM can be valuable as “add-on” treatment to combat hyperphosphatemia in patients with kidney failure. However, more research in larger populations is needed to confirm this.</p></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1051227624000360/pdfft?md5=7837abd9936820eacbf5849f93af8335&pid=1-s2.0-S1051227624000360-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141044","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}