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 MD ,&nbsp;Zih-Kai Kao MS ,&nbsp;Chih-Yu Yang MD, PhD ,&nbsp;Der-Cherng Tarng MD, PhD","doi":"10.1053/j.jrn.2025.05.004","DOIUrl":"10.1053/j.jrn.2025.05.004","url":null,"abstract":"<div><h3>Objective</h3><div>Urine albumin-creatinine ratio (UACR) is widely used to estimate daily albuminuria<span>. Despite efforts to improve the accuracy of the estimated albumin excretion rate, the individual contributions of age, sex, and body weight remain unexplored.</span></div></div><div><h3>Methods</h3><div><span>This hospital-based cohort study examined the explanatory power of various factors and compared total R</span>² values across different sets of factors to determine the optimal estimated albumin excretion rate model.</div></div><div><h3>Results</h3><div><span>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 R</span>²<span> values in estimating daily albuminuria<span>. A novel model using only UACR and body weight demonstrated performance comparable to previous models that included additional variables (total R</span></span>² values: ours 0.922 vs. 0.923, <em>P</em> = .893; ours 0.922 vs. 0.925, <em>P</em> = .727), and outperformed the model that excluded body weight (total R² values: ours 0.922 vs. 0.855, <em>P</em> &lt; .001). Receiver operating characteristic analysis identified 78.1 kg (body mass index [BMI] of 28.5 kg/m²<span>) as the optimal cutoff for predicting underestimation of daily albuminuria<span> 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 R</span></span>²: 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).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 5","pages":"Pages 607-615"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","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":"Does Protein Intake Have a Significant Impact on eGFR?","authors":"Ying Guo,&nbsp;Yizhe Xin,&nbsp;Rujia Wang,&nbsp;Bin Fu","doi":"10.1053/j.jrn.2025.02.009","DOIUrl":"10.1053/j.jrn.2025.02.009","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 5","pages":"Pages 692-693"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145362","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":"Serum Phosphate Levels and Mortality in Incident Hemodialysis Patients: A National Retrospective Cohort Study","authors":"Mariana Mazzei Caiado Bressan MD ,&nbsp;Elisa de Albuquerque Sampaio MD, PhD ,&nbsp;Ricardo de Castro Cintra Sesso MD, PhD ,&nbsp;Jocemir Ronaldo Lugon MD, PhD","doi":"10.1053/j.jrn.2024.10.003","DOIUrl":"10.1053/j.jrn.2024.10.003","url":null,"abstract":"<div><h3>Objectives</h3><div>Mineral and bone disorders are frequent in patients in hemodialysis (HD) but a definite association of serum phosphate levels with mortality in this population is still an unmet issue. We assessed the association of three phosphate-level ranges with mortality in incident HD patients.</div></div><div><h3>Methods</h3><div>This national registry-based retrospective cohort study included 6214 incident adult patients on HD for &gt;3 months. Data were collected from January 2011 to December 2018. The serum phosphate levels, represented by the median levels over the course of the entire HD treatment, were stratified into 3 ranges: &lt;3.5 mg/dL, 3.5-5.5 mg/dL, and &gt;5.5 mg/dL. The main outcome was 4-year all-cause mortality.</div></div><div><h3>Results</h3><div>The frequencies of cases in the lower, intermediate, and higher phosphate ranges were 5.8%, 64.6%, and 29.6%, respectively. In the fully adjusted multivariate model, the higher adopted phosphate range but not the lower one showed a significant association with mortality (hazard ratio [HR]: 1.54, 95% confidence interval [95% CI]: 1.21-1.95, <em>P</em>&lt; .001). In the model, sevelamer, alone (HR: 0.44, 95% CI: 0.32-0.60, <em>P</em>&lt; .001) or in combination with calcium-based phosphate binders (HR: 0.63, 95% CI: 0.40-0.98, <em>P</em>= .041), proved protective. In subgroup analyses, the lower adopted phosphate range was significantly associated with mortality only in patients &lt;60 years. In a sensitivity analysis, we evaluated the effect of incremental intervals of 0.5 mg/dL across the phosphate distribution (from &lt;2.0 mg/dL to ≥8.0 mg/dL), when serum phosphate &lt;2.0 mg/dL was strongly associated with mortality (HR: 21.9, 95% CI: 2.99-160.66, <em>P</em>= .002).</div></div><div><h3>Conclusion</h3><div>The study reinforced the association of high phosphate levels with mortality in incident HD patients. The use of sevelamer was associated with a lower mortality rate when compared to the use of calcium-based phosphate binders. The lower adopted phosphate range was only associated with mortality in patients &lt;60 years. In a sensitivity analysis though, phosphate levels below 2.0mg/dl were strongly associated with mortality.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 5","pages":"Pages 672-681"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591633","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":"Relationship Between Frailty, as Assessed Using the Kihon Checklist, and Falls in Hemodialysis Patients: A Multicenter Prospective Cohort Study","authors":"Nobuyuki Shirai PT, PhD ,&nbsp;Naoto Usui PT, PhD ,&nbsp;Daisuke Okamura PT ,&nbsp;Yoichi Sato PT, PhD ,&nbsp;Sho Kojima PT, PhD ,&nbsp;Kenta Mikami PT ,&nbsp;Mizuki Nagashima PT ,&nbsp;Yu Shimano PT ,&nbsp;Nobuhito Shinozaki PT ,&nbsp;Syun Hirukawa PT ,&nbsp;Akihiro Sakuyama PT, PhD ,&nbsp;Yoji Yamada PT, PhD ,&nbsp;Masakazu Saitoh PT, PhD","doi":"10.1053/j.jrn.2025.03.006","DOIUrl":"10.1053/j.jrn.2025.03.006","url":null,"abstract":"<div><h3>Objectives</h3><div><span>Hemodialysis (HD) patients are at a high risk of </span>frailty<span>, falls, and fractures. The Kihon checklist (KCL) consists of physical function, cognitive function, oral function, nutritional status, depressed mood, activities of daily living, and social participation. This study aimed to clarify the association between falls in HD patients and frailty as assessed using the KCL, as well as scores and each domain.</span></div></div><div><h3>Methods</h3><div><span>A multicenter prospective cohort study was conducted across 9 facilities. Frailty was assessed using the KCL. Falls were then monitored for 1 year. Participants were classified into 3 groups based on their KCL scores: robust, prefrailty, and frailty. In the </span>logistic regression analysis, the dependent variables were falls, severe falls, or fractures, whereas the independent variables were group classification, KCL score, or each domain.</div></div><div><h3>Results</h3><div>A total of 403 HD patients (70.0 [60.0-76.0] years, 170 [42.1%] women) were analyzed. During the 1-year follow-up period, 117 (29.0%) patients experienced falls. Prefrailty (odds ratio (OR) 3.00, 95% confidence interval (CI) 1.17-7.71, <em>P</em> &lt; .001) and frailty (OR 6.79, 95% CI 2.69-17.16, <em>P</em> &lt; .001) were independently associated with falls compared with robust patients. Additionally, the KCL score was associated with severe falls (OR 1.15, 95% CI 1.06-1.25, <em>P</em> = .001) and fracture (OR 1.13, 95% CI 1.01-1.28, <em>P</em> = .04). By KCL domain, physical function (OR 3.46, 95% CI 2.06-5.83, <em>P</em> &lt; .001) and cognitive function (OR 1.74, 95% CI 1.09-2.77, <em>P</em> = .02) were independently associated with falls.</div></div><div><h3>Conclusions</h3><div>The KCL may be a useful screening tool for estimating fall and fracture risk in this population.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 5","pages":"Pages 655-662"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744139","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 PhD, RDN, FNKF,&nbsp;Glenn Brietzke MS, RD, LD, CNSC,&nbsp;Rebecca Brody PhD, RD, LD, CNSC,&nbsp;Joachim Sackey PhD","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":"35 5","pages":"Pages 691-692"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","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":"Perceptions of Food and Nutrition Security Among Adults With chronic kidney disease, Nondialysis: A Mixed Method Study","authors":"Jeanette M. Andrade PhD, RDN, FAND ,&nbsp;Katherine Mullis BS ,&nbsp;Pablo Lamino PhD","doi":"10.1053/j.jrn.2025.05.003","DOIUrl":"10.1053/j.jrn.2025.05.003","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 5","pages":"Pages 589-597"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","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":"Authors’ Reply to the Letter to the Editor","authors":"Keiko Kabasawa MD, MPH, PhD,&nbsp;Ribeka Takachi PhD, RD,&nbsp;Michihiro Hosojima MD, PhD,&nbsp;Kazutoshi Nakamura MD,&nbsp;Shoichiro Tsugane MD, PhD,&nbsp;Yumi Ito MD, PhD,&nbsp;Kunihiro Matsushita MD, PhD","doi":"10.1053/j.jrn.2025.05.002","DOIUrl":"10.1053/j.jrn.2025.05.002","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 5","pages":"Pages 693-695"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096770","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":"Availability of Exercise Program, Perceived Exercise Benefits and Barriers, and Exercise Habits in Maintenance Hemodialysis Patients: A Multicenter Cross-sectional Study","authors":"Huagang Hu PhD ,&nbsp;Chanchan Wu PhD ,&nbsp;Pui Hing Chau PhD ,&nbsp;Edmond Pui Hang Choi PhD, MPhil, RN, FAAN","doi":"10.1053/j.jrn.2025.03.009","DOIUrl":"10.1053/j.jrn.2025.03.009","url":null,"abstract":"<div><h3>Objective</h3><div>Exercise resources and patients’ perceptions of exercise play a crucial role in influencing exercise participation among maintenance hemodialysis (MHD) patients. However, limited research has explored the availability of exercise programs, patients’ exercise perceptions, and their exercise habits. This study aimed to characterize the availability of exercise programs, patients’ exercise perception, and exercise habits, as well as to examine the associations of these factors in this population.</div></div><div><h3>Methods</h3><div>This multicenter cross-sectional study surveyed 722 MHD patients from 74 dialysis units across China. A structured questionnaire was used to collect data on sociodemographics, exercise habits, and responses to the Dialysis Patient-Perceived Exercise Benefits and Barriers Scale (DPEBBS) from patients. Additional information about the availability of exercise programs in dialysis units was also gathered. Data were analyzed using independent sample <em>t</em>-tests, linear mixed models, and multiple logistic regression analyses.</div></div><div><h3>Results</h3><div>Only 23.0% of dialysis units offered exercise programs. Overall, 65.7% of participants reported regular exercise. The availability of exercise programs was significantly associated with higher DPEBBS scores. MHD patients with higher DPEBBS benefits and barriers scores were more likely to exercise regularly. Furthermore, patients from dialysis units with exercise programs demonstrated significantly greater levels of exercise participation compared to those from units without such programs.</div></div><div><h3>Conclusions</h3><div>Less than one-fourth of dialysis units provide exercise programs for MHD patients, underscoring the need for broader implementation of these programs. Health-care providers and policymakers should prioritize promoting exercise programs, improving patients’ perceptions of exercise, and addressing barriers to increasing exercise participation among MHD patients.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 5","pages":"Pages 568-577"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006048","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 MD,&nbsp;Min-Sheng Lu MD,&nbsp;Wei-Yang Lee MD,&nbsp;Ping-Chen Wang BSc,&nbsp;Chih-Chung Shiao MD","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":"35 5","pages":"Pages 690-691"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","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":"Association Between Probiotic, Prebiotic, Synbiotics, and Yogurt Supplements and Diabetic Kidney Disease: The National Health and Nutrition Examination Survey 2007–2016","authors":"Wencong Guo MD ,&nbsp;Yancheng Song MD ,&nbsp;Yan Sun MM ,&nbsp;Changying Li MM ,&nbsp;Huasheng Du MM ,&nbsp;Qingqing You MM ,&nbsp;Yan Cai MM ,&nbsp;Yanhua Lang MBBS ,&nbsp;Leping Shao MD, PhD","doi":"10.1053/j.jrn.2025.03.008","DOIUrl":"10.1053/j.jrn.2025.03.008","url":null,"abstract":"<div><h3>Objective</h3><div><span><span><span>Diabetic kidney disease (DKD) is the most prevalent of </span>chronic renal disease<span> and the leading cause of end-stage renal disease worldwide, primarily attributed to the increasing prevalence of Type 2 diabetes mellitus (T2DM). We aimed to investigate potential associations between the consumption of </span></span>probiotics<span>, prebiotics, </span></span>synbiotics, and yogurt and DKD, addressing a critical gap in current research concerning dietary interventions and renal health outcomes.</div></div><div><h3>Methods</h3><div><span>We conducted a cross-sectional study among adults with T2DM in the National Health and Nutrition Examination Survey from 2007 to 2016. Weighted univariate </span>logistic regression analysis<span><span>, subgroup analysis, and interaction analysis were conducted to assess the relationship between probiotics, </span>prebiotics<span>, synbiotics, yogurt supplements and DKD. In addition, the restricted cubic spline analysis was applied to assess potential nonlinear relationships between yogurt supplements and DKD.</span></span></div></div><div><h3>Results</h3><div>The study included 2,665 individuals, of whom 1,044 (39.2%) had a diagnosis of DKD. Multivariable logistic regression indicated an independent association between probiotic, prebiotic, synbiotic, or yogurt intake and a reduced risk of DKD after adjusting for covariates (odds ratio = 0.71, 95% confidence interval: 0.52-0.96, <em>P</em><span><span><span><span> = .03). Subgroup analysis results indicated inconsistencies in the correlations between DKD and probiotics, prebiotics, </span>synbiotics, or yogurt. Interaction analysis showed that age, gender, urine albumin-to-creatinine ratio, estimated </span>glomerular filtration rate, </span>body mass index<span>, hypertension, hyperlipidemia, or antibiotic therapy had no significantly influence on the positive correlation (all </span></span><em>P</em> &gt; .05). The restricted cubic spline model indicated no nonlinear relationship between yogurt intake and DKD.</div></div><div><h3>Conclusion</h3><div>Our findings indicated significant inverse associations between probiotic, prebiotic, synbiotics, or yogurt supplements and DKD prevalence in T2DM patients. Further large-scale studies with extended follow-up periods are warranted to confirm these findings and develop evidence-based dietary guidelines for clinical practice.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 5","pages":"Pages 616-627"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047911","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}