Journal of Renal Nutrition最新文献

{"title":"Handheld Dynamometry Testing During Dialysis: Intrarater and Interrater Reliability Study.","authors":"Eva Segura-Ortí, Anna Junqué-Jiménez, Valentin Dubuis, Maycon M Reboredo, Vicente Benavent-Caballer, Noemi Valtueña-Gimeno, Fabricio Sciammarella Barros, Daniela Thomé Silva, Francisco J Martinez-Olmos","doi":"10.1053/j.jrn.2025.01.002","DOIUrl":"10.1053/j.jrn.2025.01.002","url":null,"abstract":"<p><strong>Objectives: </strong>The aim was to assess the intrarater and interrater reliability of the handheld dynamometry testing of lower limb muscles during hemodialysis.</p><p><strong>Methods: </strong>This is a cross-sectional study including subjects undertaking hemodialysis for at least 3 months. Handheld dynamometer measurements of hip and ankle muscle strength (N) were registered on 4 different occasions, 2 trials by raters A and 2 by raters B, to evaluate the intrarater and interrater reliability. Bland-Altman plots were constructed to examine the agreement between raters by scoring the difference between raters against the mean of both raters' scores. The intraclass correlation coefficient was used to assess relative intrarater and interrater reliability. Absolute reliability was assessed with the minimal detectable change.</p><p><strong>Results: </strong>Fifty-six participants (median age, 67 years) data showed high to very high relative reliability (intraclass correlation coefficients 0.75-0.98). Regarding the intrarater absolute reliability, minimal detectable change score 90% confidence interval values ranged from 27.0 to 41.6.5 N (0.14-0.26 N/kg m²) for hip muscles but increased for ankle muscles. Interrater values were wider. The mean difference between trials ranged narrowly across the two-time points for raters A (1.0-19.3 N) and for raters B (1.3 - 11.4 N). The mean difference between raters ranged from 2.4 to 13.5 N. The Bland-Altman plot revealed a systematic bias for raters A in ankle plantar flexion.</p><p><strong>Conclusions: </strong>The assessment of the hip flexion and abduction strength during dialysis with a handheld dynamometer is reliable and safe. Normalized data provides more reliable results.</p>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048761","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":"Nutritional Status Modifies the Association Between Hemoglobin Level and Mortality in Older Patients Undergoing Hemodialysis: A Nationwide Dialysis Registry in Japan.","authors":"Takaaki Kosugi, Takeshi Hasegawa, Takahiro Imaizumi, Hiroki Nishiwaki, Hirokazu Honda, Yasuhiko Ito, Kazuhiko Tsuruya, Masanori Abe, Norio Hanafusa, Takahiro Kuragano","doi":"10.1053/j.jrn.2025.01.003","DOIUrl":"10.1053/j.jrn.2025.01.003","url":null,"abstract":"<p><strong>Objectives: </strong>Anemia is a common complication associated with adverse outcomes in older patients undergoing hemodialysis (HD). They also tend to experience malnutrition, which can affect the course of anemia. We hypothesized that the optimal hemoglobin (Hb) level varies depending on nutritional status in older patients undergoing HD and aimed to investigate the association between Hb levels and mortality according to nutritional status.</p><p><strong>Methods: </strong>This is an observational study utilizing a nationwide Japanese database from 2019 to 2021. This study included 95,771 patients aged ≥75 years undergoing HD thrice a week. The nutritional risk index for Japanese hemodialysis patients (NRI-JH) was calculated. The association between Hb levels and mortality was investigated using Cox regression analysis stratified by NRI-JH. A nonlinear relationship was investigated using restricted cubic spline analysis.</p><p><strong>Results: </strong>During a median follow-up period of 24 months, 27,611 patients died. In the low-risk NRI-JH group, the risk of all-cause mortality was higher in the Hb categories of <9.0, 9.0-9.9, and ≥13 g/dL compared to the reference Hb category of 10-10.9 g/dL, with the adjusted hazard ratios and 95% confidence intervals of 1.45 (1.32-1.59), 1.15 (1.08-1.22), and 1.18 (1.07-1.29), respectively. In contrast, the impact of Hb levels on mortality was significantly attenuated in the high-risk NRI-JH group, with a mild increased risk in the <9.0 g/dL category (adjusted hazard ratio, 1.07; 95% confidence interval, 1.01-1.15).</p><p><strong>Conclusion: </strong>Among older patients undergoing HD, the impact of Hb levels on mortality was attenuated in the high-risk NRI-JH group.</p>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048762","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 of Physical Activity and Cardiorespiratory Fitness With Incident Chronic Kidney Disease in a Korean Population.","authors":"Yunmin Han, Sungjae Yoon, Soomin Lee, Younghwan Choi, Geonhui Kim, Duck-Chul Lee, Youngwon Kim, Ga-Young Lim, Ria Kwon, Yoosoo Chang, Seungho Ryu, Jeonggyu Kang, Yeon Soo Kim","doi":"10.1053/j.jrn.2024.12.009","DOIUrl":"10.1053/j.jrn.2024.12.009","url":null,"abstract":"<p><strong>Objective: </strong>This large cohort study aimed to examine the overall associations of physical activity (PA) and estimated cardiorespiratory fitness (eCRF) with incident chronic kidney disease (CKD).</p><p><strong>Methods: </strong>This study included a total of 274,292 participants (mean age, 37.9 ± 8.0 years; 41% women) using data collected from the Kangbuk Samsung Health Study. The participants were categorized into three groups: PA (inactive, insufficiently active, and active) and eCRF(low, middle, high). Furthermore, subgroup analyses were conducted to examine the differences in the risks of CKD incidence by age and sex. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs).</p><p><strong>Results: </strong>A total of 932 participants (0.34%) developed CKD. PA level was not associated with CKD risk in the overall cohort. However, younger participants (<45 years) showed lower CKD risks, with HRs of 0.53 (95% CI: 0.36-0.79) and 0.73 (95% CI: 0.53-1.00) for insufficiently active and active individuals, respectively. Similarly, men exhibited reduced CKD risks, with HRs of 0.77 (95% CI: 0.59-1.00) and 0.81 (95% CI: 0.66-1.00) in these groups. Additionally, those in the high eCRF group had a 20% reduced CKD risk (HR, 0.80; 95% CI: 0.67-0.96) compared to the low eCRF group.</p><p><strong>Conclusions: </strong>The associations between PA or eCRF and incident CKD showed differences according to age and sex.</p>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015114","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":"The Development and Testing of an Educational Video for Patients With End Stage Kidney Disease Receiving Dialysis in Two Tertiary Hospitals in Cape Town.","authors":"Hannelise Rademan, Zarina Ebrahim, Nazeema Esau","doi":"10.1053/j.jrn.2024.12.008","DOIUrl":"10.1053/j.jrn.2024.12.008","url":null,"abstract":"<p><strong>Objectives: </strong>Medical nutrition therapy plays a crucial role in managing end-stage kidney disease. Nutrition education should be comprehensible, positive, and actionable. Storytelling can provide context, aid comprehension and retention of new information, and foster a sense of connection among patients. The study aimed to develop a video based on the \"Healthy Eating in Kidney Disease\" infographic and to test the knowledge of patients before and after watching the video. The study investigated the association between factors such as the number of years receiving dialysis, income, and education level on pre- and postvideo scores.</p><p><strong>Methods: </strong>This experimental before-after study developed an animated nutrition education video based on the South African-based infographic \"Healthy Eating for Kidney Disease\" in collaboration with an animator and the researchers. The video was designed in animated format in English, Afrikaans, and isiXhosa. The developed video was used to test participants' knowledge by using the same questionnaire before and after watching the video.</p><p><strong>Results: </strong>The developed video was tested on 125 participants undergoing peritoneal dialysis or hemodialysis. Participants had a mean age of 42.06 (±standard deviation 10.99) years. Predominantly, participants used isiXhosa (n = 62, 50.8%) as their primary language, followed by Afrikaans and English. Most participants (65.6%; n = 82) exhibited adequate prevideo knowledge scores, with a mean score of 67.73%. Postvideo, the majority (59.2%; n = 74) achieved good knowledge scores with a mean of 82.32%. Noteworthy improvements were observed in knowledge categories postintervention, reflecting a significant positive change (P < .001), with a mean increase of 14.59%.</p><p><strong>Conclusion: </strong>The educational animated video for end-stage kidney disease patients was successfully developed and tested. The results indicated the video's effectiveness in enhancing participants' knowledge. Although no correlations emerged between knowledge scores and demographic factors, the study suggests that video-based education holds promise in encouraging behavioural changes and improving health outcomes.</p>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967378","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 Protein Intake With Discordance Between Cystatin C- and Creatinine-Based Estimated Glomerular Filtration Rates in Community-dwelling Japanese Adults.","authors":"Keiko Kabasawa, Ribeka Takachi, Michihiro Hosojima, Tomoyo Komata, Kazutoshi Nakamura, Norie Sawada, Shoichiro Tsugane, Yumi Ito, Junta Tanaka, Ichiei Narita, Kunihiro Matsushita","doi":"10.1053/j.jrn.2024.12.007","DOIUrl":"10.1053/j.jrn.2024.12.007","url":null,"abstract":"<p><strong>Objective: </strong>Recent studies have reported the prognostic implications of the discordance between creatinine-based and cystatin C-based estimated glomerular filtration rates (eGFR_cr and eGFR_cys, respectively); however, the associations of protein intake with the eGFR discordance have not been investigated. The present study investigated whether protein intake was associated with the discordance between eGFR_cr and eGFR_cys.</p><p><strong>Design and methods: </strong>We cross-sectionally analyzed data from a Japanese community-based cohort including 6,143 participants (50.7% women; age range, 40-97 years). Protein intake was estimated by food groups derived from a validated food frequency questionnaire. As a measure of discordance, we modeled the ratio of eGFR_cys and eGFR_cr (eGFR_cys divided by eGFR_cr) continuously in multivariable linear regression models and categorically (<0.8, 0.8-1.1, and ≥1.2) in multinomial logistic regression models. We analyzed men and women separately given their distinct dietary patterns.</p><p><strong>Results: </strong>The mean eGFR ratio was 1.15 in men and 1.19 in women. In multivariable linear regression analysis, total protein was positively associated with the eGFR ratio in men (regression coefficient, 0.005 [95% confidence interval, 0.003, 0.007]). When animal and plant proteins were analyzed separately, a significant positive association was seen for animal protein only in men (0.005 [0.003, 0.007]). The results were similar when we modeled protein intake categorically by multinomial logistic regression.</p><p><strong>Conclusion: </strong>This study suggests intake of dietary protein, especially animal protein in men, as a determinant of eGFR discordance. Future studies exploring eGFR discordance and health outcomes should consider simultaneously assessing dietary protein intake.</p>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933406","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":"Tenapanor: A Phosphate Absorption Inhibitor for the Management of Hyperphosphatemia in Patients With Kidney Failure","authors":"Kathleen M. Hill Gallant PhD, RD ,&nbsp;Stuart M. Sprague DO ,&nbsp;David P. Rosenbaum PhD ,&nbsp;David M. Spiegel MD ,&nbsp;Kenji Kozuka MS ,&nbsp;Susan Edelstein PhD ,&nbsp;Glenn M. Chertow MD, MPH","doi":"10.1053/j.jrn.2024.07.003","DOIUrl":"10.1053/j.jrn.2024.07.003","url":null,"abstract":"<div><div>Because of increased risks of cardiovascular disease and death, patients with hyperphosphatemia receiving maintenance dialysis are advised to limit phosphorus consumption and are prescribed phosphate binders in an effort to better control serum phosphate concentrations. Because of large pill size, pill burden, and tolerability issues, phosphate binder adherence is relatively poor. On ingestion, phosphate is absorbed from the intestine via transcellular or paracellular transport. Data show that inhibiting sodium-hydrogen exchanger 3 modulates paracellular phosphate absorption (the predominant pathway in humans). Tenapanor is a first-in-class, minimally absorbed, phosphate absorption inhibitor that selectively inhibits sodium-hydrogen exchanger 3, with a mechanism distinct from, and complementary to, that of phosphate binders. In phase 3 and postregistrational studies, tenapanor conferred statistically significant and clinically meaningful reductions in serum phosphate in patients receiving maintenance dialysis with hyperphosphatemia. Here, we review the available preclinical and clinical data on the effects of tenapanor on controlling intestinal phosphate absorption.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 1","pages":"Pages 25-34"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591894","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":"Nutritional and Inflammatory Aspects of Low Parathyroid Hormone in Maintenance Hemodialysis Patients—A Longitudinal Study","authors":"Shani Zilberman-Itskovich MD ,&nbsp;Baker Algamal MD ,&nbsp;Ada Azar BSc ,&nbsp;Shai Efrati MD ,&nbsp;Ilia Beberashvili MD","doi":"10.1053/j.jrn.2024.05.007","DOIUrl":"10.1053/j.jrn.2024.05.007","url":null,"abstract":"<div><h3>Background</h3><div>Low serum parathyroid hormone (PTH) is an accepted marker for adynamic bone disease which is characterized by increased morbidity and mortality in maintenance hemodialysis (MHD) patients. In light of the known cross-sectional associations between PTH and malnutrition-inflammation syndrome, we aimed to examine the longitudinal associations between PTH with changes in nutritional and inflammatory parameters and clinical outcomes in MHD patients with low PTH.</div></div><div><h3>Methods</h3><div>This historical prospective and longitudinal study analyzed a clinical database at a single hemodialysis center, containing the medical records of 459 MHD patients (mean age of 71.4 ± 12.9 years old, 171 women), treated between the years 2007-2020. Bone turnover, nutritional and inflammatory marker levels were recorded at 0, 6, 12, 18, 24, 30, and 36 months followed by a median of 24 additional months of clinical observations. According to previous use of vitamin D analogs and/or calcium-sensing receptor agonists, the study participants were divided into treatment-related and disease-related groups. A linear mixed effects model was adjusted for baseline demographics and clinical parameters.</div></div><div><h3>Results</h3><div>Of 459 MHD patients, 81 (17.6%) had PTH lower than 150pg/mL. Among them, 30 patients had treatment-related and 51 had disease-related low PTH. At baseline, MHD patients with treatment-related low PTH had a higher rate of diabetes compared to the disease-related group. In a linear mixed effects model, increased PTH over time was associated with decreased levels of alkaline phosphatase and C-reactive protein and with increased hemoglobin and albumin, but not the geriatric nutritional risk index at 3-year follow-up. The survival rate did not differ between the groups, with the risk of hospitalizations due to fractures being higher (HR: 4.04 with 95% CI: 1.51-10.8) in the disease-related group. Statistical significance of this association was abolished after adding C-reactive protein or alkaline phosphatase to the multivariate models.</div></div><div><h3>Conclusions</h3><div>Low serum PTH in MHD patients behaves differently depending on its cause, with a higher risk of fractures in the disease-related group. This association is dependent on inflammation. Our results should be verified in larger epidemiological studies.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 1","pages":"Pages 136-145"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288849","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":"Saltiness Perception and Sodium Intake in Patients With Chronic Kidney Disease","authors":"Elisa Russo MD,&nbsp;Giacomo Garibotto MD,&nbsp;Linda W. Moore PhD, RDN","doi":"10.1053/j.jrn.2024.12.005","DOIUrl":"10.1053/j.jrn.2024.12.005","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 1","pages":"Pages 1-3"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873392","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 High-Density Lipoprotein Cholesterol and Mortality in Elderly Hemodialysis Patients: Data From the Korean Society of Geriatric Nephrology Retrospective Cohort","authors":"Seung Hye Chu MD ,&nbsp;Eun Hee Park MD ,&nbsp;Haekyung Lee MD, PhD ,&nbsp;Yu Ah Hong MD, PhD ,&nbsp;Woo Yeong Park MD, PhD ,&nbsp;Jang-Hee Cho MD, PhD ,&nbsp;In O Sun MD, PhD ,&nbsp;Won Min Hwang MD, PhD ,&nbsp;Soon Hyo Kwon MD, PhD ,&nbsp;Jin Seok Jeon MD, PhD ,&nbsp;Hyunjin Noh MD, PhD ,&nbsp;Kyung Don Yoo MD, PhD ,&nbsp;Hyoungnae Kim MD, PhD","doi":"10.1053/j.jrn.2024.05.003","DOIUrl":"10.1053/j.jrn.2024.05.003","url":null,"abstract":"<div><h3>Objectives</h3><div>The association between high-density lipoprotein (HDL) cholesterol levels and mortality in elderly patients undergoing hemodialysis is not well established. Thus, this study investigated HDL levels and mortality in elderly Korean patients undergoing hemodialysis.</div></div><div><h3>Methods</h3><div>We recruited 1860 incident hemodialysis patients aged greater than 70 years from a retrospective cohort of the Korean Society of Geriatric Nephrology. The primary outcome measure was all-cause mortality.</div></div><div><h3>Results</h3><div>The mean age of the cohort was 77.8 years, and 1049 (56.4%) were men. When we grouped the patients into HDL cholesterol tertiles, the T1 group (HDL level &lt;30 mg/dL in men and &lt;33 mg/dL in women) had a higher proportion of patients with end-stage kidney disease due to diabetic nephropathy. During the median follow-up period of 3.1 years, 1109 (59.7%) deaths occurred. In a multivariable Cox regression model, the T1 group had a significantly higher risk of mortality (hazard ratio [HR], 1.28; 95% confidence interval, 1.10-1.50; <em>P</em> = .002) compared to the T3 group. A nonlinear analysis using a restrictive spline curve showed that low HDL cholesterol levels were associated with increased HR when HDL cholesterol levels were &lt;40 mg/dL; however, there was no association between HDL cholesterol and mortality when HDL cholesterol levels were &gt;40 mg/dL. Triglyceride/HDL ratio was not significantly associated with the risk of mortality (HR per 1 log increase, 1.08; 95% confidence interval, 0.99-1.18; <em>P</em> = .069).</div></div><div><h3>Conclusions</h3><div>Low HDL cholesterol levels are associated with an increased risk of mortality in elderly patients undergoing hemodialysis. However, there was no significant relationship between HDL cholesterol levels and mortality when levels were below 40 mg/dL. Therefore, low HDL cholesterol levels may be a useful risk factor for predicting mortality in elderly patients undergoing hemodialysis.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 1","pages":"Pages 128-135"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181202","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":"Impaired Saltiness Perception Contributes to Higher Sodium Intake Among Patients With Chronic Kidney Disease: A Cross-Sectional Two-Center Study","authors":"Seiji Kobayashi MD, PhD ,&nbsp;Hoichi Amano MD ,&nbsp;Hiroyuki Terawaki MD, PhD ,&nbsp;Yoshindo Kawaguchi MD, PhD","doi":"10.1053/j.jrn.2024.08.002","DOIUrl":"10.1053/j.jrn.2024.08.002","url":null,"abstract":"<div><h3>Objective</h3><div>Dietary sodium restriction is important in the prognosis of patients with chronic kidney disease (CKD). The association between saltiness perception and sodium intake among CKD patients is unclear, and the factors that influence saltiness are also not fully understood. We evaluated saltiness perception in CKD patients employing a cost-effective saltiness perception test using sodium solutions and evaluated the association between saltiness perception, sodium intake, and the influencing factors.</div></div><div><h3>Design and Methods</h3><div>CKD outpatients not undergoing dialysis were enrolled from two medical centers and underwent saltiness perception tests together with 24-hour urine collections to measure daily sodium intake. Participants who perceived saltiness using the test solution containing 25 mM sodium were regarded to have “preserved” saltiness perception, while those unable to perceive saltiness were regarded as having “impaired” saltiness perception.</div></div><div><h3>Results</h3><div>Of the total 132 participants, the median daily sodium intake was 3.36 g (range; 0.51-9.95 g/day), and 43 (32.6%) were ex- or current smokers. When participants were divided into 3 groups (G) according to daily sodium intake level: low (G1; 0.51-2.61 g/day), middle (G2; 2.62-3.99 g/day), and high (G3; 4.06-9.95 g/day), there was an obvious difference in impaired saltiness perception between three groups: 6.8% in G1, 50.0% in G2 and 86.4% in G3 (<em>P</em> value = 8.035 × 10⁻¹⁴, Cochran–Armitage test). In a multiple regression analysis in which the saltiness perception was adopted as a subjective variable, smoking habit (ex- or current smoker) and nonadherence to dietary sodium restriction were identified as significant explanatory variables.</div></div><div><h3>Conclusion</h3><div>We revealed the clear relationship between higher daily sodium intake and impaired saltiness perception that is related to nonadherence to dietary sodium restriction and smoking habit, both of which could be intervened by nutritional counseling and public health education.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 1","pages":"Pages 103-109"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057035","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}