Journal of Renal Nutrition最新文献

{"title":"Accuracy of Current Large Language Models and the Retrieval-Augmented Generation Model in Determining Dietary Principles in Chronic Kidney Disease","authors":"Feray Gençer Bingöl PhD ,&nbsp;Duygu Ağagündüz PhD ,&nbsp;Mustafa Can Bingol PhD","doi":"10.1053/j.jrn.2025.01.004","DOIUrl":"10.1053/j.jrn.2025.01.004","url":null,"abstract":"<div><h3>Objective</h3><div>Large language models (LLMs) have emerged as powerful tools with significant potential for quickly accessing information in the nutrition and health, as in many fields. Retrieval-augmented generation (RAG) has been included among artificial intelligence (AI) powered chatbot structures as a framework developed to increase the accuracy and ability of LLMs. This study aimed to evaluate the accuracy of LLMs (Generative Pre-trained Transformer 4, Gemini, and Llama) and RAG in determining dietary principles in chronic kidney disease.</div></div><div><h3>Design and Methods</h3><div>The nutrition guideline published by the National Kidney Foundation in 2020 was used as an external information source in developed RAG model. Answers were obtained using 12 medical nutritional therapy prompts for chronic kidney disease by four chatbots. The accuracy of the 48 answers generated by the chatbots was evaluated with a 5-point Likert scale.</div></div><div><h3>Results</h3><div>The results showed that Gemini and RAG had the highest accuracy scores (median: 4.0), followed by Generative Pre-trained Transformer 4 (median: 2.5) and Llama (median: 1.5), respectively. When the accuracy scores were examined between the two chatbots, a significant difference was detected between all groups except Gemini and RAG.</div></div><div><h3>Conclusion</h3><div>These chatbots produced both completely correct answers and false information with potentially harmful clinical outcomes. Customization of LLMs in specific areas such as nutrition or the development of a nutrition-specific RAG framework by improving LLM structures with current guidelines and articles may be an important strategy to increase the accuracy of AI powered chatbots.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 3","pages":"Pages 401-409"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048759","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 Discordance Between Creatinine-Based and Cystatin C-Based Estimated Glomerular Filtration Rate: A Matter of Protein Intake?","authors":"Michela Saio MD,&nbsp;Giacomo Garibotto MD,&nbsp;Linda W. Moore PhD, RDN","doi":"10.1053/j.jrn.2025.03.007","DOIUrl":"10.1053/j.jrn.2025.03.007","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 3","pages":"Pages 375-377"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774683","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":"Hypomagnesemia is a Risk Factor for Acute Kidney Injury in Patients Admitted With ST-Segment Elevation Myocardial Infarction: A Retrospective Observational Study","authors":"Youkai Jin ,&nbsp;Qingcheng Lin ,&nbsp;Dingzhou Wang ,&nbsp;Mengge Gong ,&nbsp;Weijian Huang ,&nbsp;Peiren Shan ,&nbsp;Dongjie Liang","doi":"10.1053/j.jrn.2024.12.006","DOIUrl":"10.1053/j.jrn.2024.12.006","url":null,"abstract":"<div><h3>Objectives</h3><div>Acute kidney injury (AKI) is prevalent in patients hospitalized with ST segment elevation myocardial infarction (STEMI) and is correlated with worse cardiovascular outcomes. Hypomagnesemia has been found to be associated with an elevated risk of AKI in various patient populations. Nonetheless, the relationship between hypomagnesemia and AKI incidence in patients with STEMI has not been fully elucidated. The study aims to investigate the association between admission serum magnesium levels and the development of AKI in patients with STEMI.</div></div><div><h3>Design and Methods</h3><div>A total of 1,219 patients with STEMI were retrospectively included in this study and assigned to the hypomagnesemia and nonhypomagnesemia groups. Hypomagnesemia was defined as a serum magnesium level &lt;0.75 mmol/L. The primary study outcome was AKI Incidence during hospitalization. Univariate and multivariate logistic regression analyses were conducted to assess the association between serum magnesium levels and AKI incidence.</div></div><div><h3>Results</h3><div>Overall, 163 patients (13.4%) met the hypomagnesemia criteria, and 256 (21.0%) patients developed AKI. The AKI incidence was significantly higher in the hypomagnesemia group compared to the nonhypomagnesemia group (31.9% vs. 19.3%; <em>P</em> &lt; .001). Multivariate logistic analysis, adjusted for demographic characteristics and other confounding variables, revealed that hypomagnesemia is a risk factor for AKI (odds ratio: 2.41, 95% confidence interval: 1.61-3.62; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Hypomagnesemia at admission is an independent predictor for AKI occurrence in patients with acute STEMI. Therefore, interventions targeting serum magnesium levels to mitigate AKI risk may warrant clinical consideration.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 3","pages":"Pages 387-392"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899993","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":"Handheld Dynamometry Testing During Dialysis: Intrarater and Interrater Reliability Study","authors":"Eva Segura-Ortí PhD, PT ,&nbsp;Anna Junqué-Jiménez PhD, RN ,&nbsp;Valentin Dubuis PT ,&nbsp;Maycon M. Reboredo PhD, PT ,&nbsp;Vicente Benavent-Caballer PhD, PT ,&nbsp;Noemi Valtueña-Gimeno PhD, PT ,&nbsp;Fabricio Sciammarella Barros MSc, PT ,&nbsp;Daniela Thomé Silva PT ,&nbsp;Francisco J. Martinez-Olmos PhD, PT","doi":"10.1053/j.jrn.2025.01.002","DOIUrl":"10.1053/j.jrn.2025.01.002","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim was to assess the intrarater and interrater reliability of the handheld dynamometry testing of lower limb muscles during hemodialysis.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 3","pages":"Pages 433-442"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","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":"Association of Protein Intake With Discordance Between Cystatin C- and Creatinine-Based Estimated Glomerular Filtration Rates in Community-dwelling Japanese Adults","authors":"Keiko Kabasawa MD, MPH, PhD ,&nbsp;Ribeka Takachi PhD, RD ,&nbsp;Michihiro Hosojima MD, PhD ,&nbsp;Tomoyo Komata RD ,&nbsp;Kazutoshi Nakamura MD ,&nbsp;Norie Sawada MD, PhD ,&nbsp;Shoichiro Tsugane MD, PhD ,&nbsp;Yumi Ito MD, PhD ,&nbsp;Junta Tanaka MD, PhD ,&nbsp;Ichiei Narita MD, PhD ,&nbsp;Kunihiro Matsushita MD, PhD","doi":"10.1053/j.jrn.2024.12.007","DOIUrl":"10.1053/j.jrn.2024.12.007","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Design and Methods</h3><div>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 (&lt;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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 3","pages":"Pages 378-386"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","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":"The Effect of Egg White Meal on Anemia in Patients on Hemodialysis Taking Erythropoietin and Iron Infusion","authors":"Jalal Azmandian MD ,&nbsp;Najmeh Shamspour MD ,&nbsp;Ali Azmandian MD ,&nbsp;Habibeh Ahmadipour MD ,&nbsp;Tahereh Alinaghi Langari MD","doi":"10.1053/j.jrn.2024.06.003","DOIUrl":"10.1053/j.jrn.2024.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>Eggs are a useful and cheap food source. We evaluated the effects of egg white meal on anemia in dialysis patients.</div></div><div><h3>Methods</h3><div>In an open-label, clinical trial, conducted in dialysis centers, 107 hemodialysis patients aged ≥ 18 years with hemoglobin levels below 12 g/dL and requiring treatment with artificial erythropoietin and iron infusion were included in the study. They were divided into a control and an intervention group. The participants in the intervention group consumed an egg white pack (containing 6 egg whites, 96 calories, 24 g protein) as a substitute for meat products 3 days a week for 8 weeks. Finally, changes in serum albumin, hemoglobin, ferritin and iron/total iron-binding capacity, erythropoietin dose, and iron infusion dose were measured.</div></div><div><h3>Results</h3><div>A total of 107 dialysis patients were studied (55 patients in egg white and 52 in control groups) with the mean age of 54.31 ± 16.35 years and male majority (57.90%). The mean of hemoglobin concentration had no statistically significant difference at baseline (<em>P</em> = .13) and after 4 weeks (<em>P</em> = .48), while after 8 weeks, the mean hemoglobin concentration in the intervention group was significantly higher than the control group (<em>P</em> = .03). Mean of synthetic erythropoietin dose after 4 and 8 weeks was significantly lower in the intervention group compared to the control group (<em>P</em> = .30, <em>P</em> = .001). Lower Erythropoietin Resistance Index values in intervention group were significantly higher than the control group (<em>P</em> = .02).</div></div><div><h3>Conclusion</h3><div>We observed that consumption of egg whites led to an increase in mean hemoglobin concentration, serum iron, and albumin levels. These results suggest that egg whites could be a useful dietary intervention for dialysis patients with anemia.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 3","pages":"Pages 419-424"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428132","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":"Diet Quality, Self-Efficacy, and Health Literacy in Adults With Chronic Kidney Disease: A Cross-Sectional Study","authors":"Erynn A. McAuley BNutDiet(Hons) ,&nbsp;Lynda A. Ross PhD ,&nbsp;Mary T. Hannan-Jones PhD ,&nbsp;Helen L. MacLaughlin PhD","doi":"10.1053/j.jrn.2024.06.005","DOIUrl":"10.1053/j.jrn.2024.06.005","url":null,"abstract":"<div><h3>Objective</h3><div>Adherence to high-quality dietary patterns is associated with lower risk of disease progression and all-cause mortality in chronic kidney disease (CKD). Self-efficacy and health literacy are recognized as factors that may lead to better adherence to high-quality diets. However, these associations are not well studied in CKD. This study aims to explore the relationship between health literacy, self-efficacy, and diet quality in CKD.</div></div><div><h3>Methods</h3><div>Participants with CKD stages 3a-5 recruited from 3 large tertiary hospitals were assessed using the Self-Efficacy for Managing Chronic Disease 6-item scale, the Health Literacy Questionnaire, and the Australian Eating Survey Food Frequency Questionnaire. Diet quality was measured using the Australian Recommended Food Score. Associations were examined using multivariable linear regression models, adjusted for sex and type 2 diabetes diagnosis.</div></div><div><h3>Results</h3><div>Sixty participants were included in the analysis. Mean age of participants was 74.5 years and 58% were male. The mean Australian Recommended Food Score was poor (mean = 29.9 ± 9.1/73) and characterized by high intake of Processed foods and animal protein, and low intake of fruit and vegetables. Mean Self-Efficacy for Managing Chronic Disease 6-item scale was high (7.12 ± 2.07/10). Self-efficacy and health literacy domains 6 - Actively engage with healthcare providers and 7 - Navigating healthcare system independently predicted diet quality in the adjusted model for sex and type 2 diabetes.</div></div><div><h3>Conclusion</h3><div>Adults with CKD report suboptimal diet quality. The results suggest that self-efficacy and aspects of health literacy should be considered when designing interventions aimed at improving diet quality in people with CKD.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 3","pages":"Pages 410-418"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428129","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 BSc Diet, MSc (Therapeutic Nutrition) (RDSA) ,&nbsp;Zarina Ebrahim BSc Diet, MSc (Dietetics and Nutrition), PhD (Nutrition) (SA) ,&nbsp;Nazeema Esau MSc (Dietetics and Nutrition) (SA)","doi":"10.1053/j.jrn.2024.12.008","DOIUrl":"10.1053/j.jrn.2024.12.008","url":null,"abstract":"<div><h3><strong>Objectives</strong></h3><div>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.</div></div><div><h3><strong>Methods</strong></h3><div>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.</div></div><div><h3><strong>Results</strong></h3><div>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 (<em>P</em> &lt; .001), with a mean increase of 14.59%.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 3","pages":"Pages 425-432"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","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":"Nutritional Status Modifies the Association Between Hemoglobin Level and Mortality in Older Patients Undergoing Hemodialysis: A Nationwide Dialysis Registry in Japan","authors":"Takaaki Kosugi MD, PhD ,&nbsp;Takeshi Hasegawa MD, MPH, PhD ,&nbsp;Takahiro Imaizumi MD, PhD ,&nbsp;Hiroki Nishiwaki MD, MPH, PhD ,&nbsp;Hirokazu Honda MD, PhD ,&nbsp;Yasuhiko Ito MD, PhD ,&nbsp;Kazuhiko Tsuruya MD, PhD ,&nbsp;Masanori Abe MD, PhD ,&nbsp;Norio Hanafusa MD, PhD ,&nbsp;Takahiro Kuragano MD, PhD","doi":"10.1053/j.jrn.2025.01.003","DOIUrl":"10.1053/j.jrn.2025.01.003","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 &lt;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 &lt;9.0 g/dL category (adjusted hazard ratio, 1.07; 95% confidence interval, 1.01-1.15).</div></div><div><h3>Conclusion</h3><div>Among older patients undergoing HD, the impact of Hb levels on mortality was attenuated in the high-risk NRI-JH group.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 3","pages":"Pages 443-453"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","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":"Effects of Ketoanalogue Supplements on Patients Receiving Continuous Ambulatory Peritoneal Dialysis: A Multicenter, Randomized, Double-Blinded, Placebo-Controlled Study","authors":"Sixiu Chen ,&nbsp;Li Fan ,&nbsp;Yagui Qiu ,&nbsp;Nan Chen ,&nbsp;Jianghua Chen ,&nbsp;Zhangsuo Liu ,&nbsp;Fei Xiong ,&nbsp;Qingfeng Han ,&nbsp;Haiping Mao ,&nbsp;Jianxiong Lin ,&nbsp;Wei Chen ,&nbsp;Xueqing Yu","doi":"10.1053/j.jrn.2024.11.010","DOIUrl":"10.1053/j.jrn.2024.11.010","url":null,"abstract":"<div><h3>Objectives</h3><div>Evidence of the effects of ketoanalogue supplements on residual kidney function (RKF) in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) is limited. This study aimed to evaluate the efficacy and safety of ketoanalogues in preserving RKF in CAPD patients.</div></div><div><h3>Methods</h3><div>This 1-year multicenter, randomized, double-blinded, placebo (PBO)-controlled trial involved 153 CAPD patients across 6 centers. Patients were randomly assigned to either the keto acid (KA, 100 mg/kg per day) or PBO group, both with a protein intake of 1.0 g/kg ideal body weight. The primary outcome was the changes in RKF, evaluated based on 24-hour creatinine and urea clearance, and secondary outcomes included dialysis adequacy, peritoneal function, nutritional status, and quality-of-life scores.</div></div><div><h3>Results</h3><div>The decline in RKF was 1.89 (0.44, 2.98) and 1.56 (0.35, 3.14) mL/min/1.73 m² in the KA and PBO groups, respectively, with no difference observed (<em>P</em> = .89). There were no differences in dialysis adequacy, peritoneal function, nutritional status, or quality-of-life scores between the groups. In subgroup analyses, for patients with early peritoneal dialysis (PD) initiation, patients in the KA group had a significantly lower decline in RKF compared with the PBO group (1.34 vs. 4.79 mL/min/1.73 m², <em>P</em> = .02); however, there is no significant difference between the groups in patients with late PD initiation (1.89 vs. 1.23 mL/min/1.73 m², <em>P</em> = .17).</div></div><div><h3>Conclusions</h3><div>Ketoanalogues did not reduce the decline in RKF on the basis of a protein-restricted diet in patients receiving CAPD; however, its effect on patients with early PD initiation needs further investigation.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 3","pages":"Pages 463-471"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803130","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}