Meiqiu Wang MD , Zijian Chen BS , Tingting Yu MS , Lianghui You MD , Yingchao Peng MD , Huangyu Chen MS , Pei Zhang MD , Zhuo Shi MS , Xiang Fang MD , LiLi Jia BS , Zhengkun Xia MD , Chenbo Ji PhD, MD , Hao Tang MS , Chunlin Gao MD
{"title":"Low Skeletal Muscle Density Assessed by Abdominal Computerized Tomography Predicts Outcome in Children With Chronic Kidney Disease","authors":"Meiqiu Wang MD , Zijian Chen BS , Tingting Yu MS , Lianghui You MD , Yingchao Peng MD , Huangyu Chen MS , Pei Zhang MD , Zhuo Shi MS , Xiang Fang MD , LiLi Jia BS , Zhengkun Xia MD , Chenbo Ji PhD, MD , Hao Tang MS , Chunlin Gao MD","doi":"10.1053/j.jrn.2024.11.003","DOIUrl":"10.1053/j.jrn.2024.11.003","url":null,"abstract":"<div><h3>Objectives</h3><div>Skeletal muscle loss and abnormal fat distribution are predictors of poor clinical outcomes in adults with chronic kidney disease (CKD). However, the relationship between body composition (muscle mass and adipose tissue) and prognosis in children with CKD has not been well elucidated.</div></div><div><h3>Methods</h3><div>The retrospective single-center study enrolled children with CKD and healthy group who underwent an abdominal computerized tomography examination and compared the body composition of the third lumbar spine (L3) between the 2 groups. We defined the primary outcome as hemodialysis, peritoneal dialysis, kidney transplantation, or death. Logistic regression analysis was applied to assess the connection between low skeletal muscle density (SMD) and clinical and demographic variables. Multivariate Cox regression analysis was used to evaluate the risk factors for progression to the primary outcome. Kaplan-Meier survival analysis was performed to compare the effect of different body composition on event-free survival rate.</div></div><div><h3>Results</h3><div>Thirty-two patients with CKD [estimated glomerular filtration rate: 14.89 (8.86, 29.88) (mL/min/1.73 m<sup>2</sup>)] and 66 heathy subjects [estimated glomerular filtration rate: 135.72 (121.70, 161.29) (mL/min/1.73 m<sup>2</sup>)] were recruited in our study. From the assessment of body composition assessed by computerized tomography, skeletal muscle area, SMD, and skeletal muscle index in the CKD group was lower than those in the healthy group (<em>P</em> < .05). On the other hand, visceral fat area and visceral fat index in the CKD group were significantly higher than those in the healthy group (<em>P</em> < .05). In logistic regression analysis, triglyceride (odds ratio: 8.635, 95% confidence interval (CI): 1.153-64.687) was independently associated with low SMD. After adjusting clinical data and body composition, high serum albumin (hazard ratio: 0.873, 95% CI: 0.798-0.955) and high SMD (hazard ratio: 0.895, 95% CI: 0.822-0.974) were protective factors for delaying renal failure. Based on the Kaplan-Meier analysis, only the group with low SMD had lower event-free survival in comparison to the reference group (<em>P</em> < .05).</div></div><div><h3>Conclusions</h3><div>These findings suggest that there is significant skeletal muscle loss and decrease in SMD in CKD children. Notably, low SMD is indicative of poor prognosis in CKD children.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 281-288"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645110","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":"Application of ChatGPT to Support Nutritional Recommendations for Dialysis Patients: Comment","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1053/j.jrn.2024.11.006","DOIUrl":"10.1053/j.jrn.2024.11.006","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Page 367"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824602","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":"Author's Reply to the Letter to the Editor: Is the “Nutritional Risk Index for Japanese Hemodialysis” Validated as a Nutritional and Prognostic Indicator?","authors":"Katsuhito Mori MD, PhD, Yosuke Yamamoto MD, PhD, Norio Hanafusa MD, PhD, Suguru Yamamoto MD, PhD, Shingo Fukuma MD, PhD, Yoshihiro Onishi PhD, Masanori Emoto MD, PhD, Masaaki Inaba MD, PhD","doi":"10.1053/j.jrn.2024.12.004","DOIUrl":"10.1053/j.jrn.2024.12.004","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 370-372"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824606","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":"Message From the Chair March 2025","authors":"Jill Hoyt RD, CD, FNKF","doi":"10.1053/j.jrn.2025.01.007","DOIUrl":"10.1053/j.jrn.2025.01.007","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Page 373"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374702","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":"Potential Determinants of Subjective Global Assessment Among Patients on Maintenance Hemodialysis","authors":"Carla Ferrell DCN, RD, LD , Laura Byham-Gray PhD, RDN, FNKF , Hamed Samavat PhD, RDN , Mireille Hamdan DCN, RDN","doi":"10.1053/j.jrn.2024.04.003","DOIUrl":"10.1053/j.jrn.2024.04.003","url":null,"abstract":"<div><h3>Objective</h3><div>The Subjective Global Assessment (SGA) is a validated tool for identifying nutritional status in patients receiving maintenance hemodialysis (MHD), but it is not without limitations. Current research identifies additional clinical characteristics such as phase angle (PhA) associated with SGA. This study aimed to assess the overall correlation between PhA and SGA; associations between PhA and SGA by body mass index, and to identify clinical characteristics associated with SGA.</div></div><div><h3>Design and Methods</h3><div>This is a secondary analysis of the Rutgers Nutrition & Kidney Database, which enrolled participants from four primary studies that included adults diagnosed with chronic kidney disease who were receiving MHD. Multivariable binary logistic regression analyses were conducted to estimate odds ratio (OR) and corresponding 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>The study sample included 60.0% males with 81.1% of the sample identifying as African American. Additionally, 38.9% were obese according to the body mass index classification, and 57.0% were moderately malnourished. Patients with obesity had 44% lower odds of being moderately malnourished (OR = 0.56, 95% CI = 0.37, 0.85). In the model adjusted for age and ethnicity and other clinical characteristics, increasing PhA values by one unit was associated with 28% lower odds (OR = 0.72, 95% CI = 0.53, 0.97) of being moderately malnourished while increasing waist circumference (WC) values by one unit was associated with 12% higher odds (OR = 1.12; 95% CI = 1.06, 1.19) of being moderately malnourished than well-nourished. In this fully adjusted model, increasing fat free mass (FFM, OR = 0.95, 95% CI = 0.91, 0.99) and fat mass (FM, OR = 0.92, 95% CI = 0.87, 0.97) by 1 kg was also associated with 5% and 8% lower odds of being moderately malnourished, respectively.</div></div><div><h3>Conclusion</h3><div>PhA and SGA were significantly associated only among patients classified as obese. PhA, WC, FM, and FFM were identified as potential clinical determinants of SGA. Patients receiving MHD and who have obesity may benefit from utilizing SGA along with WC, PhA, FM, and FFM to assess nutritional status.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 319-327"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860739","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":"Higher Dietary Inflammatory Index and Systemic Immune-Inflammation Index Score are Associated With Higher Risk of Chronic Kidney Disease: Analysis of the National Health and Nutrition Examination Survey From 1999 to 2018","authors":"Lijuan Guo MD , Pin Zhao MD , Zhaowei Zhu MD","doi":"10.1053/j.jrn.2024.07.013","DOIUrl":"10.1053/j.jrn.2024.07.013","url":null,"abstract":"<div><h3>Objective</h3><div>Chronic kidney disease (CKD) is characterized by a gradual decline in kidney function over time. The role of dietary inflammatory index (DII) and systemic immune-inflammation index (SII) in individuals with CKD remains uncertain. We aimed to explore the potential correlation between DII and SII with the prevalence of CKD in adult Americans.</div></div><div><h3>Methods</h3><div>This cross-sectional study used data from the National Health and Nutrition Examination Study between 1999 and 2018. The DII was calculated based on the 24-hour dietary history interview, while the SII was calculated as the product of platelet count multiplied by neutrophil count and divided by lymphocyte count. CKD was diagnosed based on impaired glomerular filtration rate (<60 mL/min per 1.73 m<sup>2</sup>) or urinary albumin-creatinine ratio ≥30 mg/g. Multivariable logistic regression analyses and subgroup analyses were performed to examine the association between DII/SII and CKD.</div></div><div><h3>Results</h3><div>In total, this study included 40,388 participants, of whom 7443 (18.4%) had CKD. The prevalence of CKD changed from 14.84% (95% confidence interval (CI): 13.20-16.48%) in 1999-2000 to 12.76% (95% CI: 11.10-14.43%) in 2017-2018. According to adjusted multivariate logistic regression models, individuals with higher DII scores had a higher likelihood of having CKD (odds ratio = 1.24; 95% CI: 1.12-1.37). Similarly, higher SII scores were associated with a higher risk of CKD (odds ratio = 1.37; 95% CI: 1.25-1.50). Subgroup analyses further demonstrated relatively stronger associations between DII/SII and CKD among individuals with other factors such as sex, age, body mass index, smoking status, drinking status, hypertension, and diabetes.</div></div><div><h3>Conclusions</h3><div>The DII and SII scores were significantly positively associated with higher risks of CKD. Anti-inflammatory diet might have the potential to prevent CKD. The SII may serve as a cost-effective and straightforward approach for detecting CKD. Further prospective longitudinal studies are needed to verify the causality.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 300-310"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793949","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}
Samuel A. Headley , Donna J. Chapman , Michael J. Germain , Elizabeth E. Evans , Karen L. Madsen , Emily M. Miele , Kristyn Kirton , Joshua Loseke , Allen Cornelius , Brian Martin , Bradley Nindl , Heekuk Park , Nosratola D. Vaziri , Talat Alp Ikizler
{"title":"Effects of High Amylose-Resistant Starch on Gut Microbiota and Uremic Toxin Levels in Patients With Stage-G3a-G4 Chronic Kidney Disease: A Randomized Trial","authors":"Samuel A. Headley , Donna J. Chapman , Michael J. Germain , Elizabeth E. Evans , Karen L. Madsen , Emily M. Miele , Kristyn Kirton , Joshua Loseke , Allen Cornelius , Brian Martin , Bradley Nindl , Heekuk Park , Nosratola D. Vaziri , Talat Alp Ikizler","doi":"10.1053/j.jrn.2024.09.005","DOIUrl":"10.1053/j.jrn.2024.09.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study was designed to determine the effect of 16 weeks of supplementation with Hi-maize 260 resistant starch (RS) on the gut microbiota, uremic toxins (indoxyl sulfate and p-cresyl sulfate [PCS]), markers of inflammation, and oxidative stress along with vascular function in patients with stage G3a-G4 chronic kidney disease (CKD).</div></div><div><h3>Design and Methods</h3><div>This was a double-blind, placebo-controlled, parallel-arm, randomized controlled trial. Sixty-eight patients with stage-G3a-G4 CKD were randomized to either RS with usual care or placebo and usual care. Patients attended four testing sessions as follows: two baseline (BL) visits and follow-up visits at 8 and 16 weeks. Fasting blood samples, resting brachial and central blood pressures, along with arterial stiffness, were collected at visits (1 or 2) and weeks 8 and 16. A stool sample was collected for analysis of microbial composition at BL and week 16. Patients were randomized after the BL visits.</div></div><div><h3>Results</h3><div>Patients receiving the RS had a reduction in PCS at week 16. This reduction was associated with a decrease in microbial α-diversity between BL and week 16 (Chao1 <em>P</em> = .014, Shannon <em>P</em> = .017, phylogenetic diversity <em>P</em> = .046, and Simpson <em>P</em> = .017) as well as increases in Subdoligranulum (<em>P</em> = .03) and Oscillospiraceae Unclassified Clostridiales Group 002 (<em>P</em> = .02) and decreases in Bacteroides (<em>P</em> = .009).There were no changes in microbial beta diversity and other biomarkers or markers of vascular function following the 16-week period.</div></div><div><h3>Conclusion</h3><div>Sixteen weeks of supplementation of RS in patients with stage-G3a-G4 CKD led to changes in microbial composition that were associated with a significant reduction in PCS.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 248-258"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373399","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}
Maryanne Zilli Canedo Silva PhD, Carla Maria Avesani PhD, Jacqueline Costa Teixeira Caramori MD, PhD
{"title":"Author’s Reply to the Letter to the Editor: “Nutritional Status of Patients Starting on Peritoneal Dialysis: Comparison Between Planned and Unplanned Dialysis Initiation”","authors":"Maryanne Zilli Canedo Silva PhD, Carla Maria Avesani PhD, Jacqueline Costa Teixeira Caramori MD, PhD","doi":"10.1053/j.jrn.2024.11.008","DOIUrl":"10.1053/j.jrn.2024.11.008","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 365-366"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822680","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":"Is the “Nutritional Risk Index for Japanese Hemodialysis” Validated as a Nutritional and Prognostic Indicator?","authors":"Takahiro Yajima MD","doi":"10.1053/j.jrn.2024.12.003","DOIUrl":"10.1053/j.jrn.2024.12.003","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 368-370"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824604","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}
Fan Zhang , Hui Wang , Yan Bai , Liuyan Huang , Huachun Zhang
{"title":"Effects of Nutritional Supplementation Combined With Exercise Training on Frailty, Physical Function, and Quality of Life in Chronic Kidney Disease: A Systematic Review and Meta-Analysis","authors":"Fan Zhang , Hui Wang , Yan Bai , Liuyan Huang , Huachun Zhang","doi":"10.1053/j.jrn.2024.11.009","DOIUrl":"10.1053/j.jrn.2024.11.009","url":null,"abstract":"<div><div>This review evaluates the effectiveness of nutritional supplementation combined with exercise training on frailty characteristics, physical function, and health-related quality of life in patients with chronic kidney disease (CKD). A systematic search of PubMed, Embase, Web of Science, and Scopus was conducted, identifying 7 articles (9 trials, 324 patients). Meta-analysis showed that combined interventions improved frailty characteristics, such as walking speed (mean difference: 0.09 m/s, 95% confidence interval (CI): 0.02 to 0.16) and physical functioning, including cardiorespiratory fitness (standardized mean difference: 0.56, 95% CI: 0.20 to 0.93) and lower extremity mobility (Timed Up and Go test: -1.11 s, 95% CI: −1.79 to -0.43). However, effects on body weight, fatigue, and health-related quality of life remain uncertain. Due to study heterogeneity and small sample sizes, findings should be interpreted cautiously. Larger, long-term studies are needed to confirm these results and explore additional health outcomes.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 259-270"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808457","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}