Journal of Renal Nutrition最新文献

{"title":"Effectiveness of L-Carnitine for the Treatment of Erythropoietin-Resistant Renal Anemia: A Randomized, Double-Blind, Placebo-Controlled Pilot Trial","authors":"Stephanie E. Reuter PhD, BSc (Hons) (Prof) ,&nbsp;Alison L. Steiber PhD, RDN (Dr) ,&nbsp;Randall J. Faull PhD, MBBS (Prof) ,&nbsp;Allan M. Evans PhD, BPharm (Hons) (Prof)","doi":"10.1053/j.jrn.2026.01.008","DOIUrl":"10.1053/j.jrn.2026.01.008","url":null,"abstract":"<div><h3>Objective</h3><div>Despite its use in the treatment of renal anemia, no adequately controlled studies have examined the impact of L-carnitine administration in the patient population for which it is indicated (i.e., those hyporesponsive to erythropoiesis-stimulating agents [ESAs]). This randomized, double-blind, placebo-controlled pilot study evaluated the potential benefit of L-carnitine supplementation for the treatment of renal anemia in chronic hemodialysis patients who were hyporesponsive to ESA treatment.</div></div><div><h3>Methods</h3><div>Patients shown to be hyporesponsive to ESA treatment were administered intravenous L-carnitine (10-20 mg/kg/dialysis session) or placebo for 3 months, during which erythropoietin resistance index (ERI) was measured as an indicator of treatment effectiveness. Secondary validation was conducted using an independent dataset.</div></div><div><h3>Results</h3><div>L-carnitine supplementation was associated with a 25% reduction in ERI, significantly greater than that seen in placebo-treated patients (3% reduction). This was supported by a 42% reduction after 6 months of treatment in the validation dataset. Overall, 88% of L-carnitine–treated patients had a clinically significant improvement in ERI, compared to 0% of placebo-treated patients.</div></div><div><h3>Conclusions</h3><div>These findings provide evidence to support the National Kidney Foundation's practice recommendations with respect to the clinical use of L-carnitine for renal anemia. While the exact mechanism is yet to be elucidated, it is proposed that L-carnitine treatment improves carnitine palmitoyltransferase activity via carnitine pool normalization, thereby resulting in stabilization of the erythrocyte membrane. If this is the case, then it is feasible that a dual approach to increase erythrocyte production and lifespan through co-administration of ESA and L-carnitine provides a viable treatment option for ESA-resistant patients.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 3","pages":"Pages 491-501"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146129216","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":"Improved Fruit and Vegetable Access to Reduce Racial/Ethnic Disparities in Kidney Health","authors":"Aisha H. Montgomery MD, MPH ,&nbsp;Donald E. Wesson MD, MBA","doi":"10.1053/j.jrn.2026.02.001","DOIUrl":"10.1053/j.jrn.2026.02.001","url":null,"abstract":"<div><div>Chronic kidney disease (CKD) disproportionately affects African American (AA) and Hispanic individuals in the United States (U.S.), with higher rates of progression, complications, and mortality. Despite advances in pharmacologic treatment, disparities persist, highlighting the need for additional evidence-based, community-level strategies. Diets rich in fruits and vegetables (F&amp;V) are linked to reduced CKD incidence, progression, mortality, and improved cardiovascular disease risk, the leading cause of death in patients with CKD. Although F&amp;V-based diets are recommended for managing diabetes and hypertension, the primary causes of CKD, these diets remain underprescribed and underutilized. Poverty, limited education, and low health literacy reduce F&amp;V access in minoritized communities, worsening CKD-related outcomes. Interventional studies show that high F&amp;V diets, alongside standard care, slow CKD progression and reduce cardiovascular disease mortality. Expanding community-level F&amp;V access might increase dietary uptake and improve outcomes for those with CKD and related conditions, helping reduce racial/ethnic disparities in kidney health across the United States.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 3","pages":"Pages 365-372"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198389","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 Virtual Reality With Intradialytic Exercise in Adult Hemodialysis Patients","authors":"Reilly Warren MS, RD, CSG,&nbsp;Diane Radler PhD, RD,&nbsp;Rena Zelig DCN, RDN, CDCES, CSG","doi":"10.1053/j.jrn.2025.10.011","DOIUrl":"10.1053/j.jrn.2025.10.011","url":null,"abstract":"<div><div>Intradialytic exercise (IDE) has demonstrated numerous health benefits; however, limited research is available on the effects of this intervention when paired with virtual reality (VR) technology. The purpose of this review article is to assess whether virtual reality (VR) intradialytic exercise (IDE) improves functional status and health-related quality of life (HRQoL) for adults with end-stage renal disease on hemodialysis and if it is a safe treatment option. A thorough search of PubMed, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library revealed 4 unique studies, one with two publications reporting on different outcomes. These articles demonstrated that IDE VR resulted in improvement in physical function, HRQoL, body composition, and inflammation while being a safe and effective intervention in this population. Practitioners should consider VR IDE as an add-on treatment option for appropriate patients to promote health in a fun and engaging way.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 2","pages":"Pages 201-210"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147588196","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":"March Meeting Announcements","authors":"","doi":"10.1053/j.jrn.2026.01.002","DOIUrl":"10.1053/j.jrn.2026.01.002","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 2","pages":"Page 333"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147588012","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":"Underappreciated Health Benefits of Edible Mushrooms in the Dietary Management of Chronic Kidney Disease","authors":"Mona S. Calvo PhD,&nbsp;Jaime Uribarri MD","doi":"10.1053/j.jrn.2025.09.002","DOIUrl":"10.1053/j.jrn.2025.09.002","url":null,"abstract":"<div><div>Current dietary guidelines for management of chronic kidney disease focus on plant-based protein consumption without enough attention given to consumption of mushrooms. This is a missed opportunity since these members of the Fungi kingdom provide high amounts of rare distinctive nutrients and bioactives. We have perused most of the data on nutritional aspects of mushrooms published over the past decade with the goal to introduce nephrology health care professionals to the broad scope of health benefits that increased mushroom consumption might offer in the dietary management of chronic kidney disease patients. The literature review supports the concept that a healthy plant-based diet supplemented with common edible mushrooms or their novel mushroom or myco-protein products could provide more antioxidants and anti-inflammatory factors in addition to those normally found in plant-based foods. Moreover, mushrooms provide rare bioactives like ergothioneine, essential micronutrients like vitamin D and selenium, relatively lower bioavailable phosphorus as phytate, low potential renal acid load, and complete essential amino acid protein sources.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 2","pages":"Pages 187-200"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182523","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":"Effect of Protein Supplementation on Health-Related Quality of Life in Individuals With Advanced Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Yasmin Iman BSc ,&nbsp;Krista Rossum MD ,&nbsp;Amanda Krueger RD ,&nbsp;Favian Co BSc ,&nbsp;Makan Pourmasoumi PhD Candidate ,&nbsp;Ruth Ewhrudjakpor BSc (Hons) ,&nbsp;Nicole Askin MLIS ,&nbsp;Rebecca C. Mollard PhD ,&nbsp;Clara Bohm MD","doi":"10.1053/j.jrn.2025.08.003","DOIUrl":"10.1053/j.jrn.2025.08.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;We performed a systematic review and meta-analysis to evaluate the effect of protein/amino acid supplementation on health-related quality of life (HRQOL) in advanced chronic kidney disease (CKD) including individuals on dialysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;We performed a systematic review and meta-analysis to evaluate the effect of protein/amino acid supplementation on health-related quality of life (HRQOL) in advanced chronic kidney disease (CKD) including individuals on dialysis.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Medline, Cochrane Central, Embase, and Cumulative Index to Nursing and Allied Health Literature were searched (establishment until August 2022) for randomized controlled trials evaluating the effect of protein or amino acid supplementation (&gt;5 g/day) on individuals with advanced chronic kidney disease (estimated glomerular filtration rate &lt;30 mL/min and/or on dialysis). Primary outcome was change in HRQOL. Secondary outcomes included biochemical, anthropometric measures, and physical function. Two reviewers independently screened articles for inclusion based on the prespecified criteria, extracted data, and assessed risk of bias. Meta-analysis was performed by pooling mean difference or standardized mean difference using a random effects model if at least three included studies reported our prespecified outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Medline, Cochrane Central, Embase, and Cumulative Index to Nursing and Allied Health Literature were searched (establishment until August 2022) for randomized controlled trials evaluating the effect of protein or amino acid supplementation (&gt;5 g/day) on individuals with advanced chronic kidney disease (estimated glomerular filtration rate &lt;30 mL/min and/or on dialysis). Primary outcome was change in HRQOL. Secondary outcomes included biochemical, anthropometric measures, and physical function. Two reviewers independently screened articles for inclusion based on the prespecified criteria, extracted data, and assessed risk of bias. Meta-analysis was performed by pooling mean difference or standardized mean difference using a random effects model if at least three included studies reported our prespecified outcomes.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of 5,699 articles, 17 were included for analysis. We found no improvement in HRQOL in qualitative synthesis of four studies. Protein and/or amino acid supplementation was associated with an improvement in serum albumin (mean difference (MD) = 1.76 g/L, 95% confidence interval (CI) [0.67, 2.84], &lt;em&gt;P&lt;/em&gt; = .002, I&lt;sup&gt;2&lt;/sup&gt; = 88%) and body mass index (BMI) (mean difference = 0.29 kg/m&lt;sup&gt;2&lt;/sup&gt;, 95% confidence interval [0.10, 0.49], &lt;em&gt;P&lt;/em&gt; = .004, I&lt;sup&gt;2&lt;/sup&gt; = 0%), as compared with controls.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Of 5,699 articles, 17 were included for analysis. We found no improvement in HRQOL in qualitative synthesis of four studies. Protein and/or amino acid supplementation was associated with an improvement in serum albumin (mean differ","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 2","pages":"Pages 222-235"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985964","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 Dietary Index Adherence With the Progression of Chronic Kidney Disease Across Cardio-Metabolic Disorders: Findings From Multi-State Models of a Nationwide Cohort Study","authors":"Dong Liu PhD ,&nbsp;Ziwei Liu BS ,&nbsp;Jun-Yi Ma BS ,&nbsp;Jing-Ni Wu BS ,&nbsp;Tong Liu PhD ,&nbsp;Li-Hua Chen PhD","doi":"10.1053/j.jrn.2025.10.002","DOIUrl":"10.1053/j.jrn.2025.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>The associations of dietary guidelines with the progression from a healthy state to cardio-metabolic disorders, then to chronic kidney disease (CKD), and ultimately to death remain unclear. This study aimed to evaluate the associations of multiple dietary pattern indices with CKD progression originating from cardio-metabolic disorders.</div></div><div><h3>Methods</h3><div>Using data from 205,826 participants in the UK Biobank, we applied multi-state models to trace CKD trajectories. Nine dietary pattern indices were derived from 24-hour dietary recalls, and their associations with the risk of transitioning to CKD from cardio-metabolic, as well as subsequent mortality, were evaluated using Cox regression.</div></div><div><h3>Results</h3><div>Greater adherence to the American Heart Association (AHA) dietary pattern was significantly associated with the lowest risk of developing CKD (hazard ratio (HR) for Q5 vs. Q1 = 0.63, 95% confidence interval (95% CI): 0.55-0.71). In comparison, adherence to other dietary patterns such as the Diabetes Risk Reduction Diet (DRRD) and EAT-Lancet diets conferred weaker protective associations. Conversely, the high adherence to an unhealthful Plant-Based Diet Index (PDI) was linked to an elevated CKD risk (HR = 1.44, 95% CI: 1.26-1.64, Q5 vs. Q1). Multi-state model analyses revealed that each 1-unit increase in the American Heart Association diet Z-score was associated with a reduced risk of CKD following cardio-metabolic conditions (HR = 0.89, 95% CI: 0.81-0.97), with a more pronounced risk reduction among participants with T2DM (HR = 0.83, 95% CI: 0.71-0.97). However, no significant association was found between dietary indices adherence and mortality after CKD onset.</div></div><div><h3>Conclusion</h3><div>The American Heart Association diet demonstrated superior protection against CKD incidence and progression from cardio-metabolic disorders, highlighting its clinical priority for early intervention. No dietary pattern influenced mortality after CKD onset, emphasizing the need for tailored prevention strategies in high-risk populations.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 2","pages":"Pages 236-247"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310683","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 Self-Management of Chronic Kidney Disease: A Systematic Review and Co-Created Qualitative Synthesis","authors":"Andrew Morris PhD ,&nbsp;Riya Patel PhD ,&nbsp;Konstantinos Papadopoulos PhD ,&nbsp;Bérénice Mahoney PhD ,&nbsp;Rebecca Stack PhD ,&nbsp;Eleanor Bradley PhD ,&nbsp;Amy Neary MSc ,&nbsp;Deborah Lycett PhD ,&nbsp;Fez Awan ,&nbsp;Anne Foster MBA ,&nbsp;Lina Johansson PhD ,&nbsp;Pat Booth ,&nbsp;Emma Murphy PhD ,&nbsp;Derek Kyte PhD","doi":"10.1053/j.jrn.2025.10.007","DOIUrl":"10.1053/j.jrn.2025.10.007","url":null,"abstract":"<div><h3>Objective</h3><div>Effective nutritional self-management is essential to reducing the risk of morbidity and mortality in chronic kidney disease (CKD). However, the most effective approach for delivering dietary interventions and supporting behavioral change remains uncertain. To inform future service delivery, a systematic qualitative evidence synthesis was conducted to understand patients’ experiences of their nutritional self-management of CKD.</div></div><div><h3>Study Design</h3><div>Systematic review.</div></div><div><h3>Setting &amp; Study Populations</h3><div>Adults with CKD stages 1 to 5.</div></div><div><h3>Search Strategy &amp; Sources</h3><div>MEDLINE, PsycINFO, and CINAHL were searched from inception to July 3, 2023. Google Scholar and Web of Science were used for citation searching.</div></div><div><h3>Data Extraction</h3><div>All qualitative results from primary qualitative and mixed method studies.</div></div><div><h3>Analytical Approach</h3><div>Thematic synthesis.</div></div><div><h3>Results</h3><div>Ninety-two studies involving 2,924 adults met the inclusion criteria across all stages. Studies reported experiences of multiple stages and modalities of treatment of CKD in 23 countries. Three themes and 8 subthemes were identified related to nutritional self-management: navigating dietary advice (receiving advice, quality of advice, tailoring of advice), living a new life (mourning an old life, trial and error, enough is enough (re)gaining control), and diet as a social construct (social influences over management, stigma and isolation). Nutritional self-management in CKD is complex and multifaceted. Patients face significant problems in navigating dietary advice, adjusting to lifestyle changes, and managing social influences.</div></div><div><h3>Limitations</h3><div>Non-English-language studies were excluded.</div></div><div><h3>Conclusions</h3><div>Adults living with CKD commonly face considerable challenges around dietary self-management across all stages of CKD and all modalities in stage 5. Incorporating dietary advice is highly complex, and current dietary service delivery often does not adequately meet patients' needs, regardless of their geographical location, stage of CKD, or treatment modality.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 2","pages":"Pages 261-276"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147588010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Different Sources of Carbohydrates and Added Sugars Intake With Subjective Sleep Quality in Chinese Patients Undergoing Hemodialysis","authors":"Shuang Zhang ,&nbsp;Qijun Wu ,&nbsp;Ping Xiao ,&nbsp;Zhihong Wang ,&nbsp;Hong Liu ,&nbsp;Yan Lu ,&nbsp;Shuxin Liu","doi":"10.1053/j.jrn.2025.10.012","DOIUrl":"10.1053/j.jrn.2025.10.012","url":null,"abstract":"<div><h3>Objective</h3><div>Recent studies have reported that the quality of carbohydrates affects sleep. The present study aimed to evaluate the associations between various carbohydrate sources and added sugar intake with the prevalence of poor sleep quality (PSQ) in patients undergoing hemodialysis (HD).</div></div><div><h3>Methods</h3><div>Dietary intake was assessed using a validated food frequency questionnaire from December 2021 to January 2022. The daily intake of dietary carbohydrates was categorized into 3 groups, with the lowest tertile serving as the reference category. Sleep quality among patients was calculated using the Pittsburgh Sleep Quality Index standard questionnaire. A multivariable logistic regression model and restricted cubic spline analyses were conducted to evaluate the aforementioned relationship.</div></div><div><h3>Results</h3><div>After adjustment for potential confounders, the highest level of carbohydrates derived from pickled products (odds ratio [OR]_{tertile 3 (T3) to tertile 1 (T1)} = 1.53, 95% confidence interval [CI] = 1.00-2.35) and sweet foods (OR_{T3 to T1} = 1.68, 95% CI = 1.02-2.76) as well as added sugar intake (OR_{T3 to T1} = 1.67, 95% CI = 1.00-2.83) were positively associated with the prevalence of PSQ compared to the reference group. Meanwhile, the linear trends were also obvious (<em>P</em> &lt; .05). Similarly, the prevalence of PSQ in patients on HD increased by 31% (OR = 1.31, 95% CI = 1.01-1.71) for each standard deviation increment in added sugar intake. The dose-response curve indicated that the prevalence of PSQ increased linearly with the intake of carbohydrates from pickled products, sweet foods, and added sugars (all <em>P</em>_nonlinear &gt;.05). In addition, the intake of carbohydrates from fresh eggs was positively associated with the prevalence of PSQ in male patients (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>A higher intake of carbohydrates from pickled products and sweet foods, as well as added sugars, was positively associated with PSQ in individuals receiving HD. These findings support the potential importance of reducing carbohydrate intake to improve sleep quality.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 2","pages":"Pages 295-307"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021077","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":"Synbiotic Supplementation for Chronic Constipation in Patients Under Peritoneal Dialysis: An Italian Multicenter Prospective Study","authors":"Gennaro Argentino MD ,&nbsp;Giuseppe Paribello MD ,&nbsp;Andrea Foderini MD ,&nbsp;Federica Marzano MD ,&nbsp;Maria Amicone MD ,&nbsp;Eleonora Riccio MD ,&nbsp;Antonio Pisani MD ,&nbsp;Simona Andriella MD ,&nbsp;Chiara Ruotolo MD ,&nbsp;Tino Paolo Ambrosino MD ,&nbsp;Francesco Cascone MD ,&nbsp;Luigi Di Martino MD ,&nbsp;Andrea Camocardi MD ,&nbsp;Raffaele Genualdo MD ,&nbsp;Francesco Maria Romano MD ,&nbsp;Lucio Selvaggi MD ,&nbsp;Francesco Selvaggi MD ,&nbsp;Marcello Dallio MD ,&nbsp;Alessandro Federico MD ,&nbsp;Luca De Nicola MD ,&nbsp;Silvio Borrelli MD","doi":"10.1053/j.jrn.2025.10.010","DOIUrl":"10.1053/j.jrn.2025.10.010","url":null,"abstract":"<div><h3>Objective</h3><div>Chronic constipation is prevalent in patients undergoing peritoneal dialysis (PD), raising the risk of catheter malfunction and transmural peritonitis. Gut dysbiosis in dialysis patients can worsen constipation.</div></div><div><h3>Methods</h3><div>A single-arm prospective study was performed to assess the effectiveness of synbiotic (fructo-oligosaccharides and <em>Lactobacillus casei, Lactobacillus rhamnosus, Lactobacillus reuteri, and Saccharomyces boulardii</em>) supplementation for 16 weeks in PD patients suffering from chronic constipation. The endpoints were the changes in the constipation scoring system and in laxative use.</div></div><div><h3>Results</h3><div>Out of 106 patients, 76 patients experienced chronic constipation and 70 completed the study. After 16 weeks of synbiotic supplementation, a significant improvement in constipation score was found (−5.3; 95% CI: −5.9/−4.7; <em>P</em> = .001) associated with suspension (36.8%) or reduction (42.1%) of laxatives among baseline users (57/70). The findings were not influenced by age, sex, diabetes, obesity, type of PD, residual diuresis, multidrug therapy, and severe constipation at baseline.</div></div><div><h3>Conclusions</h3><div>Synbiotic supplementation is associated with constipation relief and reduction in laxatives use.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 2","pages":"Pages 328-332"},"PeriodicalIF":3.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021130","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}