Journal of Renal Nutrition最新文献

{"title":"Hypoglycemia and Mortality Risk in Incident Hemodialysis Patients","authors":"Duk-Hee Kang MD, PhD ,&nbsp;Elani Streja MPH, PhD ,&nbsp;Amy S. You MS ,&nbsp;Yongkyu Lee MD ,&nbsp;Yoko Narasaki PhD, RD, MS ,&nbsp;Silvina Torres BS ,&nbsp;Alejandra Novoa-Vargas MPH ,&nbsp;Csaba P. Kovesdy MD ,&nbsp;Kamyar Kalantar-Zadeh MD, MPH, PhD ,&nbsp;Connie M. Rhee MD, MSc","doi":"10.1053/j.jrn.2023.09.001","DOIUrl":"10.1053/j.jrn.2023.09.001","url":null,"abstract":"<div><h3>Objective</h3><p>Hypoglycemia is a frequent occurrence in chronic kidney disease patients due to alterations in glucose and insulin metabolism. However, there are sparse data examining the predictors and clinical implications of hypoglycemia including mortality risk among incident hemodialysis patients.</p></div><div><h3>Design and Methods</h3><p>Among 58,304 incident hemodialysis patients receiving care from a large national dialysis organization over 2007-2011, we examined clinical characteristics associated with risk of hypoglycemia, defined as a blood glucose concentration &lt;70 mg/dL, in the first year of dialysis using expanded case-mix + laboratory logistic regression models. We then examined the association between hypoglycemia during the first year of dialysis with all-cause mortality using expanded case-mix + laboratory Cox models.</p></div><div><h3>Results</h3><p>In the first year of dialysis, hypoglycemia was observed among 16.8% of diabetic and 6.9% of nondiabetic incident hemodialysis patients. In adjusted logistic regression models, clinical characteristics associated with hypoglycemia included younger age, female sex, African-American race, presence of a central venous catheter, lower residual renal function, and longer dialysis session length. In the overall cohort, patients who experienced hypoglycemia had a higher risk of all-cause mortality risk (reference: absence of hypoglycemia): adjusted hazard ratio (95% confidence interval) 1.08 (1.04, 1.13). In stratified analyses, hypoglycemia was also associated with higher mortality risk in the diabetic and nondiabetic subgroups: adjusted hazard ratios (95% confidence interval's) 1.08 (1.04-1.13), and 1.17 (0.94-1.45), respectively.</p></div><div><h3>Conclusions</h3><p>Hypoglycemia was a frequent occurrence among both diabetic and nondiabetic hemodialysis patients and was associated with a higher mortality risk. Further studies are needed to identify approaches that reduce hypoglycemia risk in the hemodialysis population.</p></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1051227623001516/pdfft?md5=a1b939579237cf33f4421219f5fd5e8c&pid=1-s2.0-S1051227623001516-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428530","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":"Association of Neutrophil and Albumin With Mortality Risk in Patients Receiving Peritoneal Dialysis","authors":"Youqun Gao BS ,&nbsp;Ziqun Han BS ,&nbsp;Xiaoran Feng MD ,&nbsp;Huiling Zheng MS ,&nbsp;Jun Dong MD ,&nbsp;Xiaojiang Zhan MD ,&nbsp;Fenfen Peng MD ,&nbsp;Qian Zhou MS ,&nbsp;Xianfeng Wu MD ,&nbsp;Shufeng Zhong MS ,&nbsp;Chongyu Zhang MS ,&nbsp;Zebin Wang MD ,&nbsp;Yongjie Xie BS ,&nbsp;Lu Zhang BS ,&nbsp;Jianbo Liang BS ,&nbsp;Jiao Li MD ,&nbsp;Yueqiang Wen MD","doi":"10.1053/j.jrn.2023.10.009","DOIUrl":"10.1053/j.jrn.2023.10.009","url":null,"abstract":"<div><h3>Objective</h3><p>Inflammation and nutrition have been recognized as predicting mortality in patients receiving peritoneal dialysis (PD). Serum neutrophil and albumin are crucial factors in inflammation and nutrition status. Up until now, the synergistic effect of neutrophil and albumin on mortality prediction in PD patients is still being determined. Our study sought to assess the effect of the interaction between neutrophils and albumin on the risk of all-cause mortality and cardiovascular disease (CVD) mortality patients receiving PD.</p></div><div><h3>Methods</h3><p>A total of 1229 PD patients were recruited and divided into three categories in this cohort study. Their relationships with all-cause mortality and CVD mortality were analyzed in multivariable COX regression models adjusted for confounding factors.</p></div><div><h3>Results</h3><p>During the median follow-up of 34.2 months, 222 (18.1%) patients died, and 115 (51.8%) suffered from cardiovascular events. Patients with high neutrophil percentage-to-albumin ratio (NPAR) showed increased all-cause mortality and CVD mortality, with adjusted hazard ratios of 1.490 (95% confidence interval, 1.070-2.074, <em>P</em> = .018) and 1.633 (95% confidence interval, 1.041-2.561, <em>P</em> = .033), respectively, compared with those with low NPAR. Competitive risk models and sensitivity analyses further confirmed this association. In the receiver operating characteristic curve analysis, however, there was little evidence that NPAR is a better indicator than albumin and neutrophil count.</p></div><div><h3>Conclusions</h3><p>Having a high NPAR is linked to a higher risk of mortality, especially when both high neutrophil and low albumin are present.</p></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428529","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":"How to Choose a Healthier Cheese for Patients With Kidney Disease","authors":"Lucia Pérez-Galván LN,&nbsp;Fabiola Martín-del-Campo LN, PhD,&nbsp;Alfonso M. Cueto-Manzano MD, PhD","doi":"10.1053/j.jrn.2023.12.005","DOIUrl":"10.1053/j.jrn.2023.12.005","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576874","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":"Hypoglycemia in Patients With End-Stage Kidney Disease","authors":"Giacomo Garibotto MD,&nbsp;Elisa Russo MD,&nbsp;Francesca Viazzi PhD, MD,&nbsp;Linda W. Moore PhD, RDN","doi":"10.1053/j.jrn.2024.05.001","DOIUrl":"10.1053/j.jrn.2024.05.001","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892563","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 Association of Short Physical Performance Battery With Mortality and Hospitalization in Patients Receiving Hemodialysis","authors":"Juri Uchida PT, MSc ,&nbsp;Yuta Suzuki PT, PhD ,&nbsp;Keigo Imamura PT, PhD ,&nbsp;Shun Yoshikoshi PT, MSc ,&nbsp;Takuya Nakajima PT, MSc ,&nbsp;Narumi Fukuzaki PT, MSc ,&nbsp;Manae Harada PT, PhD ,&nbsp;Kentaro Kamiya PT, PhD ,&nbsp;Ryota Matsuzawa PT, PhD ,&nbsp;Atsuhiko Matsunaga PT, PhD","doi":"10.1053/j.jrn.2023.10.010","DOIUrl":"10.1053/j.jrn.2023.10.010","url":null,"abstract":"<div><h3>Objective</h3><p>The Short Physical Performance Battery (SPPB) is recommended for evaluating physical performance in patients<span> on hemodialysis (HD). However, the association between SPPB score and long-term health outcomes in these patients remains unclear. We examined the association of SPPB score with all-cause mortality, all-cause hospitalization, and cardiovascular hospitalization in patients on HD.</span></p></div><div><h3>Design and Methods</h3><p><span>This retrospective cohort study<span> included 326 patients (median age, 68 years; 62% men) who received outpatient HD therapy. These patients were divided into 2 SPPB groups: low (SPPB ≤9) and high (SPPB &gt;9). We investigated the association of SPPB score and their change over time with health outcomes using </span></span>Cox regression analysis.</p></div><div><h3>Results</h3><p>Low SPPB score was associated with a higher risk for all-cause mortality (hazard ratio [HR]: 3.19, 95% confidence interval [95% CI]: 1.89-5.38), all-cause hospitalization (HR: 2.01, 95% CI: 1.44-2.82), and cardiovascular hospitalization (HR: 2.20, 95% CI: 1.45-3.35). Additionally, change in SPPB score over 1 year was associated with health outcomes.</p></div><div><h3>Conclusions</h3><p>Lower SPPB score was significantly associated with a higher risk for all-cause mortality, all-cause hospitalization, and cardiovascular hospitalization. The SPPB may be a valuable indicator for risk stratification in patients on HD. Additionally, preventive treatments may be an effective management strategy in limiting the high mortality and hospitalization rates in patients with decreased SPPB score.</p></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488213","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":"Trace Elements Status and Their Associations With Related Antioxidant Enzyme Activities in Patients Receiving Peritoneal Dialysis and Hemodialysis","authors":"Cheng-Hsu Chen MD, PhD ,&nbsp;Shih-Chien Huang PhD ,&nbsp;Szu-Wei Huang MS, RD ,&nbsp;Shang-Feng Tsai MD, PhD ,&nbsp;Yi-Chia Huang PhD","doi":"10.1053/j.jrn.2023.11.004","DOIUrl":"10.1053/j.jrn.2023.11.004","url":null,"abstract":"<div><h3>Objective</h3><p>It remains ambiguous as to whether the status of trace elements would affect their related enzyme activities toward defending a possible higher oxidative stress in patients receiving peritoneal dialysis (PD) or hemodialysis (HD) treatment. We investigated copper (Cu), zinc (Zn), and selenium (Se) status in patients receiving PD or HD treatments and further determined the association of these trace elements with their related antioxidant capacities in those patients.</p></div><div><h3>Methods</h3><p>Sixty PD and 80 HD patients before and after HD treatment had their blood drawn. Demographic, clinical, and 24-hour diet recall data were recorded and collected. Plasma trace elements, oxidative stress indicators, and antioxidant enzyme activities were measured.</p></div><div><h3>Results</h3><p>Patients receiving PD or HD treatments experienced similar Zn and Cu intakes. PD and HD patients displayed adequate mean plasma Cu, Zn, and Se levels. Patients receiving PD treatment showed significantly higher levels of Cu, Zn, advanced oxidation protein products (AOPPs), and superoxide dismutase (SOD) activity, but had significantly lower levels of Se and total antioxidant capacity when compared to levels in the HD patients at the pre-HD session. The levels of 3 trace elements and AOPP increased significantly, while the levels of glutathione (GSH), oxidized glutathione (GSSG), GPx, and SOD activities decreased significantly after receiving HD treatment than did the levels in the pre-HD session. Plasma Cu, Se, and Zn levels had a different correlation with plasma AOPP level, GPx, and SOD activities during PD, pre- or post-HD sessions. Plasma Cu, Zn, and Se levels did not have any association with their associated enzyme activities in patients with PD, while plasma Cu and Zn levels may have influenced SOD activity in HD patients.</p></div><div><h3>Conclusions</h3><p>An adequate Cu, Zn, and Se status is required in order to help their associated enzyme activity cope with increased oxidative stress during PD or HD sessions.</p></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138441621","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 Chronic Kidney Disease With Dietary Inflammatory Index in Adults Aged 50 Years and Older: Dose-Response Analysis of a Nationally Representative Population-Based Study","authors":"Shaowen Zeng MD,&nbsp;Lei Qi MD,&nbsp;Yaofei Sun MD,&nbsp;Guishan Zhuang MD","doi":"10.1053/j.jrn.2023.09.007","DOIUrl":"10.1053/j.jrn.2023.09.007","url":null,"abstract":"<div><h3>Objective</h3><p>Dietary inflammatory index (DII) is associated with systemic inflammatory markers, which have been linked to the development of chronic kidney disease (CKD). However, epidemiological studies on the association of DII scores with CKD are sparse. This study aimed to quantitatively assess the dose-response relationship of DII scores with the prevalence of CKD.</p></div><div><h3>Methods</h3><p><span>Adults (≥50 years) from the 2007 to 2018 National Health and Nutrition Examination Survey (N = 12,090) were included. DII scores were calculated based on 27 nutritional parameters. The outcome of interest is the prevalence of CKD 3-5 stages, which is defined as an estimated glomerular filtration rate &lt;60 mL/min/1.73 m</span>²<span>. The nonlinear dose-response relationship of DII scores with the prevalence of CKD stages 3-5 was assessed with restricted cubic splines. Stratified analyses were conducted by age, sex, and race/ethnicity. Covariates included age, sex, body mass index, race/ethnicity, education, ratio of family income to poverty, smoking, physical activity, hypertension, diabetes, and daily intakes of total plain water, sodium, and energy.</span></p></div><div><h3>Results</h3><p>The weighted prevalence of CKD stages 3-5 was 14.77%. The relationship of DII scores with CKD stages 3-5 was linear, and the odds ratios (95% confidence intervals) of CKD stages 3-5 were 0.68 (0.51-0.84) for −2 (DII score), 0.83 (0.74-0.93) for −1, 1.00 for 0 (reference value), 1.20 (1.07-1.32) for 1, 1.41 (1.16-1.66) for 2, 1.63 (1.28-1.98) for 3, 1.84 (1.34-2.34) for 4, and 2.08 (1.30-2.86) for 5. The linear relationship pattern of DII scores with CKD stages 3-5 was observed in stratified analyses by age, sex, and race/ethnicity, respectively.</p></div><div><h3>Conclusions</h3><p>Higher DII scores were independently and linearly associated with the odds of CKD stages 3-5, which deserves to be confirmed in further prospective cohort studies.</p></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41179092","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":"Nutrition Support for Older Adults With Pressure Injuries Receiving Maintenance Hemodialysis: A Case Study","authors":"Julius S. Navarro RDN, CSR, CNSC, FAND, FNKF ,&nbsp;Rebecca Brody PhD, RD, LD, CNSC","doi":"10.1053/j.jrn.2023.11.006","DOIUrl":"10.1053/j.jrn.2023.11.006","url":null,"abstract":"<div><p><span>Hemodialysis<span> (HD) and pressure injuries (PI) are both hypercatabolic states that may contribute to protein-energy wasting development. These conditions require increased energy and protein to prevent losses from HD and support wound healing. Nutrition support therapy using </span></span>intradialytic parenteral nutrition<span><span> (IDPN) with or without a combination of oral nutrition supplements has yielded positive outcomes among patients receiving HD with protein-energy wasting. However, IDPN is not a standard of care for patients with PI and receiving HD. No existing guidelines support its use with these combined complex medical conditions. We present a case of an older adult with PI receiving HD who required supplemental IDPN. This case demonstrated that IDPN helps wound healing, reduces the hospital length of stay, and enhances </span>quality of life.</span></p></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138435369","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":"Academy of Nutrition and Dietetics Commentary on the Phosphorus Recommendation in the KDOQI Clinical Practice Guidelines for Nutrition in CKD: 2020 Update","authors":"Joyce Marcley Vergili EdD, RD, CSR, CDN, CDCES, FAND ,&nbsp;Gabriela V. Proaño MS, RDN ,&nbsp;Elizabeth Yakes Jimenez PhD, RDN ,&nbsp;Lisa Moloney PhD, RDN ,&nbsp;Constantina Papoutsakis PhD, RD ,&nbsp;Alison Steiber PhD, RDN","doi":"10.1053/j.jrn.2023.11.001","DOIUrl":"10.1053/j.jrn.2023.11.001","url":null,"abstract":"<div><p><span><span>The Kidney Disease Outcomes Quality Initiative Clinical Practice Guidelines for Nutrition in </span>Chronic Kidney Disease: 2020 Update recommends adjusting </span>dietary phosphorus<span> to maintain a serum phosphate goal for hemodialysis patients in the normal range (0.81 to 1.45 mmol/L [2.5 to 4.5 mg/dL]). This is lower than the serum phosphate goal used by many dialysis centers (0.97 to 1.78 mmol/L [3.0 and 5.5 mg/dL]). Although context and clinical judgment must always be considered when providing individualized care to patients, a guideline implementation study conducted from December 2020 to December 2022 found that, based on their documentation, registered dietitian nutritionists from two national dialysis chains are almost universally using dialysis center goals instead of the lower phosphate goal recommended by the guideline. This commentary discusses the possible barriers to implementing the Kidney Disease Outcomes Quality Initiative 2020 nutrition guideline's phosphorus recommendation and proposes a systems level approach to promote and support adoption of the recommendation. Calls to action for potential changes in clinician practices, organizational/institutional culture, and government regulations are put forth.</span></p></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138441619","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":"May Meeting Announcements","authors":"","doi":"10.1053/j.jrn.2024.02.002","DOIUrl":"10.1053/j.jrn.2024.02.002","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1051227624000293/pdfft?md5=9de4b15b664902c2e373ca33af4bfd87&pid=1-s2.0-S1051227624000293-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140403911","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}