Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation最新文献

{"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, Ziwei Liu, Jun-Yi Ma, Jing-Ni Wu, Tong Liu, Li-Hua Chen","doi":"10.1053/j.jrn.2025.10.002","DOIUrl":"https://doi.org/10.1053/j.jrn.2025.10.002","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>Using data from 205,826 participants in the UK Biobank, we applied multi-state models to trace CKD trajectories. Nine dietary pattern indexes 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.</p><p><strong>Results: </strong>Greater adherence to the AHA dietary pattern was significantly associated with the lowest risk of developing CKD (HR for Q5 vs. Q1 = 0.63, 95% CI: 0.55-0.71). In comparison, adherence to other dietary patterns such as the DRRD and EAT-Lancet diets conferred weaker protective associations. Conversely, the high adherence to an unhealthful 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 AHA 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.</p><p><strong>Conclusion: </strong>The AHA 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.</p>","PeriodicalId":520689,"journal":{"name":"Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relentless Challenge of Dietary Salt Restriction for Hypertension and Kidney Disease.","authors":"Linda W Moore, Giacomo Garribotto","doi":"10.1053/j.jrn.2025.10.001","DOIUrl":"https://doi.org/10.1053/j.jrn.2025.10.001","url":null,"abstract":"","PeriodicalId":520689,"journal":{"name":"Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Prognostic Significance of Malnutrition in Critically Ill Patients With Acute Kidney Injury.","authors":"Yue Shi, Hangyu Duan, Jing Liu, Xiujie Shi, Mingming Zhao, Yongfei Fang, Yu Zhang","doi":"10.1053/j.jrn.2025.09.006","DOIUrl":"10.1053/j.jrn.2025.09.006","url":null,"abstract":"<p><strong>Objective(s): </strong>Malnutrition is a significant factor associated with adverse outcomes in various diseases. However, the prevalence of malnutrition among critically ill patients with acute kidney injury (AKI) and its impact on outcomes have not been thoroughly investigated. The purpose of this study was to investigate the prevalence and prognostic significance of malnutrition in critically ill patients with AKI.</p><p><strong>Methods: </strong>Critically ill patients with AKI were selected from the Medical Information Mart for Intensive Care IV through a retrospective cohort study. The nutritional status of these patients was assessed using the Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI), and Controlling Nutritional Status (CONUT). Cox proportional hazard model, Kaplan-Meier analysis, and limited cubic spline were used to evaluate the association between malnutrition risk and 28-day mortality. In addition, logistic regression, Cox regression, and linear regression were used to assess the correlation between malnutrition risk and in-hospital mortality, 90-day mortality, and hospital length of stay, respectively.</p><p><strong>Results: </strong>Of the 1,129 patients enrolled, 49.6%, 80.0%, and 57.7% were found to have moderate to severe malnutrition based on PNI, GNRI, and CONUT scores, respectively. Higher risk of malnutrition was associated with lower hemoglobin, lymphocytes, serum albumin, total cholesterol, higher creatinine, blood urea nitrogen, sepsis organ failure assessment score, simplified acute physiology score II, higher mortality, and longer hospital stay. Among the patients, 215 (19.04%) died within 28 days of intensive care unit admission. Malnutrition was significantly associated with 28-day mortality risk compared with good nutrition (adjusted hazard ratio for severe malnutrition: PNI:HR 1.57, 95% confidence interval [CI] 1.15-2.14; GNRI:HR 1.62, 95% CI 1.01-2.55; CONUT:HR 2.51, 95% CI 1.31-4.80). These nutritional measures further enhanced the predictive accuracy of 28-day mortality, with the CONUT score demonstrating the strongest association. Furthermore, logistic regression, Cox regression, and linear regression models, respectively, revealed that malnutrition risk was significantly associated with in-hospital mortality, 90-day mortality, and hospital length of stay.</p><p><strong>Conclusions: </strong>Malnutrition is prevalent among critically ill patients with AKI and significantly correlates with 28-day mortality, in-hospital mortality, 90-day mortality, and hospital length of stay. Further research is necessary to evaluate the impact of malnutrition screening and nutritional interventions on improving adverse outcomes.</p>","PeriodicalId":520689,"journal":{"name":"Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum creatinine and cystatin C-derived indices suggesting future deterioration in muscular function, physical performance and frailty status among community dwelling older adults.","authors":"Ryota Matsuzawa, Koutatsu Nagai, Kanae Takahashi, Takara Mori, Masaaki Onishi, Shotaro Tsuji, Kana Hashimoto, Kayoko Tamaki, Yosuke Wada, Hiroshi Kusunoki, Yasuyuki Nagasawa, Ken Shinmura","doi":"10.1053/j.jrn.2025.06.010","DOIUrl":"https://doi.org/10.1053/j.jrn.2025.06.010","url":null,"abstract":"<p><strong>Objectives: </strong>Serum biomarkers, particularly serum creatinine and cystatin C, have garnered increased attention as a potential method for predicting future declines in muscle strength. Nevertheless, there is currently a dearth of research in this area. We evaluated the association of serum creatinine and cystatin C-derived indices with the subsequent decline in lower-extremity muscle strength among community-dwelling older adults.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Setting and subjects: </strong>Community-dwelling older individuals (age ≥65 years) residing in the Sasayama-Tamba area of Japan.</p><p><strong>Predictor: </strong>Five indices based on serum creatinine and cystatin C, including the total body muscle mass index (TBMM), were computed.</p><p><strong>Main outcome: </strong>Changes in muscular function including isometric knee extensor strength and handgrip strength, physical performance, and frailty status, underwent assessments at baseline and two years.</p><p><strong>Results: </strong>The final dataset comprised 528 community-dwelling older adults (72 [68, 76] years, 65.7% women). The median change and the proportion of individuals experiencing a significant decline in isometric knee extensor strength over a 2-year period were -37.4N and 40.2%, respectively. TBMM showed significant associations with the subsequent decline in isometric knee extensor strength, handgrip strength, and frailty status.</p><p><strong>Conclusions: </strong>This study demonstrates the association between serum creatinine and cystatin C-derived index, TBMM, and the subsequent decline in lower-extremity muscle strength among older adults. Utilizing markers derived from serum creatinine and cystatin C enables prompt assessment of the need for proactive measures and may facilitate initiating these interventions at a suitable juncture for older individuals.</p>","PeriodicalId":520689,"journal":{"name":"Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are mid-dialysis handgrip strength measurements reliable and reproducible? A comparison to pre-dialysis handgrip strength measurements.","authors":"Anne Snelson, Stephanie Greco, Christopher Letizi, Matthew Snelson, Kevan R Polkinghorne, Melinda Tee, Kelly Lambert","doi":"10.1053/j.jrn.2025.09.004","DOIUrl":"https://doi.org/10.1053/j.jrn.2025.09.004","url":null,"abstract":"<p><strong>Objective: </strong>Handgrip strength (HGS) is an important predictor of nutritional status. Current guidelines recommend measurement of HGS pre-dialysis; however, this may be impractical and measurement often occurs during haemodialysis (HD). This study aims to determine the reliability, reproducibility and agreement of HGS values pre- and mid-dialysis.</p><p><strong>Design: </strong>Participants were recruited from four Australian HD units (n=48). Eligible participants were stable on HD for at least 3 months and not acutely unwell. HGS was measured in triplicate on the non-fistula arm before dialysis and two hours into dialysis for three consecutive weeks. Nutritional status and frailty were assessed via subjective global assessment and the FRAIL Questionnaire, respectively. Bland Altman plots were used to determine agreement between pre- and mid-dialysis measures. Linear mixed models were used to determine differences between pre- and mid-dialysis values controlling for confounders.</p><p><strong>Results: </strong>HGS measures were statistically but not clinically greater pre-dialysis compared to mid-dialysis (19.7±12.9 vs 18.8±13.6 kg, p=0.0433, mean difference 0.5kg). Bland Altman plots demonstrated an acceptable level of agreement between pre- and mid-dialysis HGS measures, suggesting no systematic bias in HGS. The influence of confounders (gender, age, dialysis vintage, frailty status, nutritional status, UF rate, degree of fluid overload, diabetes, PVD and weight) on the differences between pre- and mid-dialysis measures were not statistically significant.</p><p><strong>Conclusion: </strong>This study found HGS taken either pre- or mid-dialysis were reliable and reproducible. Given the agreement between pre- and mid-dialysis HGS measures, HGS measured mid-dialysis may be used for nutritional assessment of HD patients.</p>","PeriodicalId":520689,"journal":{"name":"Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145215495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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 CKD.","authors":"Mona S Calvo, Jaime Uribarri","doi":"10.1053/j.jrn.2025.09.002","DOIUrl":"https://doi.org/10.1053/j.jrn.2025.09.002","url":null,"abstract":"<p><p>Current dietary guidelines for management of chronic kidney disease (CKD) 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 CKD 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 PRAL, and complete essential amino acid protein sources.</p>","PeriodicalId":520689,"journal":{"name":"Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of low muscle mass and myosteatosis with kidney transplant outcomes: a systematic review and meta-analysis.","authors":"Yue Li, Zhiling Wang, Chunmei Wang, Zhengsheng Rao, Wenqian Huo, Keqin Zhang","doi":"10.1053/j.jrn.2025.09.003","DOIUrl":"https://doi.org/10.1053/j.jrn.2025.09.003","url":null,"abstract":"<p><strong>Objective: </strong>Patients with end-stage renal disease are predisposed to low muscle mass and myosteatosis. This study aimed to investigate the predictive value of low muscle mass and myosteatosis, as assessed by computed tomography (CT), in predicting clinical outcomes following kidney transplantation.</p><p><strong>Methods: </strong>A systematic search of PubMed, EMBASE, and the Cochrane Library was conducted to retrieve relevant English-language studies. Eligible studies reported on the associations of low muscle mass and myosteatosis, determined via CT scan, with clinical outcomes in kidney transplant recipients. The primary outcomes were patient and graft survival.</p><p><strong>Results: </strong>A total of 13 studies involving 2,764 kidney transplant recipients were included. The pooled prevalence of low muscle mass was 28% (95% confidence interval [CI]: 0.16 - 0.40, I² = 98%), while that of myosteatosis was 24% (95% CI: 0.16 - 0.33, I² = 96%). Low muscle mass was significantly associated with an increased risk of patient mortality (hazard ratio [HR] = 2.08, 95% CI: 1.62 - 2.67, I² = 13%) and graft loss (HR = 1.43, 95% CI: 1.03 - 1.98, I² = 0%). Furthermore, low muscle mass was linked to an increased incidence of hospital readmissions within both 1 month (odds ratio [OR] = 2.05, 95% CI: 1.41 - 3.00, I² = 0%) and 3 months (OR = 1.78, 95% CI: 1.25 - 2.52, I² = 0%). Recipients with myosteatosis also demonstrated a significantly increased risk of mortality (HR = 1.82, 95% CI: 1.24 - 2.67, I² = 7%) and graft loss (HR = 1.99, 95% CI: 1.21 - 3.26, I² = 0%).</p><p><strong>Conclusion: </strong>Low muscle mass and myosteatosis are prevalent in kidney transplant recipients and significantly impact prognosis. Comprehensive utilization of preoperative CT-derived muscle mass and density data may facilitate early risk stratification and inform clinical decision-making.</p>","PeriodicalId":520689,"journal":{"name":"Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-violet Spectrophotometric Analysis of Phosphate Content in Plant-Based Milk Alternatives in Relation to Advanced Chronic Kidney Disease.","authors":"Alison L Lyles, Estere Sture, Ross Walker","doi":"10.1053/j.jrn.2025.07.002","DOIUrl":"10.1053/j.jrn.2025.07.002","url":null,"abstract":"<p><strong>Objective: </strong>Managing dietary phosphorus is critical in advanced chronic kidney disease (CKD), where excess intake can lead to complications such as hyperphosphataemia. Plant-based milk alternatives (PBMAs) are increasingly consumed, yet their phosphorus content, particularly in relation to phosphate additives, remains poorly defined in the United Kingdom. This study aimed to quantify and compare the total phosphorus content and phosphorus-to-protein ratio (PPR) in a range of commercially available UK PBMAs, with and without phosphate additives, using ultra-violet (UV) spectrophotometric analysis.</p><p><strong>Design and methods: </strong>Fourteen PBMAs (from seven plant sources) were analyzed using the molybdenum blue method. Samples were categorized based on presence or absence of phosphate additives. Phosphorus content (mg/100g) and PPR (mg/g protein) were calculated and compared with previously documented data for cow's milk.</p><p><strong>Results: </strong>PBMAs with phosphate additives contained significantly higher phosphorus levels (mean 58.47 mg/100g) than those without (mean 7.38 mg/100g; P < .001). Similarly, PPR was substantially higher in additive-containing PBMAs (mean 197.76 mg/g) versus additive-free options (mean 16.25 mg/g; P < .001). Some PBMAs with additives had phosphorus content and PPR values exceeding those of cow's milk, raising concerns for phosphate management in CKD.</p><p><strong>Conclusion: </strong>Phosphate additives significantly increase the phosphorus load and PPR of PBMAs, which may not be readily apparent to consumers or clinicians due to insufficient labeling. For patients with advanced CKD, selecting additive-free PBMAs may support better phosphorus control and dietary management.</p>","PeriodicalId":520689,"journal":{"name":"Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Selenium and Zinc Levels on Erythropoiesis-Stimulating Agent Response in Chronic Kidney Disease Patients: A Comparative Study of Predialysis, Hemodialysis, and Peritoneal Dialysis Patients.","authors":"Ayşe Şeker, Beyza Temel","doi":"10.1053/j.jrn.2025.09.001","DOIUrl":"10.1053/j.jrn.2025.09.001","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigated serum selenium and zinc levels across three groups of chronic kidney disease patients and examined their associations with inflammation, nutrition parameters, and erythropoiesis-stimulating agent response.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 298 patients (98 hemodialysis (HD), 92 peritoneal dialysis (PD), and 108 predialysis). We analyzed demographic data andlaboratory parameters, including selenium, zinc, hemoglobin, and erythropoietin resistance index (ERI). Multivariable linear regression analyses evaluated independent associations between trace elements and ERI while controlling for potential confounders.</p><p><strong>Results: </strong>Selenium levels were significantly lower in PD patients compared to HD and predialysis patients, while zinc levels were highest in HD patients. In PD patients, selenium demonstrated a significant negative correlation with ERI (r = -0.32, P = .009), which remained significant in multivariable regression analysis (β = -0.13, P = .008) after adjusting for confounders. Partial correlation analysis revealed significant positive associations between urine output and selenium levels in PD (r_p = .29, P = .005) and predialysis patients (r_p = .21, P = .028). Albumin showed positive correlations with selenium across all groups.</p><p><strong>Conclusions: </strong>Selenium and zinc levels vary significantly across patient groups. Selenium levels showed a significant independent negative correlation with ERI in PD patients, suggesting its potential involvement in erythropoiesis. The association between selenium and nutritional markers suggests that nutritional status plays a crucial role in maintaining adequate trace element levels. Residual renal function appears to significantly influence selenium levels, particularly in PD patients.</p>","PeriodicalId":520689,"journal":{"name":"Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying Integrative Analysis of Dietary Patterns to Understand Ramadan-Induced Nutritional Status Alterations in Hemodialysis Patients.","authors":"Imliya Ibrahim, Jun-Hao Lim, Nurul Iman Hafizah Adanan, Cordelia-Kheng-May Lim, Geeta Appannah, Wan Ahmad Hafiz Wan Md Adnan, Nor Fadhlina Zakaria, Christopher-Thiam-Seong Lim, Rosnawati Yahya, Bayan Tashkandi, Tilakavati Karupaiah, Zulfitri Azuan Mat Daud","doi":"10.1053/j.jrn.2025.08.004","DOIUrl":"10.1053/j.jrn.2025.08.004","url":null,"abstract":"<p><strong>Objective: </strong>The changes in dietary behaviors and food choices during Ramadan lead to significant nutritional status alterations in hemodialysis (HD) patients. Routine dietary assessment may not capture disruptions in food behaviors of Muslim HD patients during Ramadan. This study aimed to elucidate changes in nutritional status affected by Ramadan food choices using a dietary pattern (DP) approach.</p><p><strong>Methods: </strong>This 6-week, multicenter, prospective longitudinal study included 102 Malaysian Muslim HD patients who observed fasting during Ramadan. Nutritional assessments, including anthropometry and biochemical parameters, were conducted at 2 timepoints: 2 weeks prior to Ramadan (V0) and during the fourth week of Ramadan (V1). DPs were derived from 3-day diet records collected at V1 using principal component analysis (PCA) and reduced rank regression (RRR). A general linear model with repeated measures was applied to evaluate the variations in Ramadan-induced nutritional status changes across tertiles within each DP. Further, the integrative analysis between the DPs identified the specific foods that contributed to these changes.</p><p><strong>Results: </strong>PCA identified 4 DPs: Home-Foods_DP, Chicken-Meat_DP, Carbohydrate-based_DP, and Traditional_DP. Meanwhile, RRR yielded 1 DP, which is Quick-Foods_DP. Significant interactions between DPs and serum phosphate changes were observed in the Chicken-Meat_DP (P = .020) and Quick-Foods_DP (P = .004), where high adherence to either pattern was associated with increased serum phosphate during Ramadan. The Quick-Foods_DP showed a significant interaction with serum potassium (P < .001), where high adherence was linked to an increasing trend during Ramadan. Additionally, the Home-Foods_DP exhibited a significant interaction with serum albumin (P = .035), where low adherence was associated with a greater reduction during Ramadan.</p><p><strong>Conclusion: </strong>Dietary pattern analysis reveals the synergistic effects of food-food interaction on Ramadan-induced nutritional alterations in HD patients, providing a foundation for evidence-based dietary guidance for Muslim HD patients during Ramadan.</p>","PeriodicalId":520689,"journal":{"name":"Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}