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

{"title":"Indoxyl Sulfate and Soluble Prorenin Receptor Axis Contributes to Sarcopenia in Maintenance Hemodialysis Patients by Inducing Mitochondrial Damage: An Integrated Clinical and Experimental Study.","authors":"Liu Yun, Wen Luona, Zheng Yuanyuan, Zuo Sujun, Hu Jianguang, Liu Yan, Tan Rongshao, Zhong Xiaoshi","doi":"10.1053/j.jrn.2026.08.007","DOIUrl":"https://doi.org/10.1053/j.jrn.2026.08.007","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to elucidate the role of indoxyl sulfate (IS) and soluble (pro)renin receptor [s(P)RR] in sarcopenia among maintenance hemodialysis (MHD) patients, integrating clinical observations with in vitro mechanistic investigations.</p><p><strong>Methods: </strong>A single-center cross-sectional study enrolled 141 MHD patients to analyze correlations between serum IS, s(P)RR, and sarcopenia parameters. Multivariate logistic regression was conducted to determine independent predictors of sarcopenia in MHD patients. Mechanistic insights were derived from C2C12 myotube experiments, including myostatin (MSTN) knockdown and renin-angiotensin system (RAS) inhibition, to evaluate IS- and s(P)RR-induced mitochondrial dysfunction, oxidative stress, and atrophy.</p><p><strong>Results: </strong>Sarcopenic patients exhibited elevated IS and s(P)RR levels and impaired physical performance. s(P)RR independently predicted sarcopenia. In vitro, IS upregulated s(P)RR, suppressed peroxisome proliferator-activated receptor-γ coactivator-1α (PGC1α) and nuclear respiratory factor-1 (Nrf-1), and induced mitochondrial dysfunction, oxidative stress, and myotube atrophy, which were rescued by s(P)RR inhibition. Recombinant s(P)RR suppressed PGC1α and Nrf-1 expression, exacerbating mitochondrial damage and atrophy in C2C12 myotubes, which were reversed by PGC1α overexpression. MSTN knockdown attenuated IS-induced myotube atrophy, oxidative stress, and PGC1α downregulation, effects reversed by s(P)RR. Similarly, RAS blockade ameliorated IS-induced myotube atrophy and s(P)RR upregulation, and restored PGC1α expression.</p><p><strong>Conclusion: </strong>Clinical data reveal significant associations between IS, s(P)RR, and sarcopenia in MHD patients. In vitro experiments further indicate that the IS-s(P)RR-PGC1α/Nrf-1 axis, with MSTN and the RAS as key mediators, contributes to muscle atrophy via mitochondrial dysfunction and oxidative stress. s(P)RR emerges as a novel diagnostic biomarker and a modifiable target, providing a foundation for further translational studies.</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":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805399","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":"In Memoriam George Alan Kaysen, MD, PhD (1943-2026).","authors":"Joel D Kopple, S Russ Price","doi":"10.1053/j.jrn.2026.07.003","DOIUrl":"https://doi.org/10.1053/j.jrn.2026.07.003","url":null,"abstract":"<p><p>George Alan Kaysen, MD, PhD (1943-2026), was an internationally recognized physician-scientist whose work helped define our modern understanding of protein metabolism, inflammation, and nutritional disorders in kidney disease. Over a distinguished academic career that included leadership positions at the University of California, San Francisco, the Veterans Administration Medical Center in Martinez, and the University of California, Davis, he made foundational contributions to the study of albumin kinetics, lipoprotein metabolism, nephrotic-range proteinuria, dialysis-associated metabolic derangements, protein-energy wasting, sarcopenia, and frailty. He also played major leadership roles in the International Society of Renal Nutrition and Metabolism, serving in multiple council positions, as Secretary-Treasurer, as President-Elect, and as President. He was also a member of the Editorial Boards of the Journal of Renal Nutrition and several other journals. His scholarly impact was extraordinary: approximately 290 publications, more than 18,500 citations, and three publications cited more than 1,000 times. Dr. Kaysen's scientific leadership, mentorship, and service to the international renal nutrition community left a lasting legacy that continues to shape research, clinical practice, and professional collaboration.</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":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764537","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":"\"Phase Angle From Bioelectrical Impedance Analysis Predicts Protein-Energy Wasting Independently of Anorexia and Sarcopenia in Patients on Hemodialysis: The Hemodialysis Anorexia Sarcopenia Protein-Energy Wasting Study\".","authors":"Emmanouil Chaviaras, Konstantina Nikolakopoulou, Dimitrios Karayiannis, Georgios Triantafyllis, Velissarios Gkinis, Emmanouil Kalaitzakis, Konstantina Tsantila, Antonis Zampelas, Michail Chourdakis, Kalliopi Anna Poulia","doi":"10.1053/j.jrn.2026.07.005","DOIUrl":"10.1053/j.jrn.2026.07.005","url":null,"abstract":"<p><strong>Objective: </strong>Patients on hemodialysis (HD) commonly report poor nutritional status, which is associated with negative clinical outcomes. The aim of the \"Hemodialysis Anorexia Sarcopenia Protein-Energy Wasting\" study was to determine the prevalence of protein-energy wasting (PEW) syndrome, to explore associations between PEW, anorexia, and sarcopenia, as well as to assess the diagnostic accuracy of phase angle (PhA) from bioelectrical impedance analysis (BIA) in predicting PEW in patients on HD.</p><p><strong>Methods: </strong>The Hemodialysis Anorexia Sarcopenia Protein-Energy Wasting study was a single-center, cross-sectional study in patients undergoing HD. The International Society of Renal Nutrition and Metabolism criteria were used for the diagnosis of PEW by using the PEW score index. Anorexia was diagnosed by Simplified Nutritional Appetite Questionnaire, sarcopenia was identified by European Working Group on Sarcopenia in Older People 2 criteria, and body composition was analyzed by BIA.</p><p><strong>Results: </strong>A total of 190 patients (129 men; median age: 70.0 years, interquartile range: 58.0.-78.0) were evaluated. PEW was diagnosed in 14.7% of the patients, while 25.3% reported anorexia and 30.0% sarcopenia. Both anorexia (P < .001) and sarcopenia (P < .001) were positively associated with PEW. Patients with anorexia, sarcopenia or lower PhA values had significantly higher risk of PEW than those without anorexia, sarcopenia, or with higher PhA [odds ratio [OR] = 4.5 (1.96-10.40), P < .001; OR = 5.7 (2.42-13.32), P < .001; OR = 0.3 (0.15-0.42), P < .001, respectively). After adjusting for age, handgrip strength, C-reactive protein levels, HD vintage, anorexia, and sarcopenia, PhA continued to demonstrate a significant association with the development of PEW (OR adjust = 0.3, P < .001). Receiver operating characteristic curve analysis revealed cut-off points of 4.25° for males and 4.10° for females, for the ability of PhA to identify PEW syndrome, while the agreement between PhA (PhA for the whole sample: ≤4.24°) and International Society of Renal Nutrition and Metabolism criteria for PEW diagnosis was found to be moderate (κ = 0.414, P < .001).</p><p><strong>Conclusions: </strong>Anorexia and sarcopenia may increase the risk of PEW syndrome in HD patients. BIA-derived PhA seems to be a valid marker for PEW detection independent of anorexia and sarcopenia.</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":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762489","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":"Authors' Reply: Toward Actionable Clinical Tools for Nutritional Monitoring in Maintenance Hemodialysis Patients.","authors":"Jiaxin Li, Xiaoqin Zhang, Honghong Lv","doi":"10.1053/j.jrn.2026.07.006","DOIUrl":"10.1053/j.jrn.2026.07.006","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":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764265","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":"Letter to the Editor: Longitudinal Trajectories of Serum Prealbumin and Their Association With Mortality in Maintenance Hemodialysis Patients.","authors":"Ting-Yu Chen","doi":"10.1053/j.jrn.2026.06.011","DOIUrl":"10.1053/j.jrn.2026.06.011","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":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764365","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":"Effects of Ketoanalogue Supplementation and Intradialytic Resistance Exercise on Functional Performance, Fatigue, and Muscle-Related Indices in Maintenance Hemodialysis Patients: A Randomised Controlled Trial.","authors":"Ammar Ali, Ahmed Moustafa, Mirna Shahin, Hala Ehab, Sara Abdelgawad, Alaa Awad, Hanan Elberashi, Mohamed El-Gamal, Alaa Sabry, Emad Samaan","doi":"10.1053/j.jrn.2026.08.006","DOIUrl":"https://doi.org/10.1053/j.jrn.2026.08.006","url":null,"abstract":"<p><strong>Objective: </strong>Patients on maintenance hemodialysis commonly develop protein-energy wasting, sarcopenia, and disabling fatigue. Whether ketoanalogue (KA) supplementation, low-intensity intradialytic resistance exercise, or the two combined can improve physical function over a short period is uncertain.</p><p><strong>Methods: </strong>In a single-centre, 12-week randomised trial, 100 prevalent hemodialysis patients were allocated 1:1:1:1 to KA only, KA plus exercise, exercise only, or control. The primary outcome was the 30-second sit-to-stand test (STS-30). Secondary outcomes were fatigue (MFIS), handgrip strength, bioimpedance skeletal muscle index (SMI), and quadriceps ultrasound total thickness. Between-group inference used baseline-adjusted 2×2 factorial ANCOVA with a KA-by-exercise interaction term, which tests whether the effect of one intervention depends on whether the other is present. Simple effects were estimated when the interaction was significant.</p><p><strong>Results: </strong>Ninety-five patients completed follow-up. The four arms were similar at baseline in age, sex, dialysis vintage, comorbidities, and daily protein intake (0.65-0.77 g/kg), confirming successful randomisation. KA had a significant main effect on STS-30 (+1.34 reps; 95% CI 0.41-2.28; p=0.005) and on quadriceps thickness (+2.85; 95% CI 0.98-4.72; p=0.003), with no KA-by-exercise interaction. The exercise's main effect on STS-30 was not significant. For handgrip, KA alone and exercise alone each improved performance, but combining them did not produce additive gains (significant interaction, p<0.001). Fatigue and SMI showed no significant between-group effects; these findings are considered exploratory CONCLUSION: Twelve weeks of KA supplementation was associated with improved functional performance and preservation of quadriceps muscle thickness relative to non-supplemented patients in hemodialysis patients with low baseline protein intake. The low-intensity intradialytic exercise prescription tested did not, on its own, improve STS-30.</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":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763477","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":"Comment on \"Associations Between Different Sources of Carbohydrates and Added Sugars Intake With Subjective Sleep Quality in Chinese Patients Undergoing Hemodialysis\".","authors":"Lan Li","doi":"10.1053/j.jrn.2026.06.010","DOIUrl":"10.1053/j.jrn.2026.06.010","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":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763577","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":"Response Letter to Comment on: \"Associations Between Different Sources of Carbohydrates and Added Sugars Intake With Subjective Sleep Quality in Chinese Patients Undergoing Hemodialysis\".","authors":"Shuang Zhang, Qijun Wu, Ping Xiao, Zhihong Wang, Hong Liu, Yan Lu, Shuxin Liu","doi":"10.1053/j.jrn.2026.08.003","DOIUrl":"10.1053/j.jrn.2026.08.003","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":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763949","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":"Comment on \"Gastrointestinal Mucosal Cell Injury Caused by Sevelamer Crystals: Case Series and Literature Review\".","authors":"S Dhanya Dedeepya, Vaishali Goel, Nivedita Nikhil Desai","doi":"10.1053/j.jrn.2025.10.021","DOIUrl":"10.1053/j.jrn.2025.10.021","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":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703265","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":"Response to Letter to the Editor \"Gastrointestinal Mucosal Cell Injury Caused by Sevelamer\".","authors":"Ahmed Elkalashy, Randall R Rainwater, Umair Ali, Enas Elbahnasawy, Manisha Singh, Nithin Karakala","doi":"10.1053/j.jrn.2026.07.004","DOIUrl":"10.1053/j.jrn.2026.07.004","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":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703297","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}