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

{"title":"Nutritional Status in Maintenance Hemodialysis Patients in A Large Chinese Region: A Multicenter Cross-Sectional Survey.","authors":"Shasha Lv, Jia Cheng, Yuanyuan Wang, Mengqi Gao, Qingqing Zhang, Gang Liu, Hecun Xiao","doi":"10.1053/j.jrn.2026.06.004","DOIUrl":"10.1053/j.jrn.2026.06.004","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the nutritional status of maintenance hemodialysis (MHD) patients in a large Chinese region.</p><p><strong>Methods: </strong>A multicenter cross-sectional investigation was carried out. All MHD patients received dialysis treatment from April to June 2024 in dialysis centers selected by convenience sampling within a large Chinese region were recruited. Demographic characteristics, physical parameters, and laboratory indices were collected. Protein-energy wasting (PEW) was adopted as a standard for malnutrition assessment and was analyzed in accordance with geographical subgroups. A multivariate logistic regression model was conducted to identify the influencing factors of PEW.</p><p><strong>Results: </strong>In this study, the data of 4,618 MHD patients from 86 dialysis centers were analyzed. The prevalence rate of PEW was 33.2% (1,531/4,618). Subgroup analysis indicated that the prevalence rate was the highest in the Southern region, reaching 37% (535/1,446), and there were significant differences among different areas (Χ² = 19.992, P = .001). However, the primary manifestations were all characterized by the reduced muscle mass and muscle strength. Multivariate logistic regression analysis demonstrated that age (oddrs ratio [OR] = 1.026, 95% confidence interval [CI]: 1.021-1.032, P < .01), sex (OR = 1.185, 95% CI: 1.038-1.352, P = .012), dialysis frequency (OR = 0.842, 95% CI: 0.731-0.969, P = .017), and hemodiafiltration frequency (OR = 0.936, 95% CI: 0.896-0.978, P = .003) were independent influencing factors of PEW.</p><p><strong>Conclusions: </strong>This study revealed the prevalence and manifestations of PEW among MHD patients in the large Chinese region as well as differences and related factors in different areas. It offered certain evidence for monitoring the nutritional status and future nutritional interventions of MHD patients in this region.</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":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148274489","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 the Letter to the Editor Regarding \"Structured Appetite Assessment in Children With Chronic Kidney Disease\".","authors":"Matthew J Harmer","doi":"10.1053/j.jrn.2026.06.006","DOIUrl":"10.1053/j.jrn.2026.06.006","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":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267880","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":"Advancing Artificial Intelligence in Renal Nutrition: The Need for Culturally Adaptive, Equity-Focused Frameworks Beyond Retrieval-Augmented Generation.","authors":"Ravi Shankar, Qian Xu","doi":"10.1053/j.jrn.2026.04.016","DOIUrl":"10.1053/j.jrn.2026.04.016","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":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267821","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":"Association Between Subcutaneous Adipose Tissue Radiodensity and All-Cause Mortality in Patients Undergoing Hemodialysis: A Retrospective Cohort Study.","authors":"Ryosuke Ishikawa, Yoshihiro Nakamura, Takahiro Imaizumi, Shimon Kurasawa, Masaki Okazaki, Nobuhiro Nishibori, Mitsuharu Kojima, Takumi Yamada, Shigefumi Ishikawa, Manabu Hishida, Toru Kondo, Yuhei Otobe, Hangsoo Kim, Kazuhiro Furuhashi, Hirotake Kasuga, Shoichi Maruyama","doi":"10.1053/j.jrn.2026.06.002","DOIUrl":"10.1053/j.jrn.2026.06.002","url":null,"abstract":"<p><strong>Objective: </strong>Malnutrition and altered body composition are major determinants of mortality in patients undergoing maintenance hemodialysis (HD). We aimed to evaluate the association between subcutaneous adipose tissue radiodensity (SAT-HU) measured on noncontrast abdominal computed tomography (CT) and 5-year all-cause mortality.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 444 maintenance HD patients within the Kaikoukai Healthcare Group who underwent noncontrast CT between 2011 and 2021. The primary exposure was mean SAT-HU at the third lumbar vertebra, categorized into sex-specific tertiles; visceral adipose tissue radiodensity was assessed secondarily. The primary end point was 5-year all-cause mortality. Cox proportional hazards models with multiple imputation were used to estimate adjusted hazard ratios, adjusting for nutritional indices (e.g., body mass index and serum albumin) and other covariates.</p><p><strong>Results: </strong>During a median follow-up of 3.1 years, 87 deaths (19.6%) occurred. Patients in the highest SAT-HU tertile had lower body mass index, serum albumin and triglyceride levels, and subcutaneous fat area than those in the other tertiles (P < .001). Survival was poorest in the highest SAT-HU tertile (log-rank P < .001). In the fully adjusted model, the highest SAT-HU tertile had higher mortality risk than the lowest tertile (hazard ratio 2.44; 95% confidence interval 1.24-4.80), with a stronger association among patients aged ≥ 75 years (P for interaction = .004). Higher visceral adipose tissue radiodensity was not significantly associated with mortality after adjustment.</p><p><strong>Conclusions: </strong>Higher SAT-HU independently predicts all-cause mortality in HD, particularly in older patients, and may provide a practical CT-based biomarker for risk stratification beyond conventional nutritional indices.</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":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221650","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":"Cognitive Impairment in Chronic Kidney Disease: Pathophysiological Mechanisms and Potential Modulatory Effects of Resveratrol.","authors":"Penélope Aguilera, Iván Alquisiras-Burgos, Javier Franco-Pérez","doi":"10.1053/j.jrn.2026.05.006","DOIUrl":"10.1053/j.jrn.2026.05.006","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is a prevalent systemic disorder associated with cognitive impairment affecting memory, executive function, and attention, reflecting a disruption of the kidney-brain axis. This narrative review synthesizes current evidence regarding the pathophysiological mechanisms underlying CKD-associated cognitive decline and evaluates the therapeutic potential of resveratrol as a neuroprotective strategy. Cognitive impairment in CKD arises from uremic toxin accumulation, chronic inflammation, oxidative stress, and cerebrovascular dysfunction, leading to disruption of the blood-brain barrier and impaired synaptic plasticity. Additional contributors include glymphatic dysfunction, mitochondrial impairment, and Klotho deficiency. Preclinical evidence indicates that resveratrol mitigates oxidative stress and neuroinflammation, enhances mitochondrial function via sirtuin-1/peroxisome proliferator-activated receptor gamma coactivator-1 signaling, improves endothelial function, and restores Klotho expression. However, clinical evidence remains limited and sometimes inconsistent. Resveratrol represents a biologically plausible therapeutic approach for CKD-related cognitive impairment, although further well-designed clinical studies are required to establish its efficacy and translational potential.</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":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148202171","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 on \"Synbiotic Supplementation for Chronic Constipation in Patients Under Peritoneal Dialysis: An Italian Multicenter Prospective Study\".","authors":"Gennaro Argentino, Giuseppe Paribello, Silvio Borrelli","doi":"10.1053/j.jrn.2026.04.013","DOIUrl":"10.1053/j.jrn.2026.04.013","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":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152972","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 on \"Synbiotic Supplementation for Chronic Constipation in Patients Under Peritoneal Dialysis: An Italian Multicenter Prospective Study\".","authors":"Daijuan Xu, Liuyan Huang","doi":"10.1053/j.jrn.2026.03.008","DOIUrl":"10.1053/j.jrn.2026.03.008","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":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059469","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":"Association of Triglyceride-Glucose Index With Femoral but Not Carotid Atherosclerosis in Chronic Kidney Disease: A Two-Sample Mendelian Randomization Study.","authors":"Serafí Cambray, Manuel Marti-Antonio, Marcelino Bermúdez-López, Alicia Garcia-Carrasco, Carlos Javier Pérez Sánchez, Maria Luisa Martín-Conde, Jose M Valdivielso","doi":"10.1053/j.jrn.2026.05.002","DOIUrl":"10.1053/j.jrn.2026.05.002","url":null,"abstract":"<p><strong>Objective: </strong>Patients with chronic kidney disease (CKD) have a higher risk of cardiovascular events than matched non-CKD individuals. The triglyceride-glucose (TyG) index is a calculated metric used to predict cardiometabolic risk. Although TyG is associated with cardiovascular events in CKD, its relationship with atherosclerotic burden remains unexplored. This study aimed to investigate this association using Mendelian randomization (MR) METHODS: Subjects from the NEFRONA study with ultrasound assessment of atherosclerotic plaque presence in 6 carotid and 4 femoral arterial territories were included. Multivariable linear regression models were used to explore the association between TyG index and atherosclerotic burden. Two-sample MR was employed to assess whether the TyG index has a causal effect on the number of carotid and femoral plaques.</p><p><strong>Results: </strong>358 controls, 709 CKD G3, 569 CKD G4-5 and 463 dialysis subjects were included. Higher TyG levels, analyzed as a continuous variable or by quartiles, were positively associated with the number of plaques in both territories. After multivariable adjustment, the association with femoral plaques remained statistically significant both as a linear variable (beta = 0.11; P = .02) and by quartiles (Q3 vs Q1: beta = 0.16; P = .026; Q4 vs Q1: beta = 0.17; P = .026; Tendency analysis: beta = 0.06; P = .02). Several unadjusted MR methods showed an effect of genetic variants associated with higher TyG levels on femoral, but not carotid, atherosclerosis. Multivariable inverse-variance weighted analysis adjusted for multiple variables suggested a causal relationship between higher TyG index and the number of femoral plaques (estimate:0.95; 95% confidence interval: 0.1-1.80, P = .029).</p><p><strong>Conclusions: </strong>Our two-sample MR study suggests a causal effect of higher TyG index on subclinical atherosclerotic burden in femoral arteries in CKD. Genetic testing could be used to stratify the risk of lower-limb atherosclerosis in CKD 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":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045442","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 Effect of Creatine Supplementation on Kidney Function: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Andreas Tsiaras, Georgios Loufopoulos, Xenophon Theodoridis, Vassilios Liakopoulos, Kalliopi Anna Poulia, Michail Chourdakis","doi":"10.1053/j.jrn.2026.04.010","DOIUrl":"10.1053/j.jrn.2026.04.010","url":null,"abstract":"<p><strong>Objective: </strong>Despite the widespread use of creatine (Cre) as a dietary supplement and its potential benefits, concerns have been raised about its possible adverse effects on kidney function. This systematic review and meta-analysis assesses the impact of Cre supplementation on kidney function based on data from randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>A systematic literature search was conducted to identify RCTs assessing the effects of Cre supplementation on kidney function. The primary outcomes were serum creatinine (Crn), urea, and estimated glomerular filtration rate (eGFR). A random-effects meta-analysis was performed, and subgroup analyses were conducted for each primary outcome, based on supplementation duration and participant physical status.</p><p><strong>Results: </strong>A total of 19 RCTs and one double-blind randomized crossover study were included. Cre supplementation was associated with an increase in serum Crn (mean difference (MD) = 0.13 mg/dL, 95% confidence interval [CI]: 0.07 to 0.18, n = 19). There was neither a difference in urea concentrations (MD = -0.60 mg/dL; 95% CI: -2.15 to 0.96, n = 12) nor in eGFR values (MD = -5.20 mL/min/1.73 m²; 95% CI: -15.00 to 4.60, n = 8) between the two groups. No differences were observed between the <1-month and >1-month supplementation subgroups regarding serum Crn (P = .15), serum urea (P = .15), or eGFR (P = .88).</p><p><strong>Conclusions: </strong>Cre supplementation seems to relate to an increase in serum Crn, but this is not related to significant alterations in urea concentrations and eGFR. Further long-term RCTs, extending beyond 1 year, are needed to assess its safety in terms of renal function.</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":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795068","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":"U-Shaped Relationship Between Preoperative Serum Magnesium and Postoperative Acute Kidney Injury in Elderly Patients Undergoing Noncardiac Surgery: A Retrospective Cohort Study.","authors":"Mengyao Yuan, Xianghan Ruan, Yang Li, Yumeng Peng, Chunxiang Hao, Hao Li, Jingsheng Lou, Jiangbei Cao, Yanhong Liu, Weidong Mi, Xiaoying Zhang","doi":"10.1053/j.jrn.2026.04.004","DOIUrl":"10.1053/j.jrn.2026.04.004","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the association between preoperative serum magnesium (sMg) and postoperative acute kidney injury (PO-AKI) risk in elderly noncardiac surgery patients, and to explore the potential mediating role of systemic inflammation measured by C-reactive protein (CRP).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including patients aged ≥65 years undergoing elective noncardiac surgery at a tertiary center from 2014 to 2021. Preoperative sMg and CRP were measured within 30 days before surgery. PO-AKI within 7 days postoperatively was defined using Kidney Disease: Improving Global Outcomes criteria. Confounders were selected using a directed acyclic graph. Logistic regression and restricted cubic spline models assessed the association between sMg and PO-AKI, and CRP-mediated effects were evaluated via formal mediation analysis.</p><p><strong>Results: </strong>Among 13,245 patients (median age, 71 years; 45.6% male), 884 (6.7%) developed PO-AKI. A U-shaped relationship was observed between preoperative sMg and PO-AKI risk. Compared with patients in the fourth quintile (0.90-0.95 mmol/L), those in the lowest (≤0.83 mmol/L) and highest (>0.95 mmol/L) quintiles had 50% and 25% higher odds of PO-AKI, respectively. Mediation analysis indicated that CRP partially explained this association, accounting for 14.35% of the total effect, with higher contributions in cancer patients and younger elderly individuals.</p><p><strong>Conclusions: </strong>Deviations from the optimal preoperative sMg range, particularly lower levels, were associated with an increased risk of PO-AKI in elderly surgical patients, whereas high-normal levels conferred a modest relative risk elevation. Systemic inflammation partially mediated these associations, suggesting that preoperative sMg assessment may help identify vulnerable patients and inform perioperative monitoring strategies.</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":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795158","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}