Advances in kidney disease and health最新文献_第10页

Medical Nutrition Therapy for Chronic Kidney Disease: Low Access and Utilization 慢性肾病的医学营养疗法：获得和利用率低。

Advances in kidney disease and health Pub Date : 2023-11-01 DOI: 10.1053/j.akdh.2023.12.001

Promise Lee , Joanne Kouba , Elizabeth Yakes Jimenez , Holly Kramer

{"title":"Medical Nutrition Therapy for Chronic Kidney Disease: Low Access and Utilization","authors":"Promise Lee , Joanne Kouba , Elizabeth Yakes Jimenez , Holly Kramer","doi":"10.1053/j.akdh.2023.12.001","DOIUrl":"10.1053/j.akdh.2023.12.001","url":null,"abstract":"<div><div><span><span>CKD affects approximately half of US adults aged 65 years and older and accounts for almost 1 out of every 4 dollars of total Medicare fee-for-service spending. Efforts to prevent or slow CKD progression are urgently needed to reduce the incidence of kidney failure and reduce health care expenditures. Current CKD care guidelines recommend </span>medical nutrition therapy (MNT), a personalized, evidence-based application of the Nutrition Care Process (assessment, intervention, diagnosis, and monitoring and evaluation) provided by registered dietitian nutritionists (RDNs) to help slow CKD progression, improve </span>quality of life, and delay kidney failure. MNT is covered by Medicare Part B and most private insurances with no cost sharing. Despite recommendations that patients with CKD receive MNT and insurance coverage for MNT, utilization remains low. This article demonstrates low utilization of MNT and inadequate numbers of RDNs and RDNs who are board certified in renal nutrition relative to the estimated number of Medicare eligible adults with self-reported diagnosed CKD by state, with noted disparities across states. We discuss interventions to increase MNT utilization, such as improving MNT reimbursement, augmenting accessibility of RDNs via telenutrition services and increasing health care provider promotion of MNT and referral to MNT to optimize CKD outcomes.</div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"30 6","pages":"Pages 508-516"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061432","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}

引用次数: 0

Easy Kidney-Healthy Recipes 简易健肾食谱。

Advances in kidney disease and health Pub Date : 2023-11-01 DOI: 10.1053/j.akdh.2023.08.001

Blake Shusterman

引用次数: 0

Nutrition in Peritoneal Dialysis 腹膜透析中的营养。

Advances in kidney disease and health Pub Date : 2023-11-01 DOI: 10.1053/j.akdh.2023.12.008

Andrew Shammas , Shivam Joshi , Ankur D. Shah

引用次数: 0

Revisiting Intradialytic Parenteral Nutrition: How Can We Apply the Evidence in Clinical Practice? 重新审视椎管内肠外营养：如何将证据应用于临床实践？

Advances in kidney disease and health Pub Date : 2023-11-01 DOI: 10.1053/j.akdh.2023.07.006

Anthony Meade , Jessica Dawson , Adam Mullan

{"title":"Revisiting Intradialytic Parenteral Nutrition: How Can We Apply the Evidence in Clinical Practice?","authors":"Anthony Meade , Jessica Dawson , Adam Mullan","doi":"10.1053/j.akdh.2023.07.006","DOIUrl":"10.1053/j.akdh.2023.07.006","url":null,"abstract":"<div><div><span>Intradialytic parenteral nutrition (IDPN) remains a controversial nutrition support practice in </span>hemodialysis<span><span><span>. Multiple reviews and evidence-based clinical practice guidelines have been published in the past 20 years. Despite essentially looking at the same evidence, conclusions and recommendations vary significantly, leading to widespread uncertainty among clinicians on the value of and indications for IDPN. This paper aims to bring a clinical perspective to the current state of evidence and clinical practice, recognizing the strengths and weaknesses of current evidence and the clinical questions that remain unanswered, as well as providing guidance for using IDPN in clinical practice. IDPN should be considered a strategy to complement spontaneous oral intake in clinically stable patients receiving maintenance </span>hemodialysis or who have or are at risk of malnutrition and who have substantial but not adequate protein and/or </span>energy intake<span>. There is a clear need for robust randomized controlled trials<span> evaluating the impact of IDPN in appropriately selected patients. Additionally, future trials should include patient-centered outcome measures such as appetite, spontaneous oral intake, quality of life, and reliable measures of nutritional status.</span></span></span></div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"30 6","pages":"Pages 502-507"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061436","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}

引用次数: 0

Animal Protein Intake and Possible Cardiovascular Risk in People With Chronic Kidney Disease: Mechanisms and Evidence 动物蛋白摄入量与慢性肾脏病患者可能的心血管风险：机制与证据

Advances in kidney disease and health Pub Date : 2023-11-01 DOI: 10.1053/j.akdh.2023.06.003

Jaimon T. Kelly , Ailema Gonzalez-Ortiz , David E. St-Jules , Juan Jesus Carrero

{"title":"Animal Protein Intake and Possible Cardiovascular Risk in People With Chronic Kidney Disease: Mechanisms and Evidence","authors":"Jaimon T. Kelly , Ailema Gonzalez-Ortiz , David E. St-Jules , Juan Jesus Carrero","doi":"10.1053/j.akdh.2023.06.003","DOIUrl":"10.1053/j.akdh.2023.06.003","url":null,"abstract":"<div><div><span><span>Individuals with chronic kidney disease (CKD) have an increased risk of cardiovascular disease (CVD), and the kidney function is a critical determinant of this risk. CKD is also a major cause of complications and </span>disease progression in patients with CVD. Practice guidelines suggest that CVD risk in CKD patients can be managed through healthy lifestyle and dietary behaviors. Assessing the impact of diet on heart and kidney health is complex because numerous bioactive compounds from diet may contribute to or prevent CVD or CKD via a myriad of pathways and mechanisms. The objective of this review was to provide a discussion of the mechanisms and evidence linking protein-rich foods and CVD risk in people with CKD. This review highlights the current evidence-based strategies for primary CKD prevention that incorporate a healthy dietary pattern, while </span>tertiary prevention<span><span> strategies focus on avoiding excess protein and reducing dietary acid load. The effect of protein restriction for improving CVD and CKD outcomes is conflicting; however, these approaches show no negative effects on kidney health. Low-protein and very low-protein diets are promising interventions for reducing the progression of CKD and CVD. Animal-sourced protein may be more detrimental to kidney health than plant-sourced protein due to specific acid load, amino acid composition, generation of </span>uremic toxins<span>, accompanying saturated fat content, low fiber composition, and higher generation of advanced glycation end-products. There are no one-size fits all nutrition prescriptions. Personalized nutrition interventions that target the unique risk factors for CVD associated with reduced kidney function are required to improve the health of people living with CKD.</span></span></div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"30 6","pages":"Pages 480-486"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061390","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}

引用次数: 0

Popular Diets and Kidney Stones 流行饮食与肾结石。

Advances in kidney disease and health Pub Date : 2023-11-01 DOI: 10.1053/j.akdh.2023.10.002

Sara Zayed , David S. Goldfarb , Shivam Joshi

{"title":"Popular Diets and Kidney Stones","authors":"Sara Zayed , David S. Goldfarb , Shivam Joshi","doi":"10.1053/j.akdh.2023.10.002","DOIUrl":"10.1053/j.akdh.2023.10.002","url":null,"abstract":"<div><div><span><span><span>Popular diets often influence dietary patterns, which have different implications for kidney stone risk. Despite the wide variety of popular diets, some general principles can be gleaned from investigating their potential impact on nephrolithiasis. Plant-based diets, including </span>Dietary Approaches to Stop Hypertension, Mediterranean, flexitarian, and vegetarian diets, may protect against nephrolithiasis when they consist largely of unprocessed plant foods, while carbohydrate-restricted diets (including high-protein diets and the ketogenic diet) may raise kidney stone risk. Patients should be advised to consume a diet rich in whole plants, particularly fruits and vegetables, and minimize their consumption of animal proteins. Accompanying fruits and vegetables that are higher in </span>oxalate<span> content with more water and some dairy intake may also be useful. (We address the oxalate content of fruits and vegetables further below). Calcium consumption is an important component of decreasing the risk of kidney stones, as higher dietary calcium from dairy </span></span><em>or</em><span><span> nondairy sources is independently associated with lower kidney stone risk. Patients should also be advised to be conscious of fat intake, as fat in the intestinal lumen may complex with calcium and therefore increase </span>urinary oxalate excretion. Finally, patients should avoid consumption of processed foods, which often contain added fructose and high sodium content, two factors that increase kidney stone risk.</span></div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"30 6","pages":"Pages 529-536"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061435","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}

引用次数: 0

Low-Protein Diets and Its Synergistic Role in the SGLT2 Inhibitor Era 低蛋白饮食及其在 SGLT2 抑制剂时代的协同作用。

Advances in kidney disease and health Pub Date : 2023-11-01 DOI: 10.1053/j.akdh.2023.12.005

Jason Patel , Kamyar Kalantar-Zadeh , Shivam Joshi

{"title":"Low-Protein Diets and Its Synergistic Role in the SGLT2 Inhibitor Era","authors":"Jason Patel , Kamyar Kalantar-Zadeh , Shivam Joshi","doi":"10.1053/j.akdh.2023.12.005","DOIUrl":"10.1053/j.akdh.2023.12.005","url":null,"abstract":"<div><div><span><span>Low-protein diets (LPDs), usually defined as a daily dietary protein intake of 0.6 to 0.8 g/kg body weight, have been recommended for decades as a safe and effective lifestyle modification to ameliorate inflammatory damage and </span>proteinuria, reduce glomerular </span>hyperfiltration<span><span>, and improve metabolic acidosis<span><span> control in patients with chronic kidney disease (CKD). The mechanism for this is largely attributed to altered tubuloglomerular feedback and afferent </span>arteriole contraction leading to decreased glomerular pressure. Additionally, low protein intake reduces urea generation, which can help delay dialysis initiation in advanced CKD. LPDs have different types including plant-dominant LPDs that can exert additional kidney protective effects as a result of dietary protein quality in addition to quantity. In addition, strong clinical evidence shows that a new class of diabetes mellitus medications, the sodium-glucose cotransporter 2 inhibitors, reduces </span></span>albuminuria<span> and slows the estimated glomerular filtration rate<span><span> decline in CKD, even in patients without diabetes mellitus, especially if significant proteinuria is present. Given prior studies investigating the effect of LPDs used in conjunction with </span>angiotensin pathway modulators, we argue that LPDs have a synergistic role in disease management and are expected to display additive effects when combined with sodium-glucose cotransporter 2 inhibitor usage or other pharmacologic agents. Even with medical therapy, it is prudent to implement tailored LPDs for different types of CKD.</span></span></span></div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"30 6","pages":"Pages 523-528"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061431","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}

引用次数: 0

Mediterranean Diet for Cardiovascular Risk Reduction in Chronic Kidney Disease 降低慢性肾脏病心血管风险的地中海饮食。

Advances in kidney disease and health Pub Date : 2023-11-01 DOI: 10.1053/j.akdh.2023.07.007

Hugo Bakis , Philippe Chauveau , Christian Combe , Pierre Pfirmann

{"title":"Mediterranean Diet for Cardiovascular Risk Reduction in Chronic Kidney Disease","authors":"Hugo Bakis , Philippe Chauveau , Christian Combe , Pierre Pfirmann","doi":"10.1053/j.akdh.2023.07.007","DOIUrl":"10.1053/j.akdh.2023.07.007","url":null,"abstract":"<div><div><span><span>The Mediterranean diet is a plant-based healthy diet similar to the vegetarian and the Dietary Approaches to Stop Hypertension diets<span>. Unlike vegetarian and Dietary Approaches to Stop Hypertension diets, the Mediterranean diet encourages a lifestyle associated with physical activity, and social connections. In addition, the Mediterranean diet is not based on restriction of nutrients but does limit intake of processed foods. Prospective studies have confirmed that the Mediterranean diet confers primary and secondary cardiovascular disease prevention in the general population. The benefits of the Mediterranean diet lifestyle include reducing the risk of diabetes mellitus, </span></span>dyslipidemia<span><span>, and lowers blood pressure. In adults with CKD, adherence to the Mediterranean diet is associated with a lower risk of CKD progression and its complications such as hyperphosphatemia and </span>metabolic acidosis<span>, and reduces production of uremic toxins<span> and inflammatory mediators when compared to omnivore dietary patterns. Nevertheless, prospective studies are needed to confirm the cardiovascular disease prevention with the Mediterranean diet in adults with CKD. </span></span></span></span>Medical nutrition therapy remains a cornerstone of CKD management, and the Mediterranean diet could be utilized to slow CKD progression and complications.</div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"30 6","pages":"Pages 496-501"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061433","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}

引用次数: 0

Hyperkalemia and Plant-Based Diets in Chronic Kidney Disease 慢性肾脏病患者的高钾血症和植物性饮食。

Advances in kidney disease and health Pub Date : 2023-11-01 DOI: 10.1053/j.akdh.2023.10.001

John Sebastian Babich , Léonie Dupuis , Kamyar Kalantar-Zadeh , Shivam Joshi

{"title":"Hyperkalemia and Plant-Based Diets in Chronic Kidney Disease","authors":"John Sebastian Babich , Léonie Dupuis , Kamyar Kalantar-Zadeh , Shivam Joshi","doi":"10.1053/j.akdh.2023.10.001","DOIUrl":"10.1053/j.akdh.2023.10.001","url":null,"abstract":"<div><div><span>Traditional dietary guidelines for patients with kidney disease recommend restriction of plant foods due to concerns about </span>hyperkalemia<span><span> and associated adverse events. Studies conducted over several decades have shown that the basis for these guidelines does not match the evidence. Serum potassium levels can be elevated in patients with reduced kidney function after consumption of foods with potassium-based additives or with highly concentrated potassium content such as juices, dried fruit, or purees. However, plant foods may have certain qualities that may blunt potassium retention including their alkalinizing effects, the lack of bioavailable potassium, and the impact of dietary fiber in organic plant foods on colonic </span>potassium excretion. Furthermore, there are many benefits of plant foods that patients with kidney disease may be missing by excluding them from their diets by recommending the historical low-potassium “renal diet.” Revised dietary recommendations for kidney health may encourage patient-centered kidney recipes that revolve around plant foods and do not restrict them.</span></div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"30 6","pages":"Pages 487-495"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061430","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}

引用次数: 0

A Low-Protein, Plant-Dominant Gluten-Free Diet for Immunoglobulin A Nephropathy and Focal Segmental Glomerulosclerosis 低蛋白、以植物为主的无麸质饮食治疗免疫球蛋白 A 肾病和局灶性肾小球硬化症。

Advances in kidney disease and health Pub Date : 2023-11-01 DOI: 10.1053/j.akdh.2023.09.001

Jason Patel , Kamyar Kalantar-Zadeh , Melanie Betz , Shivam Joshi

{"title":"A Low-Protein, Plant-Dominant Gluten-Free Diet for Immunoglobulin A Nephropathy and Focal Segmental Glomerulosclerosis","authors":"Jason Patel , Kamyar Kalantar-Zadeh , Melanie Betz , Shivam Joshi","doi":"10.1053/j.akdh.2023.09.001","DOIUrl":"10.1053/j.akdh.2023.09.001","url":null,"abstract":"<div><div><span><span>Immunoglobulin A nephropathy<span><span> is the most common glomerulonephritis syndrome in the world, yet there is currently no cure. While blood pressure control, renin-angiotensin-aldosterone system inhibition, and </span>immunosuppression may slow </span></span>disease progression, low-protein diets, defined as a daily </span>dietary protein<span><span><span> intake of 0.6 to 0.8 g/kg body weight, may also decrease </span>immune complex deposition<span> and disease severity, as evidenced in animal models. The link between secondary immunoglobulin A nephropathy and celiac disease has also led to the rise of gluten-free diets and zinc supplementation as potential lifestyle modifications to help manage common immunoglobulin A nephropathy symptoms such as </span></span>proteinuria<span><span> and hematuria. In addition, case reports and prospective studies suggest that patients with </span>focal segmental glomerulosclerosis<span>, which manifests as steroid-resistant nephrotic syndrome may also benefit from a gluten-free diet. We highlight the example of a gluten-free, plant-dominant low-protein diet (a different type of low-protein diet that addresses both protein quantity and quality) for patients with immunoglobulin A nephropathy or focal segmental glomerulosclerosis.</span></span></span></div></div>","PeriodicalId":72096,"journal":{"name":"Advances in kidney disease and health","volume":"30 6","pages":"Pages 517-522"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061389","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}

引用次数: 0