Journal of Renal Nutrition最新文献

英文中文

A Center for Nutrition Care to Provide Renal Nutrition Therapy to Chronic Kidney Disease Patients 营养护理中心，为慢性肾病患者提供肾脏营养治疗。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-07-01 DOI: 10.1053/j.jrn.2025.02.005

Abril Gutiérrez-Espinoza MNH , Julia Nava-Hernández MNH , Rocío Urbina-Arronte MNC , Araceli Aguilar-Gamiño MNC , Adriana Salinas-Rico MNC , Nadia Aldana-Solís MNC , Sara De La Rosa-Diez MNC , Rafael Montufar-Cárdenas MD , Joel D. Kopple MD

Objective

This paper describes a novel program that provides nutritional care to people with chronic kidney disease (CKD).

Design and Methods

This is an observational study of the structure and function of Centro de Atencion Nutricional—Center of Nutritional Care (CEAN) Centers in metropolitan areas in Mexico that provide nutritional care to patients with CKD. Data on nutritional outcomes to treatment were obtained retrospectively from clinic records.

Results

The centers consist of several offices that are staffed by licensed dietitians who have undergone training in renal nutrition and are experienced in treating CKD patients. Any licensed physician in Mexico can refer patients to these centers for nutritional assessment and counseling. At their initial visit, patients undergo a comprehensive nutritional assessment by a dietitian, which includes anthropometry, bioelectrical impedance and handgrip strength, and requests for laboratory measurements. A nutritional diagnosis and dietary treatment plan are developed. The patient’s referring physician receives a typed consultation. Almost 50% of the patients make 4 or more follow-up visits to the Center. Those patients who had an initial visit and a tenth visit displayed a reduced dietary protein intake with no reduction in serum albumin or handgrip strength. Body mass index, which averaged overweight, decreased slightly.

Conclusions

Centro de Atencion Nutricional in Mexico can provide sophisticated nutritional assessment, dietary therapy and nutritional follow-up for patients with CKD. Preliminary data suggest good nutritional responses in these centers. Clinical trials are needed to examine more definitively whether these centers improve nutritional and clinical outcomes in patients with CKD.

目的：本文介绍了一项为慢性肾脏病（CKD）患者提供营养护理的新计划：本文介绍了一项为慢性肾病（CKD）患者提供营养护理的新型计划：这是一项观察性研究，旨在了解墨西哥大都市地区为慢性肾脏病患者提供营养护理的 CEAN（Centro de Atencion Nutricional - 营养护理中心）中心的结构和功能。从门诊记录中回顾性地获得了有关营养治疗效果的数据：这些中心由几个办公室组成，其工作人员都是经过肾脏营养培训、在治疗慢性肾脏病患者方面经验丰富的持证营养师。墨西哥的任何持证医生都可以将患者转介到这些中心进行营养评估和咨询。首次就诊时，营养师会对患者进行全面的营养评估，包括人体测量、生物电阻抗和握力，并要求进行实验室测量。然后制定营养诊断和饮食治疗计划。患者的转诊医生会收到一份打印好的会诊报告。近 50%的患者会到中心进行四次或四次以上的复诊。初次就诊和第十次就诊的患者饮食中的蛋白质摄入量有所减少，但血清白蛋白和握力没有下降。平均超重的体重指数略有下降：墨西哥的 CEAN 中心可以为慢性肾脏病患者提供复杂的营养评估、饮食治疗和营养随访。初步数据表明，这些中心的营养状况良好。需要进行临床试验，以更明确地检验这些中心是否能改善慢性肾脏病患者的营养状况和临床疗效。

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引用次数: 0

Nutritional Intake and Diet Quality in Hemodialysis Patients: Scope for Improvement 血液透析患者的营养摄入和饮食质量：有待改善的范围。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-07-01 DOI: 10.1053/j.jrn.2025.03.004

Manon de Geus MSc , Wesley Visser PhD , Anneke van Egmond-de Mik BSc , Manouk Dam PhD , Evelien de Cuyper BSc , Marian de van der Schueren (Prof.) , Michael Tieland PhD , Peter Weijs (Prof.) , Hinke Kruizenga PhD , Karin Ipema PhD

Objective

Hemodialysis (HD) patients face challenges in upholding dietary compliance. This study aimed to compare dietary intake against disease-specific guidelines. Secondary, to assess the overall diet quality and to explore the association between dietary potassium intake and serum potassium concentrations.

Methods

In this cross-sectional multicenter study, nutrient intake of Dutch adult HD patients was assessed using food frequency questionnaires and diet quality with the Dutch Healthy Diet 15-index. Intake and diet quality were compared to disease-specific dietary recommendations or Dutch Dietary Guidelines. Insufficient intake was defined as <90% of the requirement, sufficient as 90-100%, and excessive as >110%. The association between serum potassium concentration and dietary potassium intake was modeled with linear regression analysis.

Results

The study population consisted of 248 participants (60% male) from 21 dialysis centers. Energy intake (1789 [872] kcal/day) was insufficient for 45% of the participants, while protein intake (1 [0.5] g/kg/d) was insufficient for 50%. Despite 67% of participants managing to align their energy intake below 110% of the recommended level, a high prevalence of overweight (61%) was observed in this cohort. Saturated fat intake was excessive for 87% of participants, while only 15% met the recommended fiber intake. Overall diet quality was low (74 [20] maximum score of 150). No association was observed between serum potassium and dietary potassium intake after adjusting for relevant confounders (r = 0.163, P = .261).

Conclusions

A considerable proportion of Dutch HD patients were unable to meet disease-specific dietary guidelines. Diet quality was shown to be poor.

目的：血液透析（HD）患者在维持饮食依从性方面面临挑战。这项研究的目的是比较饮食摄入量和疾病特异性指南。其次，评估整体饮食质量，探讨膳食钾摄入量与血清钾浓度之间的关系。方法：在本横断面多中心研究中，采用食物频率问卷（FFQs）评估荷兰成年HD患者的营养摄入，并采用荷兰健康饮食15指数（DHD15-index）评估饮食质量。将摄入量和饮食质量与疾病特定饮食建议或荷兰饮食指南进行比较。摄入不足的定义为110%。血清钾浓度与饲粮钾摄入量之间的关系采用线性回归分析。结果：研究人群包括来自21个透析中心的248名参与者（60%为男性）。45%的参与者能量摄入（1789[872]千卡/天）不足，50%的参与者蛋白质摄入（1[0.5]克/公斤/天）不足。尽管67%的参与者设法将他们的能量摄入控制在推荐水平的110%以下，但在该队列中观察到超重的高患病率（61%）。87%的参与者饱和脂肪摄入量过高，而只有15%的参与者达到了建议的纤维摄入量。总体饮食质量较低（74桶，最高得分为150）。校正相关混杂因素后，血清钾和膳食钾摄入量之间无相关性（r= 0.163， P= 0.261）。结论：相当比例的荷兰HD患者无法满足特定疾病的饮食指南。饮食质量很差。

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引用次数: 0

A Guide to Filipino Foods While on Dialysis 透析期间的菲律宾食物指南。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-07-01 DOI: 10.1053/j.jrn.2025.04.004

Melissa Prest DCN, Alanna Marder MSN

引用次数: 0

Evaluation of Amino Acid Kinetics During Low-Dose Continuous Renal Replacement Therapy in Patients With Acute Kidney Injury: A Prospective Single-Center Study 急性肾损伤患者低剂量连续肾替代治疗期间氨基酸动力学的评估：一项前瞻性单中心研究。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-07-01 DOI: 10.1053/j.jrn.2025.02.004

Hiroomi Tatsumi MD, PhD , Shinya Chihara MD, PhD , Masayuki Akatsuka MD, PhD , Hiromitsu Kuroda MD, PhD , Satoshi Kazuma MD, PhD , Miyuki Tani MS , Satoru Kamoshita BA , Akiyoshi Kuroda PhD , Yoshiki Masuda MD, PhD

Objective

Amino acid and protein loss during continuous renal replacement therapy has been proposed to contribute to protein-energy wasting in patients with acute kidney injury (AKI); however, the actual amount removed remains unclear. We investigated the loss of amino acids and proteins in the filtrate during continuous renal replacement therapy in patients who did not receive nutritional supplementation.

Methods

A total of 19 patients with AKI who received low-dose continuous venovenous hemofiltration (CVVH) were included. Blood samples were collected before CVVH initiation and at 30, 60, 120, and 240 minutes thereafter, and a filtrate sample was collected at 240 minutes. Changes in blood amino acid concentrations during 240-minute CVVH sessions were measured. The amino acid and protein concentrations in the filtrate were determined at the end of the 240-minute CVVH session, and the amounts of amino acids and proteins lost during 240-minute CVVH were calculated.

Results

The median total amino acid blood concentrations did not decrease and were near the lower limits of the reference ranges. The median concentrations of 3-methyl histidine, a marker of skeletal muscle catabolism, were above the upper limits of the reference ranges throughout the CVVH session. The median total amino acidloss during the 240-minute CVVH session was 0.95 g. In 10 patients with detectable proteins in the filtrate, the median protein loss was 2.52 g.

Conclusion

These results suggest that optimal nutritional management in patients with AKI who receive CVVH should take into account amino acid and protein loss and hypercatabolism.

目的：在持续肾替代治疗（CRRT）期间氨基酸和蛋白质的损失被认为是急性肾损伤（AKI）患者蛋白质能量浪费（PEW）的原因之一；然而，实际的撤资数额仍不清楚。我们研究了没有接受营养补充的患者在CRRT期间滤液中氨基酸和蛋白质的损失。方法：选取19例接受低剂量连续静脉-静脉血液滤过（CVVH）治疗的AKI患者。CVVH起始前和起始后30、60、120、240分钟采集血样，240分钟采集滤液样本。测量240分钟CVVH期间血液氨基酸浓度的变化。在240分钟CVVH结束时测定滤液中的氨基酸和蛋白质浓度，并计算240分钟CVVH期间氨基酸和蛋白质的损失量。结果：总氨基酸（TAA）血药浓度中位数未下降，接近参考范围下限。3-甲基组氨酸（骨骼肌分解代谢的标志物）的中位浓度在整个CVVH期间都高于参考范围的上限。在240分钟的CVVH期间，TAA损失的中位数为0.95 g。在滤液中检测到蛋白质的10例患者中，平均蛋白质损失为2.52 g。结论：这些结果表明，接受CVVH治疗的AKI患者的最佳营养管理应考虑氨基酸和蛋白质的损失以及高分解代谢。

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引用次数: 0

Comment on: The Effect of Antihypertensive Therapy on Skeletal Muscle Mass and Bone Mineral Density in Patients With End-Stage Kidney Disease 评论：降压治疗对终末期肾病患者骨骼肌质量和骨密度的影响。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-07-01 DOI: 10.1053/j.jrn.2025.01.009

Aqsa Sabir MBBS, Alaita Fatima Bakhtiari MBBS

引用次数: 0

Message From the ChairPerson CRN -主席留言。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-07-01 DOI: 10.1053/j.jrn.2025.04.003

Jill Hoyt RDN, CD, FNKF

引用次数: 0

July Meeting Announcements 7月会议公告

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-07-01 DOI: 10.1053/j.jrn.2025.04.002

引用次数: 0

Response Letter to Comment on: The Effect of Antihypertensive Therapy on Skeletal Muscle Mass and Bone Mineral Density in Patients With End-Stage Kidney Disease 关于“降压治疗对终末期肾病患者骨骼肌质量和骨密度的影响”评论的回复信。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-07-01 DOI: 10.1053/j.jrn.2025.03.003

Rena Suzukawa, Shintaro Mandai MD, PhD, Hiroko Hashimoto MD, PhD, Satomi Shikuma MD, Mai Kimura MD, Hayato Toma MD, Yuki Sakaguchi MD, Sayuka Shiraishi MD, Noriyuki Toshima MD, Motoki Hoshino MD, Moe Kimura MD, Jun Ota MD, Susumu Horiuchi MD, Susumu Adachi MD, Shinichi Uchida MD

引用次数: 0

Diet Quality Components and Gut Microbiota of Patients on Peritoneal Dialysis 腹膜透析患者饮食质量组成及肠道菌群。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-05-01 DOI: 10.1053/j.jrn.2025.01.001

Christiane Ishikawa Ramos PhD , Laila Santos de Andrade PhD , Renata Rodrigues Teixeira MD , Natália Barros Ferreira Pereira MD , Fabiana da Silva Lima PhD , Christian Hoffmann PhD , Lilian Cuppari PhD

Objectives

To evaluate the associations between the quality of the diet and its components and microbial diversity and composition in peritoneal dialysis (PD) patients.

Design and Methods

This cross-sectional study included PD patients for at least 3 months, aged 18-75 years and clinically stable. The Diet Quality Index (DQI), validated for the Brazilian population, is based on the energy density of 11 components (“sugar and sweets;” “beef, pork, and processed meat;” “refined grains and breads;” “animal fat;” “poultry, fish, and eggs;” “whole cereals, tubers, and roots;” “fruits”; “nonstarch vegetables;” “legumes and nuts;” “milk and dairy products;” and “vegetable oil”). A proportional score—based on the adequacy of the intake to Brazilian dietary guidelines—is calculated, and a final score ranged from 0 (worse) to 100 (better) is obtained. Fecal samples were collected at home, in a sterile material, kept refrigerated, and delivered to the clinic within 12 hours; α-diversity indices (Observed operational taxonomic units, Chao-1, Shannon’s, Gini-Simpson’s, Pielou eveness, and Faith phylogenetics) and microbial profile were determined by 16S ribosomal DNA with polymerase chain reaction-amplification and sequenced on an Illumina MiSeq platform.

Results

Forty-three participants were included (53.5% men, 52.4 ± 14.1 years, body mass index: 25.9 ± 4.1 kg/m², 30.2% had diabetes mellitus). DQI score was 50.5 (41.9-54.9). The lowest energy density was for the components “animal fat” and “whole cereals and breads, tubers, and roots,” and the highest were for “refined grains and bread” and “beef, pork, and processed meat.” Diversity indices and Enterorhabdus genus were directly associated with the energy density of the components “whole cereals and breads, tubers, and roots” and inversely with “refined grains and bread,” after adjustments for age and diabetes.

Conclusions

Even low, the intake of whole cereals, tubers, and roots has the potential to positively influence the microbiota profile in PD patients.

目的：评价腹膜透析（PD）患者饮食质量及其成分与微生物多样性和组成之间的关系。设计和方法：本横断面研究纳入年龄18-75岁且临床稳定的PD患者，时间至少3个月。巴西人的饮食质量指数（DQI）基于11种成分的能量密度(“糖和甜食”；“牛肉、猪肉及加工肉类”；“精制谷物和面包”；“动物脂肪”;“家禽、鱼和蛋”；“全谷类、块茎和块根”；“水果”;“非淀粉蔬菜”;“豆类和坚果”；“牛奶及乳制品”；“植物油”)。根据巴西膳食指南的摄入量是否足够，计算出一个比例分数，并得到一个从0（较差）到100（较好）的最终分数。在家中收集粪便样本，用无菌材料保存，并在12小时内送到诊所。α-多样性指数（OTUs、chao1、Shannon’、gini - simpson’、Pielou均匀度和faith系统发育）和微生物谱采用16S核糖体DNA进行pcr扩增，并在Illumina MiSeq平台上测序。结果：纳入43例受试者（男性53.5%,52.4±14.1岁，BMI:25.9±4.1 kg/m2，糖尿病患者30.2%）。DQI评分为50.5（41.9 ~ 54.9）。能量密度最低的成分是“动物脂肪”和“全谷物和面包、块茎和根茎”，能量密度最高的成分是“精制谷物和面包”和“牛肉、猪肉和加工肉类”。在调整了年龄和糖尿病因素后，肠道菌属的多样性指数与“全谷物和面包、块茎和根”成分的能量密度呈正相关，与“精粮和面包”成分的能量密度呈负相关。结论：即使摄入量很低，全谷物、块茎和根类食物也可能对腹膜透析患者的微生物群有积极的影响。

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May Meeting Announcements 五月会议公告

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-05-01 DOI: 10.1053/j.jrn.2025.03.001

Mary Kay Hensley MS, RDN, FAND, FNKF

引用次数: 0

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