Pub Date : 2025-03-01Epub Date: 2025-02-05DOI: 10.1053/j.jrn.2025.01.007
Jill Hoyt RD, CD, FNKF
{"title":"Message From the Chair March 2025","authors":"Jill Hoyt RD, CD, FNKF","doi":"10.1053/j.jrn.2025.01.007","DOIUrl":"10.1053/j.jrn.2025.01.007","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Page 373"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-10-01DOI: 10.1053/j.jrn.2024.09.005
Samuel A. Headley , Donna J. Chapman , Michael J. Germain , Elizabeth E. Evans , Karen L. Madsen , Emily M. Miele , Kristyn Kirton , Joshua Loseke , Allen Cornelius , Brian Martin , Bradley Nindl , Heekuk Park , Nosratola D. Vaziri , Talat Alp Ikizler
Objective
This study was designed to determine the effect of 16 weeks of supplementation with Hi-maize 260 resistant starch (RS) on the gut microbiota, uremic toxins (indoxyl sulfate and p-cresyl sulfate [PCS]), markers of inflammation, and oxidative stress along with vascular function in patients with stage G3a-G4 chronic kidney disease (CKD).
Design and Methods
This was a double-blind, placebo-controlled, parallel-arm, randomized controlled trial. Sixty-eight patients with stage-G3a-G4 CKD were randomized to either RS with usual care or placebo and usual care. Patients attended four testing sessions as follows: two baseline (BL) visits and follow-up visits at 8 and 16 weeks. Fasting blood samples, resting brachial and central blood pressures, along with arterial stiffness, were collected at visits (1 or 2) and weeks 8 and 16. A stool sample was collected for analysis of microbial composition at BL and week 16. Patients were randomized after the BL visits.
Results
Patients receiving the RS had a reduction in PCS at week 16. This reduction was associated with a decrease in microbial α-diversity between BL and week 16 (Chao1 P = .014, Shannon P = .017, phylogenetic diversity P = .046, and Simpson P = .017) as well as increases in Subdoligranulum (P = .03) and Oscillospiraceae Unclassified Clostridiales Group 002 (P = .02) and decreases in Bacteroides (P = .009).There were no changes in microbial beta diversity and other biomarkers or markers of vascular function following the 16-week period.
Conclusion
Sixteen weeks of supplementation of RS in patients with stage-G3a-G4 CKD led to changes in microbial composition that were associated with a significant reduction in PCS.
{"title":"Effects of High Amylose-Resistant Starch on Gut Microbiota and Uremic Toxin Levels in Patients With Stage-G3a-G4 Chronic Kidney Disease: A Randomized Trial","authors":"Samuel A. Headley , Donna J. Chapman , Michael J. Germain , Elizabeth E. Evans , Karen L. Madsen , Emily M. Miele , Kristyn Kirton , Joshua Loseke , Allen Cornelius , Brian Martin , Bradley Nindl , Heekuk Park , Nosratola D. Vaziri , Talat Alp Ikizler","doi":"10.1053/j.jrn.2024.09.005","DOIUrl":"10.1053/j.jrn.2024.09.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study was designed to determine the effect of 16 weeks of supplementation with Hi-maize 260 resistant starch (RS) on the gut microbiota, uremic toxins (indoxyl sulfate and p-cresyl sulfate [PCS]), markers of inflammation, and oxidative stress along with vascular function in patients with stage G3a-G4 chronic kidney disease (CKD).</div></div><div><h3>Design and Methods</h3><div>This was a double-blind, placebo-controlled, parallel-arm, randomized controlled trial. Sixty-eight patients with stage-G3a-G4 CKD were randomized to either RS with usual care or placebo and usual care. Patients attended four testing sessions as follows: two baseline (BL) visits and follow-up visits at 8 and 16 weeks. Fasting blood samples, resting brachial and central blood pressures, along with arterial stiffness, were collected at visits (1 or 2) and weeks 8 and 16. A stool sample was collected for analysis of microbial composition at BL and week 16. Patients were randomized after the BL visits.</div></div><div><h3>Results</h3><div>Patients receiving the RS had a reduction in PCS at week 16. This reduction was associated with a decrease in microbial α-diversity between BL and week 16 (Chao1 <em>P</em> = .014, Shannon <em>P</em> = .017, phylogenetic diversity <em>P</em> = .046, and Simpson <em>P</em> = .017) as well as increases in Subdoligranulum (<em>P</em> = .03) and Oscillospiraceae Unclassified Clostridiales Group 002 (<em>P</em> = .02) and decreases in Bacteroides (<em>P</em> = .009).There were no changes in microbial beta diversity and other biomarkers or markers of vascular function following the 16-week period.</div></div><div><h3>Conclusion</h3><div>Sixteen weeks of supplementation of RS in patients with stage-G3a-G4 CKD led to changes in microbial composition that were associated with a significant reduction in PCS.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 248-258"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-07-27DOI: 10.1053/j.jrn.2024.07.013
Lijuan Guo MD , Pin Zhao MD , Zhaowei Zhu MD
Objective
Chronic kidney disease (CKD) is characterized by a gradual decline in kidney function over time. The role of dietary inflammatory index (DII) and systemic immune-inflammation index (SII) in individuals with CKD remains uncertain. We aimed to explore the potential correlation between DII and SII with the prevalence of CKD in adult Americans.
Methods
This cross-sectional study used data from the National Health and Nutrition Examination Study between 1999 and 2018. The DII was calculated based on the 24-hour dietary history interview, while the SII was calculated as the product of platelet count multiplied by neutrophil count and divided by lymphocyte count. CKD was diagnosed based on impaired glomerular filtration rate (<60 mL/min per 1.73 m2) or urinary albumin-creatinine ratio ≥30 mg/g. Multivariable logistic regression analyses and subgroup analyses were performed to examine the association between DII/SII and CKD.
Results
In total, this study included 40,388 participants, of whom 7443 (18.4%) had CKD. The prevalence of CKD changed from 14.84% (95% confidence interval (CI): 13.20-16.48%) in 1999-2000 to 12.76% (95% CI: 11.10-14.43%) in 2017-2018. According to adjusted multivariate logistic regression models, individuals with higher DII scores had a higher likelihood of having CKD (odds ratio = 1.24; 95% CI: 1.12-1.37). Similarly, higher SII scores were associated with a higher risk of CKD (odds ratio = 1.37; 95% CI: 1.25-1.50). Subgroup analyses further demonstrated relatively stronger associations between DII/SII and CKD among individuals with other factors such as sex, age, body mass index, smoking status, drinking status, hypertension, and diabetes.
Conclusions
The DII and SII scores were significantly positively associated with higher risks of CKD. Anti-inflammatory diet might have the potential to prevent CKD. The SII may serve as a cost-effective and straightforward approach for detecting CKD. Further prospective longitudinal studies are needed to verify the causality.
{"title":"Higher Dietary Inflammatory Index and Systemic Immune-Inflammation Index Score are Associated With Higher Risk of Chronic Kidney Disease: Analysis of the National Health and Nutrition Examination Survey From 1999 to 2018","authors":"Lijuan Guo MD , Pin Zhao MD , Zhaowei Zhu MD","doi":"10.1053/j.jrn.2024.07.013","DOIUrl":"10.1053/j.jrn.2024.07.013","url":null,"abstract":"<div><h3>Objective</h3><div>Chronic kidney disease (CKD) is characterized by a gradual decline in kidney function over time. The role of dietary inflammatory index (DII) and systemic immune-inflammation index (SII) in individuals with CKD remains uncertain. We aimed to explore the potential correlation between DII and SII with the prevalence of CKD in adult Americans.</div></div><div><h3>Methods</h3><div>This cross-sectional study used data from the National Health and Nutrition Examination Study between 1999 and 2018. The DII was calculated based on the 24-hour dietary history interview, while the SII was calculated as the product of platelet count multiplied by neutrophil count and divided by lymphocyte count. CKD was diagnosed based on impaired glomerular filtration rate (<60 mL/min per 1.73 m<sup>2</sup>) or urinary albumin-creatinine ratio ≥30 mg/g. Multivariable logistic regression analyses and subgroup analyses were performed to examine the association between DII/SII and CKD.</div></div><div><h3>Results</h3><div>In total, this study included 40,388 participants, of whom 7443 (18.4%) had CKD. The prevalence of CKD changed from 14.84% (95% confidence interval (CI): 13.20-16.48%) in 1999-2000 to 12.76% (95% CI: 11.10-14.43%) in 2017-2018. According to adjusted multivariate logistic regression models, individuals with higher DII scores had a higher likelihood of having CKD (odds ratio = 1.24; 95% CI: 1.12-1.37). Similarly, higher SII scores were associated with a higher risk of CKD (odds ratio = 1.37; 95% CI: 1.25-1.50). Subgroup analyses further demonstrated relatively stronger associations between DII/SII and CKD among individuals with other factors such as sex, age, body mass index, smoking status, drinking status, hypertension, and diabetes.</div></div><div><h3>Conclusions</h3><div>The DII and SII scores were significantly positively associated with higher risks of CKD. Anti-inflammatory diet might have the potential to prevent CKD. The SII may serve as a cost-effective and straightforward approach for detecting CKD. Further prospective longitudinal studies are needed to verify the causality.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 300-310"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Subjective Global Assessment (SGA) is a validated tool for identifying nutritional status in patients receiving maintenance hemodialysis (MHD), but it is not without limitations. Current research identifies additional clinical characteristics such as phase angle (PhA) associated with SGA. This study aimed to assess the overall correlation between PhA and SGA; associations between PhA and SGA by body mass index, and to identify clinical characteristics associated with SGA.
Design and Methods
This is a secondary analysis of the Rutgers Nutrition & Kidney Database, which enrolled participants from four primary studies that included adults diagnosed with chronic kidney disease who were receiving MHD. Multivariable binary logistic regression analyses were conducted to estimate odds ratio (OR) and corresponding 95% confidence intervals (CIs).
Results
The study sample included 60.0% males with 81.1% of the sample identifying as African American. Additionally, 38.9% were obese according to the body mass index classification, and 57.0% were moderately malnourished. Patients with obesity had 44% lower odds of being moderately malnourished (OR = 0.56, 95% CI = 0.37, 0.85). In the model adjusted for age and ethnicity and other clinical characteristics, increasing PhA values by one unit was associated with 28% lower odds (OR = 0.72, 95% CI = 0.53, 0.97) of being moderately malnourished while increasing waist circumference (WC) values by one unit was associated with 12% higher odds (OR = 1.12; 95% CI = 1.06, 1.19) of being moderately malnourished than well-nourished. In this fully adjusted model, increasing fat free mass (FFM, OR = 0.95, 95% CI = 0.91, 0.99) and fat mass (FM, OR = 0.92, 95% CI = 0.87, 0.97) by 1 kg was also associated with 5% and 8% lower odds of being moderately malnourished, respectively.
Conclusion
PhA and SGA were significantly associated only among patients classified as obese. PhA, WC, FM, and FFM were identified as potential clinical determinants of SGA. Patients receiving MHD and who have obesity may benefit from utilizing SGA along with WC, PhA, FM, and FFM to assess nutritional status.
{"title":"Potential Determinants of Subjective Global Assessment Among Patients on Maintenance Hemodialysis","authors":"Carla Ferrell DCN, RD, LD , Laura Byham-Gray PhD, RDN, FNKF , Hamed Samavat PhD, RDN , Mireille Hamdan DCN, RDN","doi":"10.1053/j.jrn.2024.04.003","DOIUrl":"10.1053/j.jrn.2024.04.003","url":null,"abstract":"<div><h3>Objective</h3><div>The Subjective Global Assessment (SGA) is a validated tool for identifying nutritional status in patients receiving maintenance hemodialysis (MHD), but it is not without limitations. Current research identifies additional clinical characteristics such as phase angle (PhA) associated with SGA. This study aimed to assess the overall correlation between PhA and SGA; associations between PhA and SGA by body mass index, and to identify clinical characteristics associated with SGA.</div></div><div><h3>Design and Methods</h3><div>This is a secondary analysis of the Rutgers Nutrition & Kidney Database, which enrolled participants from four primary studies that included adults diagnosed with chronic kidney disease who were receiving MHD. Multivariable binary logistic regression analyses were conducted to estimate odds ratio (OR) and corresponding 95% confidence intervals (CIs).</div></div><div><h3>Results</h3><div>The study sample included 60.0% males with 81.1% of the sample identifying as African American. Additionally, 38.9% were obese according to the body mass index classification, and 57.0% were moderately malnourished. Patients with obesity had 44% lower odds of being moderately malnourished (OR = 0.56, 95% CI = 0.37, 0.85). In the model adjusted for age and ethnicity and other clinical characteristics, increasing PhA values by one unit was associated with 28% lower odds (OR = 0.72, 95% CI = 0.53, 0.97) of being moderately malnourished while increasing waist circumference (WC) values by one unit was associated with 12% higher odds (OR = 1.12; 95% CI = 1.06, 1.19) of being moderately malnourished than well-nourished. In this fully adjusted model, increasing fat free mass (FFM, OR = 0.95, 95% CI = 0.91, 0.99) and fat mass (FM, OR = 0.92, 95% CI = 0.87, 0.97) by 1 kg was also associated with 5% and 8% lower odds of being moderately malnourished, respectively.</div></div><div><h3>Conclusion</h3><div>PhA and SGA were significantly associated only among patients classified as obese. PhA, WC, FM, and FFM were identified as potential clinical determinants of SGA. Patients receiving MHD and who have obesity may benefit from utilizing SGA along with WC, PhA, FM, and FFM to assess nutritional status.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 319-327"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-12-11DOI: 10.1053/j.jrn.2024.11.008
Maryanne Zilli Canedo Silva PhD, Carla Maria Avesani PhD, Jacqueline Costa Teixeira Caramori MD, PhD
{"title":"Author’s Reply to the Letter to the Editor: “Nutritional Status of Patients Starting on Peritoneal Dialysis: Comparison Between Planned and Unplanned Dialysis Initiation”","authors":"Maryanne Zilli Canedo Silva PhD, Carla Maria Avesani PhD, Jacqueline Costa Teixeira Caramori MD, PhD","doi":"10.1053/j.jrn.2024.11.008","DOIUrl":"10.1053/j.jrn.2024.11.008","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 365-366"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-12-19DOI: 10.1053/j.jrn.2024.12.003
Takahiro Yajima MD
{"title":"Is the “Nutritional Risk Index for Japanese Hemodialysis” Validated as a Nutritional and Prognostic Indicator?","authors":"Takahiro Yajima MD","doi":"10.1053/j.jrn.2024.12.003","DOIUrl":"10.1053/j.jrn.2024.12.003","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 368-370"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-12-08DOI: 10.1053/j.jrn.2024.11.009
Fan Zhang , Hui Wang , Yan Bai , Liuyan Huang , Huachun Zhang
This review evaluates the effectiveness of nutritional supplementation combined with exercise training on frailty characteristics, physical function, and health-related quality of life in patients with chronic kidney disease (CKD). A systematic search of PubMed, Embase, Web of Science, and Scopus was conducted, identifying 7 articles (9 trials, 324 patients). Meta-analysis showed that combined interventions improved frailty characteristics, such as walking speed (mean difference: 0.09 m/s, 95% confidence interval (CI): 0.02 to 0.16) and physical functioning, including cardiorespiratory fitness (standardized mean difference: 0.56, 95% CI: 0.20 to 0.93) and lower extremity mobility (Timed Up and Go test: -1.11 s, 95% CI: −1.79 to -0.43). However, effects on body weight, fatigue, and health-related quality of life remain uncertain. Due to study heterogeneity and small sample sizes, findings should be interpreted cautiously. Larger, long-term studies are needed to confirm these results and explore additional health outcomes.
目的：营养补充和运动训练的联合干预策略有可能支持慢性肾脏疾病（CKD）患者虚弱的治疗和改善健康结果。本研究旨在评估营养补充结合运动训练干预对CKD患者虚弱特征、身体功能和健康相关生活质量的有效性。设计与方法：检索PubMed、Embase、Web of Science和Scopus，检索时间为成立至2022年10月22日，更新时间为2023年5月。一项随机对照试验（RCT）将营养补充结合运动训练与常规护理/单一营养补充或运动训练进行比较，以评估对CKD患者弗里德基础虚弱特征和身体功能的影响。两位作者独立选择文献，提取数据，并使用Cochrane偏倚风险工具2评估偏倚风险。使用hartung - knap - sidik - jonkman方法的随机效应模型或使用受限最大似然的固定效应模型对结果进行分析。采用“留一”法进行敏感性分析。结果：纳入7篇文章（9项试验，共324例患者）。荟萃分析显示，营养补充结合运动训练干预可以改善透析患者的虚弱特征，如步行速度（平均差值（MD）： 0.09 m/s, 95%（置信区间）CI 0.02至0.16），身体功能，如心肺功能（标准化平均差值（SMD）： 0.56, 95% CI 0.20至0.93），以及通过timed up and go测试评估的下肢活动能力（MD: -1.11 s, 95% CI -1.79至-0.43）。然而，联合干预对体重（MD: 1.28 kg, 95% CI -2.06 - 4.62）、疲劳（SMD: 0.57, 95% CI -1.44 - 0.30）和健康相关生活质量等其他指标的影响尚不确定。由于纳入研究的异质性和相对较小的样本量，这些结果应谨慎解释。结论：营养补充与运动训练相结合的干预策略可能有助于改善CKD患者的虚弱和身体功能，特别是步行速度、心肺健康和下肢活动能力。未来的研究应侧重于更大的样本量和长期随访，以证实这些初步发现，并探讨对其他健康指标的潜在影响。
{"title":"Effects of Nutritional Supplementation Combined With Exercise Training on Frailty, Physical Function, and Quality of Life in Chronic Kidney Disease: A Systematic Review and Meta-Analysis","authors":"Fan Zhang , Hui Wang , Yan Bai , Liuyan Huang , Huachun Zhang","doi":"10.1053/j.jrn.2024.11.009","DOIUrl":"10.1053/j.jrn.2024.11.009","url":null,"abstract":"<div><div>This review evaluates the effectiveness of nutritional supplementation combined with exercise training on frailty characteristics, physical function, and health-related quality of life in patients with chronic kidney disease (CKD). A systematic search of PubMed, Embase, Web of Science, and Scopus was conducted, identifying 7 articles (9 trials, 324 patients). Meta-analysis showed that combined interventions improved frailty characteristics, such as walking speed (mean difference: 0.09 m/s, 95% confidence interval (CI): 0.02 to 0.16) and physical functioning, including cardiorespiratory fitness (standardized mean difference: 0.56, 95% CI: 0.20 to 0.93) and lower extremity mobility (Timed Up and Go test: -1.11 s, 95% CI: −1.79 to -0.43). However, effects on body weight, fatigue, and health-related quality of life remain uncertain. Due to study heterogeneity and small sample sizes, findings should be interpreted cautiously. Larger, long-term studies are needed to confirm these results and explore additional health outcomes.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 259-270"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The effects of alpha-lipoic acid (ALA) supplementation on cardiovascular-related factors have been evaluated in a number of randomized clinical trials, with different results. Thus, in this meta-analysis, the effects of ALA on blood levels of inflammatory, lipid, and hematological markers as well as anthropometric indices in patients with chronic kidney disease (CKD) were evaluated.
Methods
Five electronic databases were used to conduct a comprehensive search through October 2023. Risk of bias assessment and data extraction were carried out separately by 2 reviewers on the included papers. The data were analyzed using the random-effects model in meta-analyses. The data were analyzed using the random-effects model in meta-analyses. We assessed inter-study heterogeneity with I2 and Cochran's Q test.
Results
Nine of the 421 potential reports were included. Using random-effects models, no significant changes were observed in weight loss, body mass index, hemoglobin, and iron following ALA supplementation (600 mg/day). Results exhibited that ALA significantly reduced high-sensitivity C-reactive protein levels in individuals with CKD (weighted mean difference (WMD) = −2.91 mg/L, 95% CI: −4.65, −1.17, I2 = 50.5%, P = .09); however, there were no significant variations in levels of interleukin-6 (IL-6) or malondialdehyde. Regarding lipid profiles, findings revealed that ALA administration had no significant impact on high-density lipoprotein cholesterol and triglycerides levels among patients with CKD. However, compared to the control group, total cholestrol levels were considerably lower in CKD patients (WMD = −5.48 mg/dL, 95% CI: −10.55, −0.41, I2 = 0.0%, P = .50). Moreover, the sensitivity analyses showed that pooled WMDs for low-density lipoprotein cholesterol levels were significantly changed (−6.88 mg/dL, 95% CI, −12.78, −0.98).
Conclusions
These findings revealed that ALA supplementation slightly but significantly reduced blood levels of high-sensitivity C-reactive protein, total cholestrol, and low-density lipoprotein cholesterol, but did not affect IL-6, malondialdehyde, high-density lipoprotein cholesterol, weight, body mass index, iron, and hemoglobin in patients with CKD.
{"title":"Effects of Alpha-Lipoic Acid Supplementation on Weight Loss, Inflammatory, Lipid, and Hematological Levels in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Hadi Rezaei MD , Mahdi Ravankhah MD , Mahboobeh Ansari MD , Aida Alirezaee MD , Omid Keshavarzian MD , Mozhan Abdollahi MD , Hamid Reza Sabet MSc","doi":"10.1053/j.jrn.2024.08.004","DOIUrl":"10.1053/j.jrn.2024.08.004","url":null,"abstract":"<div><h3>Objectives</h3><div>The effects of alpha-lipoic acid (ALA) supplementation on cardiovascular-related factors have been evaluated in a number of randomized clinical trials, with different results. Thus, in this meta-analysis, the effects of ALA on blood levels of inflammatory, lipid, and hematological markers as well as anthropometric indices in patients with chronic kidney disease (CKD) were evaluated.</div></div><div><h3>Methods</h3><div>Five electronic databases were used to conduct a comprehensive search through October 2023. Risk of bias assessment and data extraction were carried out separately by 2 reviewers on the included papers. The data were analyzed using the random-effects model in meta-analyses. The data were analyzed using the random-effects model in meta-analyses. We assessed inter-study heterogeneity with I<sup>2</sup> and Cochran's Q test.</div></div><div><h3>Results</h3><div>Nine of the 421 potential reports were included. Using random-effects models, no significant changes were observed in weight loss, body mass index, hemoglobin, and iron following ALA supplementation (600 mg/day). Results exhibited that ALA significantly reduced high-sensitivity C-reactive protein levels in individuals with CKD (weighted mean difference (WMD) = −2.91 mg/L, 95% CI: −4.65, −1.17, I<sup>2</sup> = 50.5%, <em>P</em> = .09); however, there were no significant variations in levels of interleukin-6 (IL-6) or malondialdehyde. Regarding lipid profiles, findings revealed that ALA administration had no significant impact on high-density lipoprotein cholesterol and triglycerides levels among patients with CKD. However, compared to the control group, total cholestrol levels were considerably lower in CKD patients (WMD = −5.48 mg/dL, 95% CI: −10.55, −0.41, I<sup>2</sup> = 0.0%, <em>P</em> = .50). Moreover, the sensitivity analyses showed that pooled WMDs for low-density lipoprotein cholesterol levels were significantly changed (−6.88 mg/dL, 95% CI, −12.78, −0.98).</div></div><div><h3>Conclusions</h3><div>These findings revealed that ALA supplementation slightly but significantly reduced blood levels of high-sensitivity C-reactive protein, total cholestrol, and low-density lipoprotein cholesterol, but did not affect IL-6, malondialdehyde, high-density lipoprotein cholesterol, weight, body mass index, iron, and hemoglobin in patients with CKD.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 289-299"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-01Epub Date: 2024-11-14DOI: 10.1053/j.jrn.2024.11.004
Hongjun Zhao MD, Yanchen Wang MD, Lihui Guan MD, Yaofei Sun MD
Objectives
Higher serum magnesium concentrations have been linked to reduced risk of chronic kidney diseases (CKDs). However, the dose–response relationships between magnesium intake and CKD and kidney stones in the general population remain unknown. This study aimed to quantitatively assess the dose–response relationships between magnesium intake and CKD and kidney stones.
Methods
Adult participants (≥50 years) from the 2007-2018 National Health and Nutrition Examination Survey were included. Magnesium intake from diet and supplements were determined with structured dietary recalls. Patients with kidney stones were identified using a standard questionnaire. CKD was defined as estimated glomerular filtration rate <60 mL/min/1.73 m2. The nonlinear relationships were explored with restricted cubic splines. Stratified analyses by sex were conducted.
Results
The weighted prevalence of CKD and kidney stones was 12.16% and 13.13%, respectively. A nonlinear relationship between magnesium intake and CKD (Pfor nonlinearity<.01) and kidney stones (Pfor nonlinearity = .02) was found. There was an initial steep decrease in odds of CKD and kidney stones with increasing intakes of magnesium, and then a platform or weaker decrease in odds of CKD and kidney stones was observed beyond 350 mg/day of magnesium intake [odds ratio (95% confidence interval) for CKD: 0.60 (0.46-0.78), 0.77 (0.61-0.98) for kidney stones]. Higher magnesium intake was inversely associated with odds of CKD in both males and females, while the inverse association between higher magnesium intake and odds of kidney stones was only statistically significant in females.
Conclusions
Higher magnesium intake was nonlinearly associated with lower odds of kidney stones and CKD, and a threshold level of 350 mg/day of magnesium intake was observed in adults aged 50 years and older. These findings deserve to be confirmed by prospective cohort studies.
{"title":"Association Between Magnesium Intake and Chronic Kidney Diseases and Kidney Stones in Adults Aged 50 years and Older: Dose–Response Analysis of a Nationally Representative Population-Based Study","authors":"Hongjun Zhao MD, Yanchen Wang MD, Lihui Guan MD, Yaofei Sun MD","doi":"10.1053/j.jrn.2024.11.004","DOIUrl":"10.1053/j.jrn.2024.11.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Higher serum magnesium concentrations have been linked to reduced risk of chronic kidney diseases (CKDs). However, the dose–response relationships between magnesium intake and CKD and kidney stones in the general population remain unknown. This study aimed to quantitatively assess the dose–response relationships between magnesium intake and CKD and kidney stones.</div></div><div><h3>Methods</h3><div>Adult participants (≥50 years) from the 2007-2018 National Health and Nutrition Examination Survey were included. Magnesium intake from diet and supplements were determined with structured dietary recalls. Patients with kidney stones were identified using a standard questionnaire. CKD was defined as estimated glomerular filtration rate <60 mL/min/1.73 m<sup>2</sup>. The nonlinear relationships were explored with restricted cubic splines. Stratified analyses by sex were conducted.</div></div><div><h3>Results</h3><div>The weighted prevalence of CKD and kidney stones was 12.16% and 13.13%, respectively. A nonlinear relationship between magnesium intake and CKD (<em>P</em><sub>for nonlinearity</sub><.01) and kidney stones (<em>P</em><sub>for nonlinearity</sub> = .02) was found. There was an initial steep decrease in odds of CKD and kidney stones with increasing intakes of magnesium, and then a platform or weaker decrease in odds of CKD and kidney stones was observed beyond 350 mg/day of magnesium intake [odds ratio (95% confidence interval) for CKD: 0.60 (0.46-0.78), 0.77 (0.61-0.98) for kidney stones]. Higher magnesium intake was inversely associated with odds of CKD in both males and females, while the inverse association between higher magnesium intake and odds of kidney stones was only statistically significant in females.</div></div><div><h3>Conclusions</h3><div>Higher magnesium intake was nonlinearly associated with lower odds of kidney stones and CKD, and a threshold level of 350 mg/day of magnesium intake was observed in adults aged 50 years and older. These findings deserve to be confirmed by prospective cohort studies.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 311-318"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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