Journal of Renal Nutrition最新文献

{"title":"Prevalence and Prognostic Significance of Malnutrition in Critically Ill Patients With Acute Kidney Injury","authors":"Yue Shi ,&nbsp;Hangyu Duan ,&nbsp;Jing Liu ,&nbsp;Xiujie Shi ,&nbsp;Mingming Zhao ,&nbsp;Yongfei Fang ,&nbsp;Yu Zhang","doi":"10.1053/j.jrn.2025.09.006","DOIUrl":"10.1053/j.jrn.2025.09.006","url":null,"abstract":"<div><h3>Objective(s)</h3><div>Malnutrition is a significant factor associated with adverse outcomes in various diseases. However, the prevalence of malnutrition among critically ill patients with acute kidney injury (AKI) and its impact on outcomes have not been thoroughly investigated. The purpose of this study was to investigate the prevalence and prognostic significance of malnutrition in critically ill patients with AKI.</div></div><div><h3>Methods</h3><div>Critically ill patients with AKI were selected from the Medical Information Mart for Intensive Care IV through a retrospective cohort study. The nutritional status of these patients was assessed using the Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI), and Controlling Nutritional Status (CONUT). Cox proportional hazard model, Kaplan-Meier analysis, and limited cubic spline were used to evaluate the association between malnutrition risk and 28-day mortality. In addition, logistic regression, Cox regression, and linear regression were used to assess the correlation between malnutrition risk and in-hospital mortality, 90-day mortality, and hospital length of stay, respectively.</div></div><div><h3>Results</h3><div>Of the 1,129 patients enrolled, 49.6%, 80.0%, and 57.7% were found to have moderate to severe malnutrition based on PNI, GNRI, and CONUT scores, respectively. Higher risk of malnutrition was associated with lower hemoglobin, lymphocytes, serum albumin, total cholesterol, higher creatinine, blood urea nitrogen, sepsis organ failure assessment score, simplified acute physiology score II, higher mortality, and longer hospital stay. Among the patients, 215 (19.04%) died within 28 days of intensive care unit admission. Malnutrition was significantly associated with 28-day mortality risk compared with good nutrition (adjusted hazard ratio for severe malnutrition: PNI:HR 1.57, 95% confidence interval [CI] 1.15-2.14; GNRI:HR 1.62, 95% CI 1.01-2.55; CONUT:HR 2.51, 95% CI 1.31-4.80). These nutritional measures further enhanced the predictive accuracy of 28-day mortality, with the CONUT score demonstrating the strongest association. Furthermore, logistic regression, Cox regression, and linear regression models, respectively, revealed that malnutrition risk was significantly associated with in-hospital mortality, 90-day mortality, and hospital length of stay.</div></div><div><h3>Conclusions</h3><div>Malnutrition is prevalent among critically ill patients with AKI and significantly correlates with 28-day mortality, in-hospital mortality, 90-day mortality, and hospital length of stay. Further research is necessary to evaluate the impact of malnutrition screening and nutritional interventions on improving adverse outcomes.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 1","pages":"Pages 58-69"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226507","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}

{"title":"Plant-Based Calcium-Rich Food Ideas for Dialysis Patients to Improve Hypocalcemia","authors":"Jing Feng MSPH, RDN","doi":"10.1053/j.jrn.2025.11.004","DOIUrl":"10.1053/j.jrn.2025.11.004","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 1","pages":"Pages e1-e6"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650712","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}

{"title":"Ultra-violet Spectrophotometric Analysis of Phosphate Content in Plant-Based Milk Alternatives in Relation to Advanced Chronic Kidney Disease","authors":"Alison L. Lyles BSc (hons) Pharmacology, MSc Dietetics ,&nbsp;Estere Sture BSc (hons) Nutrition ,&nbsp;Ross Walker BSc, MSc","doi":"10.1053/j.jrn.2025.07.002","DOIUrl":"10.1053/j.jrn.2025.07.002","url":null,"abstract":"<div><h3>Objective</h3><div>Managing dietary phosphorus is critical in advanced chronic kidney disease (CKD), where excess intake can lead to complications such as hyperphosphataemia. Plant-based milk alternatives (PBMAs) are increasingly consumed, yet their phosphorus content, particularly in relation to phosphate additives, remains poorly defined in the United Kingdom. This study aimed to quantify and compare the total phosphorus content and phosphorus-to-protein ratio (PPR) in a range of commercially available UK PBMAs, with and without phosphate additives, using ultra-violet (UV) spectrophotometric analysis.</div></div><div><h3>Design and Methods</h3><div>Fourteen PBMAs (from seven plant sources) were analyzed using the molybdenum blue method. Samples were categorized based on presence or absence of phosphate additives. Phosphorus content (mg/100g) and PPR (mg/g protein) were calculated and compared with previously documented data for cow's milk.</div></div><div><h3>Results</h3><div>PBMAs with phosphate additives contained significantly higher phosphorus levels (mean 58.47 mg/100g) than those without (mean 7.38 mg/100g; <em>P</em> &lt; .001). Similarly, PPR was substantially higher in additive-containing PBMAs (mean 197.76 mg/g) versus additive-free options (mean 16.25 mg/g; <em>P</em> &lt; .001). Some PBMAs with additives had phosphorus content and PPR values exceeding those of cow's milk, raising concerns for phosphate management in CKD.</div></div><div><h3>Conclusion</h3><div>Phosphate additives significantly increase the phosphorus load and PPR of PBMAs, which may not be readily apparent to consumers or clinicians due to insufficient labeling. For patients with advanced CKD, selecting additive-free PBMAs may support better phosphorus control and dietary management.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 1","pages":"Pages 83-89"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796676","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}

{"title":"Response to Letter to the Editor: ‘The Role of Smoking in Dietary and Potassium Balance Among Hemodialysis Patients’","authors":"Manon de Geus MSc,&nbsp;Wesley Visser PhD,&nbsp;Anneke van Egmond-de Mik BSc,&nbsp;Manouk Dam MSc,&nbsp;Evelien de Cuyper BSc,&nbsp;Marian de van der Schueren PhD,&nbsp;Michael Tieland PhD,&nbsp;Peter Weijs PhD,&nbsp;Hinke Kruizenga PhD,&nbsp;Karin Ipema PhD","doi":"10.1053/j.jrn.2025.07.010","DOIUrl":"10.1053/j.jrn.2025.07.010","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 1","pages":"Pages 154-155"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786364","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}

{"title":"Amino Acid and Protein Losses in Adult Patients Receiving Maintenance Dialysis: A Literature Review","authors":"Bruno Mafrici RD, BSc, MSc ,&nbsp;Daniela Viramontes-Hörner BSc, MRes, PhD ,&nbsp;David S. Gardner BSc, PhD, DSc ,&nbsp;Kenneth Smith ,&nbsp;Maarten W. Taal FRCP, MD ,&nbsp;Nicholas M. Selby BMedSci, BMBS, DM ,&nbsp;Matt Hall MA, MBBChir, MD, FRCP","doi":"10.1053/j.jrn.2025.07.012","DOIUrl":"10.1053/j.jrn.2025.07.012","url":null,"abstract":"<div><h3>Background</h3><div>A comprehensive, scoping review was initiated with the aim of providing an update regarding amino acid/protein losses in maintenance hemodialysis/hemodiafiltration (HD/HDF), peritoneal dialysis (PD), home HD (HHD), and nocturnal HD (NHD).</div></div><div><h3>Methods</h3><div>From 2000 to 2024, all records that measured amino acid and peptide/protein losses in the dialysate effluent were included.</div></div><div><h3>Results</h3><div>Twenty-nine eligible records were identified (14 HD/15 PD). Amino acid losses ranged from 9.3 ± 2.9 g to 12.0 ± 2.0 g per 4-hour HD session and 0.314 g to 0.522 g/day in PD. Albumin losses ranged from 0.448 g to 3.99 g per HD/HDF session and 4.23 g to 6.12 g/day in PD. Albumin losses were higher with postdilution HDF compared to HD. Total protein losses were not reported in HD studies. Daily protein losses in PD ranged from 4.37 ± 1.71 g to 10.0 ± 0.6 g. No studies in home HD or nocturnal HD populations were identified.</div></div><div><h3>Conclusion</h3><div>Amino acid/protein losses differ between HD/HDF and PD. Since PD occurs daily, patients receiving PD have greater weekly amino acid/protein losses than HD. Whether individualized replacement of these losses is linked to better clinical outcomes needs to be further explored.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 1","pages":"Pages 30-48"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786362","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}

{"title":"Nutritional Parameters Associated With Hospital Mortality in Patients With Acute Kidney Injury","authors":"Fabiola Martín-del-Campo ,&nbsp;Rosalba Sotelo-Anaya ,&nbsp;Pilar C. Castro-Mata ,&nbsp;Guillermo García-García ,&nbsp;Alejandro Martínez Gallardo-González ,&nbsp;Juan A. Gómez-Fregoso ,&nbsp;Francisco G. Rodríguez-García ,&nbsp;Victor H. Luquin-Arellano ,&nbsp;Gabriela Abundis-Mora ,&nbsp;Luz Alcantar-Vallin ,&nbsp;Ramón Medina-González ,&nbsp;Jonathan S. Chavez-Iñiguez","doi":"10.1053/j.jrn.2025.07.003","DOIUrl":"10.1053/j.jrn.2025.07.003","url":null,"abstract":"<div><h3>Objectives</h3><div>Acute kidney injury (AKI) in hospitalized patients is linked to high morbidity and mortality. Nutritional status may be a modifiable factor influencing outcomes, but its role in critically ill patients with AKI remains unclear.</div></div><div><h3>Methods</h3><div>In this single-center prospective study, we evaluated hospitalized adults with AKI who underwent baseline nutritional assessments, including dietary intake, anthropometric data, and subjective global assessment. Nutritional data were collected through direct evaluation or clinical records for those receiving enteral or parenteral nutrition. Logistic regression identified variables associated with in-hospital mortality.</div></div><div><h3>Results</h3><div>A total of 102 patients were included (mean age 53 ± 17 years; 73% male). Sepsis and hypovolemia were the leading causes of AKI; 50% had stage 3 AKI and 40% required renal replacement therapy. The in-hospital mortality rate was 36%. At AKI diagnosis, 26% were fasting; 53% received oral nutrition, 14% enteral nutrition, and 7% parenteral nutrition. Median protein and energy intakes were 0.45 (0.2–0.7) g/kg and 13 (7–23) kcal/kg, respectively. Mortality was significantly higher among fasting patients (<em>P</em> = .004). No significant differences in energy or protein intake were found between survivors and nonsurvivors. Logistic regression showed that fasting at AKI diagnosis increased the risk of death (odds ratio = 3.53, <em>P</em> = .03; AUC = 0.67). Additionally, 34% had moderate to severe wasting, but this was not associated with increased mortality.</div></div><div><h3>Conclusions</h3><div>In this cohort of AKI patients, nutrient intake was frequently below recommended levels, and one-third was fasting at diagnosis. Fasting was independently associated with increased in-hospital mortality, highlighting the need for early nutritional assessment and intervention in this population.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 1","pages":"Pages 49-57"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652062","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}

{"title":"Vegetarian Diet and Kidney Function in Women and Men From Different Ethnic Groups: The Healthy Life in an Urban Setting (HELIUS) Study","authors":"Robin L.A. Smits PhD ,&nbsp;Taryn G. Vosters MSc ,&nbsp;Liffert Vogt MD, PhD ,&nbsp;Henrike Galenkamp PhD ,&nbsp;Mary Nicolaou PhD ,&nbsp;Irene G.M. van Valkengoed PhD","doi":"10.1053/j.jrn.2025.07.011","DOIUrl":"10.1053/j.jrn.2025.07.011","url":null,"abstract":"<div><h3>Objectives</h3><div>A vegetarian diet may benefit kidney function. However, the sex-specific association of adherence to a vegetarian diet and change in kidney function, and its potential underlying mechanisms remain to be established.</div></div><div><h3>Methods</h3><div>Our observational study included baseline and follow-up data on vegetarian diet adherence and estimated glomerular filtration rate (eGFR) from Dutch, South-Asian Surinamese, African Surinamese, Turkish, and Moroccan participants from Healthy Life in an Urban Setting, a multiethnic prospective cohort in Amsterdam. The median time between baseline and follow-up was 81 (70, 95) months. Vegetarian diet adherence was determined through a questionnaire and intake of dietary components was calculated using the food frequency questionnaire. The sex-specific association between vegetarian diet adherence and change in eGFR and albumin-creatinine ratio (ACR) was assessed with linear regression analysis. To explore whether associations were consistent by ethnic group, we stratified the groups of women and men by ethnicity.</div></div><div><h3>Results</h3><div>Among 5,776 women and 4,443 men (median age: 48 [38, 55] and 48 [37, 56], respectively), the median eGFR was 102 (89, 112) and 101 (89, 111) at baseline and 92 (80, 104) and 93 (80, 103) at follow-up. We did not find an association between vegetarian diet adherence and eGFR or ACR change for both sexes. However, a 1 g/day higher fiber intake at baseline was associated with a lower decrease in eGFR of 0.10 (95% confidence interval [CI] 0.02, 0.17) in women and 0.07 (95% CI 0.00, 0.15) in men. Moreover, a 1 g/day higher intake of processed meat intake at baseline was associated with a 0.09 (95% CI 0.04, 0.14) higher increase in ACR in women.</div></div><div><h3>Conclusion</h3><div>We found no evidence that vegetarian diet adherence was associated with a slower kidney function decline for both sexes across ethnic groups. Higher fiber intake and lower processed meat intake (women only) were associated with slower kidney function decline.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 1","pages":"Pages 99-111"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850286","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}

{"title":"Muscle Mass and Myosteatosis as Predictors of Outcome in Kidney Transplantation","authors":"Giacomo Garibotto MD,&nbsp;Daniela Picciotto PhD, MD,&nbsp;Linda W. Moore PhD, RDN","doi":"10.1053/j.jrn.2025.12.001","DOIUrl":"10.1053/j.jrn.2025.12.001","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 1","pages":"Pages 1-3"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746491","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}

{"title":"Author's Response: Effects of Ketoanalogue Supplements on Patients Receiving Continuous Ambulatory Peritoneal Dialysis: A Multicenter, Randomized, Double-Blinded, Placebo-Controlled Study","authors":"Sixiu Chen MD, PhD,&nbsp;Wei Chen MD, PhD,&nbsp;Xueqing Yu MD, PhD","doi":"10.1053/j.jrn.2025.07.013","DOIUrl":"10.1053/j.jrn.2025.07.013","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 1","pages":"Pages 156-157"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796674","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}

{"title":"Is There a De Facto Silo in the Nutrition Management of Dialysis Patients? Examining the Evidence and Potential for Coordinated Interventions by Renal Dietitians and Nephrology Social Workers to Better Optimize Patients’ Nutritional Status","authors":"William A. Wolfe MSW","doi":"10.1053/j.jrn.2025.06.008","DOIUrl":"10.1053/j.jrn.2025.06.008","url":null,"abstract":"<div><div>Moving away from silos in health care, interdisciplinary collaboration has become the standard for optimizing malnutrition outcomes in all affected population groups. Despite this, there has not been any documented coordinated involvement by nephrology social workers with renal dietitians to address psychosocial factors known to adversely affect dialysis patients’ nutritional status. The purpose of this paper is to provide an overview of evidence on ways the integrated involvement of nephrology social workers, targeting depression and cognitive impairment, can help to mitigate their adverse effects and enable renal dietitians to be more effective in their nutritional management of patients. A concluding discussion looks briefly at potential barriers to the coordinated interventions, as well as a possible areas for interdisciplinary research involving nephrology social workers and renal dietitians.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 1","pages":"Pages 24-29"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532759","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}