Journal of Renal Nutrition最新文献

{"title":"Applying Integrative Analysis of Dietary Patterns to Understand Ramadan-Induced Nutritional Status Alterations in Hemodialysis Patients","authors":"Imliya Ibrahim BSc ,&nbsp;Jun-Hao Lim MSc ,&nbsp;Nurul Iman Hafizah Adanan MSc ,&nbsp;Cordelia-Kheng-May Lim MSc ,&nbsp;Geeta Appannah PhD ,&nbsp;Wan Ahmad Hafiz Wan Md Adnan MD ,&nbsp;Nor Fadhlina Zakaria MD, MMed ,&nbsp;Christopher-Thiam-Seong Lim MBBch, MRCP, FAMS, FRCP ,&nbsp;Rosnawati Yahya MBChB, MRCP, FRCP ,&nbsp;Bayan Tashkandi PhD ,&nbsp;Tilakavati Karupaiah PhD, APD ,&nbsp;Zulfitri Azuan Mat Daud PhD, RD","doi":"10.1053/j.jrn.2025.08.004","DOIUrl":"10.1053/j.jrn.2025.08.004","url":null,"abstract":"<div><h3>Objective</h3><div>The changes in dietary behaviors and food choices during Ramadan lead to significant nutritional status alterations in hemodialysis (HD) patients. Routine dietary assessment may not capture disruptions in food behaviors of Muslim HD patients during Ramadan. This study aimed to elucidate changes in nutritional status affected by Ramadan food choices using a dietary pattern (DP) approach.</div></div><div><h3>Methods</h3><div>This 6-week, multicenter, prospective longitudinal study included 102 Malaysian Muslim HD patients who observed fasting during Ramadan. Nutritional assessments, including anthropometry and biochemical parameters, were conducted at 2 timepoints: 2 weeks prior to Ramadan (V0) and during the fourth week of Ramadan (V1). DPs were derived from 3-day diet records collected at V1 using principal component analysis (PCA) and reduced rank regression (RRR). A general linear model with repeated measures was applied to evaluate the variations in Ramadan-induced nutritional status changes across tertiles within each DP. Further, the integrative analysis between the DPs identified the specific foods that contributed to these changes.</div></div><div><h3>Results</h3><div>PCA identified 4 DPs: Home-Foods_DP, Chicken-Meat_DP, Carbohydrate-based_DP, and Traditional_DP. Meanwhile, RRR yielded 1 DP, which is Quick-Foods_DP. Significant interactions between DPs and serum phosphate changes were observed in the Chicken-Meat_DP (<em>P</em> = .020) and Quick-Foods_DP (<em>P</em> = .004), where high adherence to either pattern was associated with increased serum phosphate during Ramadan. The Quick-Foods_DP showed a significant interaction with serum potassium (<em>P</em> &lt; .001), where high adherence was linked to an increasing trend during Ramadan. Additionally, the Home-Foods_DP exhibited a significant interaction with serum albumin (<em>P</em> = .035), where low adherence was associated with a greater reduction during Ramadan.</div></div><div><h3>Conclusion</h3><div>Dietary pattern analysis reveals the synergistic effects of food-food interaction on Ramadan-induced nutritional alterations in HD patients, providing a foundation for evidence-based dietary guidance for Muslim HD patients during Ramadan.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 1","pages":"Pages 130-143"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035040","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":"The Association of Serum Bicarbonate With Psychological and Physical Health-Related Quality of Life in Patients Receiving Maintenance Hemodialysis: A Secondary Analysis of the Frequent Hemodialysis Network Daily Trial","authors":"Katherine Scovner Ravi MD, MPH ,&nbsp;Enass Elsayed MD ,&nbsp;Glenn M. Chertow MD, MPH ,&nbsp;Finnian R. Mc Causland MBBCh, MMSc","doi":"10.1053/j.jrn.2025.05.007","DOIUrl":"10.1053/j.jrn.2025.05.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Serum bicarbonate (S_BIC) is a surrogate for acid-base. Although higher and lower S_BIC concentrations are associated with mortality in patients receiving maintenance hemodialysis (HD), the association of S_BIC with patient-reported outcomes is unclear.</div></div><div><h3>Methods</h3><div>Using data from the Frequent Hemodialysis Network Daily Trial, we performed linear and repeated measures random effects regression to assess the association of pre-HD S_BIC with general well-being (feeling thermometer score), Beck Depression Inventory (BDI) score, and Physical Health Composite score.</div></div><div><h3>Results</h3><div>Among the 244 subjects included in this study, mean age was 50 ± 14 years, 39% were women, and 42% were Black. Compared with S_BIC 25–&lt;28 mEq/L, S_BIC &lt;22 mEq/L and S_BIC ≥28 mEq/L were associated with lower feeling thermometer scores (−3.4; 95% confidence interval [CI] –10.3, +3.5 and −4.4; 95% CI –12.2, +3.4, respectively); S_BIC levels ≥28 mEq/L were associated with higher BDI scores (4.3; 95% CI + 0.5, +8.1). Compared with S_BIC 25–&lt;28 mEq/L in the adjusted repeated measures analysis, S_BIC &lt;22 mEq/L and S_BIC ≥28 mEq/L were associated with lower feeling thermometer scores (−5.1; 95% CI –9.1, −1.1 and −3.7; 95% CI –8.2, +0.7, respectively); S_BIC levels ≥28 mEq/L were associated with higher BDI scores (1.5; 95% CI –0.0, +3.1). There was no association of S_BIC with Physical Health Composite score.</div></div><div><h3>Conclusion</h3><div>Higher and lower pre-HD S_BIC were associated with a lower sense of general well-being and higher S_BIC was associated with more pronounced depressive symptoms. Whether normalization of S_BIC could enhance the well-being of patients receiving maintenance dialysis is unclear.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"36 1","pages":"Pages 121-129"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007021","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":"Technological Devices for Nutritional Counseling in Patients With Diabetic Kidney Disease","authors":"Fabiola Martín-del-Campo PhD ,&nbsp;Andrea Arriaga-Verduzco MSc ,&nbsp;Ari Cisneros-Hernández MSc ,&nbsp;Norma García-Galindo MSc ,&nbsp;Francisco Gerardo Yanowsky-Escatell PhD ,&nbsp;Leonardo Pazarín-Villaseñor PhD ,&nbsp;Jorge Andrade-Sierra PhD","doi":"10.1053/j.jrn.2025.05.006","DOIUrl":"10.1053/j.jrn.2025.05.006","url":null,"abstract":"<div><h3>Objectives</h3><div><span>This study explored the access, use, and acceptance of technological devices for nutritional counseling in patients with </span>diabetic kidney disease (DKD) in a low socioeconomic setting.</div></div><div><h3>Methods</h3><div><span>In this cross-sectional study, 80 adult patients with DKD from an underserved population, attending the </span>nephrology service of a tertiary-care teaching hospital were included. All patients had a clinical, nutritional, and biochemical evaluation; a direct questionnaire was applied to evaluate access and use of technological devices for nutritional counseling as well as their acceptance (knowledge and perception about benefits, barriers, needs, and easy to use).</div></div><div><h3>Results</h3><div>Eighty-seven percent of patients had access to a smartphone, whereas 20% and 6% to a computer and tablet, respectively; 40% use technological devices for health/nutrition search. Knowledge (1 [1-2]) and barriers (1.4 [1-1.8]) scores were low; scores for benefits (3.7 [3-4]), needs (4.4 [3.7-5]), and easy to use (4.2 [3.7-4.5]) were high. Higher perceptions of the benefits, needs, and willingness to receive nutritional counseling via telemedicine and lower barriers perception were associated with higher easy to use score.</div></div><div><h3>Conclusions</h3><div>Despite advanced age and low educational level, patients had good access to smartphones and perceived their possible benefits and need for nutritional counseling. Regardless of low knowledge, perception of barriers was very low. Telemedicine via smartphones may be a good option to improve nutritional knowledge and skills of patients with DKD.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 6","pages":"Pages 734-740"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288075","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":"The Relentless Challenge of Dietary Salt Restriction for Hypertension and Kidney Disease","authors":"Linda W. Moore PhD, RDN,&nbsp;Giacomo Garibotto MD","doi":"10.1053/j.jrn.2025.10.001","DOIUrl":"10.1053/j.jrn.2025.10.001","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 6","pages":"Pages 697-699"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282486","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":"The Effect of Low-grade Inflammation on Body Composition in Peritoneal Dialysis Patients","authors":"Andrew Davenport MD","doi":"10.1053/j.jrn.2025.06.005","DOIUrl":"10.1053/j.jrn.2025.06.005","url":null,"abstract":"<div><h3>Objective</h3><div>Kidney dialysis patients are at an increased risk of sarcopenia and mortality. Although there are many potential causes, the effect of chronic inflammation on changes in body composition in peritoneal dialysis (PD) over time was reviewed.</div></div><div><h3>Methods</h3><div>Changes in body composition were measured by multifrequency bioimpedance in PD outpatients attending routine clinic review with sustained normal or raised C reactive protein (CRP) concentrations, excluding patients with peritonitis, and other acute hospitalizations.</div></div><div><h3>Results</h3><div>Body composition was measured; median 12 (11-14) months apart in 427 PD outpatients (59.5% male, 37.2% diabetic), median dialysis vintage 12 months, 215 sustained normal CRP, and (≤5 mg/L) versus 212 sustained raised CRP (9 [6-19] mg/L). Body composition did not differ initially, but over time whereas there were no changes in fat mass, fat-free mass index remained stable in the normal CRP group (17.8 ± 2.3 vs 17.9 ± 2.4) but decreased in the raised CRP group (18.0 ± 2.6 vs 14.4 ± 2.6, <em>P</em> &lt; .05), and over time serum albumin was lower in the raised CRP group (36.8 ± 4.7 vs 38.8 ± 4.0, <em>P</em> &lt; .001). Estimated dietary protein intake declined over time in both groups but remained lower in the raised CRP group (0.83 ± 0.32 vs 0.87 ± 0.21 g/kg/day, <em>P</em> &lt; .05). In a multivariable model, loss of lean body tissue was associated with persistently raised CRP (odds ratio 2.6, 95% confidence intervals 1.58-4.2, <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>Sustained low-grade inflammation leads to a loss of lean body tissue in PD outpatients. Studies are required to determine whether treating the causes of, and reducing, low-grade inflammation results in prevention of lean tissue loss.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 6","pages":"Pages 787-794"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532778","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":"Knowledge, Attitude, and Practice Toward Low-Salt Diets Among Patients With Chronic Kidney Disease and Their Spouses: A Cross-Sectional Study","authors":"Yinhui Li MD,&nbsp;Baoling Liu MD,&nbsp;Liqian Dong MD,&nbsp;Heng Sang BD,&nbsp;Ni Kang BD","doi":"10.1053/j.jrn.2025.06.007","DOIUrl":"10.1053/j.jrn.2025.06.007","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to assess the knowledge, attitude, and practice (KAP) of patients with chronic kidney disease (CKD) and their spouses toward low-salt diets.</div></div><div><h3>Methods</h3><div>This cross-sectional study enrolled patients with CKD and their spouses at the outpatient nephrology clinic of our hospital between September 2023 and February 2024.</div></div><div><h3>Results</h3><div>The study enrolled 443 patients and 499 spouses of patients. The mean KAP scores for patients were 13.64 ± 3.1, 35.19 ± 5.98, and 29.44 ± 7.58, respectively. Spouses of patients had mean scores of 14.39 ± 3.22, 31.66 ± 4.70, and 30.56 ± 6.52, respectively. Path analysis demonstrated that among patients, education, duration of CKD, and income had direct effects on knowledge. Knowledge, gender, marital status, duration of CKD, and residence had direct effects on attitude. Knowledge, attitude, education, CKD stage, employment, and type of medical insurance had direct effects on practice. For the spouses, duration of CKD had direct effect on knowledge; knowledge, residence, and education had direct effects on attitude; knowledge, attitude, residence, education, employment, CKD stage, and dialysis had direct effects on practice.</div></div><div><h3>Conclusion</h3><div>Both patients with CKD and their spouses demonstrated sufficient knowledge, positive attitude, and proactive practice toward low-salt diets. Clinicians should emphasize education and support programs targeting patients and their spouses to reinforce positive attitude and encourage sustained adherence to low-salt diets, particularly focusing on socioeconomic factors influencing KAP.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 6","pages":"Pages 700-707"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532760","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":"Higher Renal Net Acid, but Not Higher Phosphate Excretion During Growth Associates With Lower Adult Circulating Uromodulin","authors":"Seyedeh-Masomeh Derakhshandeh-Rishehri PhD ,&nbsp;Luciana Peixoto Franco MS ,&nbsp;Hermann Kalhoff MD ,&nbsp;Stefan A. Wudy MD ,&nbsp;Thomas Remer PhD","doi":"10.1053/j.jrn.2024.12.002","DOIUrl":"10.1053/j.jrn.2024.12.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Uromodulin is the most abundant urinary protein in healthy subjects, which under physiological conditions protects against kidney stone formation. Acid-base imbalances, especially states with acidic urine, increase the risk for uric acid and oxalate stones, but lower it for phosphate (PO₄)-containing stones. Whether habitual high acid loads and high dietary phosphorus intake (P-In) themselves may influence plasma uromodulin concentrations in the long-term is not known.</div></div><div><h3>Methods</h3><div>We prospectively examined biomarker based on the associations of P-In and endogenous acid loads of 3-17-year-old healthy participants (n = 358) of the Dortmund Nutritional and Anthropometric Longitudinally Designed study (Dortmund, Germany), with their circulating uromodulin levels later in adulthood. Urinary (PO₄)excretion, net acid excretion (NAE), potential renal acid load (uPRAL), and pH were analyzed in 24-hour urine samples repeatedly collected during growth. Circulating uromodulin was analyzed in adult fasting blood samples. Individual means of age- and sex-stratified standard deviation scores of growth- and nutritional biomarker-related parameters were calculated. Multilinear regression models adjusted for anthropometric, renal, and blood parameters were conducted to examine the prospective relationships of preadulthood urinary biomarkers with adult circulating uromodulin.</div></div><div><h3>Results</h3><div>Uromodulin associated inversely with NAE (<em>P</em>_{<em>for-trend</em>} &lt; .03) and positively with urinary pH (<em>P</em>_{<em>for-trend</em>} = .05; lowest pH-quintile vs. highest quintile: <em>P</em> = .03), but not significantly with uPRAL and (PO₄) excretion during growth.</div></div><div><h3>Conclusions</h3><div>The known increased urolithiasis risk associated with high endogenous acid production may be further augmented by a high NAE-related reduction of the stone-formation inhibitor uromodulin. Despite not observing a significant association with uPRAL, the potential of habitual low-PRAL diets to raise uromodulin needs to be further studied.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 6","pages":"Pages 726-733"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808455","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":"The Association of Antiemetics Use With Incident Chronic Kidney Disease","authors":"Diana S. Kalantar BS ,&nbsp;Rina Takahashi MD, PhD ,&nbsp;Jenny I. Shen MD ,&nbsp;Diana Tran MPH ,&nbsp;Adnan Ismail BS ,&nbsp;Erika Lopez Pena BS ,&nbsp;Mayara Abichequer-Beer RD ,&nbsp;Fridtjof Thomas PhD ,&nbsp;Jun Ling Lu MD ,&nbsp;Keiichi Sumida MD ,&nbsp;Kamyar Kalantar-Zadeh MD, MPH, PhD ,&nbsp;Csaba P. Kovesdy MD ,&nbsp;Connie M. Rhee MD, MSc","doi":"10.1053/j.jrn.2025.06.004","DOIUrl":"10.1053/j.jrn.2025.06.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Gastrointestinal symptoms can significantly impact patients' nutritional status. Effective management using antiemetics is crucial for maintaining adequate nutrition. However, the effect of antiemetics on long-term renal function remains unclear. This study aimed to examine the association of antiemetics with the incident chronic kidney disease (CKD) in patients with normal renal function.</div></div><div><h3>Methods</h3><div>In a historical cohort study involving 323,970 US Veterans with normal estimated glomerular filtration rate, we identified 13,154 Veterans initiating antiemetics. The Cox proportional hazards model adjusted for demographics, major comorbidities, and laboratory measurements was used to estimate the relationship between antiemetics and the incident CKD, defined as estimated glomerular filtration rate &lt;60 mL/min/1.73 m² on two occasions, separated by ≥ 90 days. Propensity score (PS) matching and PS overlap weighting were also performed.</div></div><div><h3>Results</h3><div>The mean age of nonusers and users of antiemetics was 64.1 ± 14.2 and 62.1 ± 12.9 years. Antiemetic users were more likely to be female, smokers, and had a higher prevalence of comorbidities. Antiemetic use was associated with an increased risk of incident CKD across various models: unmatched adjusted (hazard ratio [HR] 1.26; 95% confidence interval [CI] 1.22-1.31), PS matched (HR 1.22; 95% CI 1.17-1.28), and PS overlap weighting (HR 1.28; 95% CI 1.18-1.46).</div></div><div><h3>Conclusions</h3><div>Antiemetic use is associated with a higher risk of incident CKD in individuals without preexisting kidney disease. This association appears robust across different analytical models. While antiemetics are essential for managing gastrointestinal symptoms—potentially improving nutritional status—the results underscore the necessity for careful monitoring of renal function in patients prescribed antiemetics.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 6","pages":"Pages 749-755"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532762","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":"Hyperphosphatemia in Patients on Hemodialysis May be Driven by the Consumption of Ultraprocessed Foods","authors":"Andrea C. Sczip MSc ,&nbsp;Jyana G. Morais PhD ,&nbsp;Adaiane Calegari MSc ,&nbsp;Tatiana S. Kruger ,&nbsp;Jorgiane C. Oliveira ,&nbsp;Natália K. Scatone MSc ,&nbsp;Rafaela G. dos Santos ,&nbsp;Fellype C. Barreto MD, PhD ,&nbsp;Fabiana B. Nerbass PhD","doi":"10.1053/j.jrn.2025.07.007","DOIUrl":"10.1053/j.jrn.2025.07.007","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to investigate the role of dietary diversity of unprocessed and minimally processed foods and the intake of ultraprocessed foods (UPFs), along with their respective phosphorus source subgroups, in hyperphosphatemia among patients on chronic hemodialysis.</div></div><div><h3>Methods</h3><div>This is a secondary analysis of a multicenter cross-sectional study conducted in seven dialysis units in Southern Brazil. Two validated questionnaires were used: a dietary diversity questionnaire to assess the intake of unprocessed and minimally processed foods, and a UPFs consumption questionnaire to evaluate the intake of UPFs. Dietary intake was assessed on 2 separate days—1 dialysis day and 1 nondialysis day. From these instruments, scores were calculated for overall dietary diversity, total UPFs consumption, and phosphorus sources subgroups.</div></div><div><h3>Results</h3><div>A total of 297 patients participated (age: 52.1 ± 14.1 years; 57.9% men; 42% with hyperphosphatemia). While unprocessed and minimally processed phosphorus sources were more commonly consumed, multivariate analysis revealed that UPFs, particularly those from animal-based sources, were independently associated with hyperphosphatemia. Each one-point increase in intake of UPFs scores corresponded to an increased likelihood of hyperphosphatemia: 25% for total UPF, 76% for animal-based UPFs, and 24% for other UPF sources.</div></div><div><h3>Conclusion</h3><div>Our findings indicate that although phosphorus sources from UPFs were consumed less frequently than those from unprocessed and minimally processed foods, consumption of UPFs—especially those from animal-based sources—was an independent determinant of hyperphosphatemia. These results highlight the need for dietary interventions that prioritize healthy food choices in the management of hyperphosphatemia.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 6","pages":"Pages 780-786"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700947","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":"Development and Validation of a Prediction Model for Estimating 24-Hour Urinary Sodium Excretion Using Spot Urine Samples in Adult Patients","authors":"Miriam Menacho-Roman BSc ,&nbsp;Martin Fabregate-Fuente BSc ,&nbsp;Laura Caja-Guayerbas BSc ,&nbsp;Sergio Jiménez-Sánchez BSc ,&nbsp;Javier Soto BSc ,&nbsp;Ignacio Arribas-Gómez PhD, MD","doi":"10.1053/j.jrn.2024.09.004","DOIUrl":"10.1053/j.jrn.2024.09.004","url":null,"abstract":"<div><h3>Introduction</h3><div>The measurement of urinary<span><span><span> sodium excretion provides valuable information about an individual's sodium balance and can help in the management of various medical conditions. However, the collection of 24-hour urine samples is subject to errors. Spot </span>urine sodium (uNa) measurements are a reliable alternative to 24-hour urine collections for estimating </span>urinary sodium excretion.</span></div></div><div><h3>Objective</h3><div>To assess whether 24-h urinary sodium excretion (24 h uNa) can be estimated from spot samples in adult patients who attend hospital clinics.</div></div><div><h3>Design and Methods</h3><div>A cross-sectional study with a development (284 patients) and a validation cohort (229 patients) was conducted at our hospital. A multivariate linear regression model was built which was compared with former models. Concordance analyses and comparison of the ability to correctly classify each patient against a prespecified uNa cutoff value of 130 mmol/24 h were performed, assessed by the C-statistic.</div></div><div><h3>Results</h3><div>The model was well calibrated (slope [95% confidence interval] in internal validation: 0.965 [0.947-0.987], showing good discrimination, and performed robustly in an external validation cohort (slope: 0.811 [0.675-0.946]). The mean bias between the measured and the estimated 24 h uNa by NaRYC was 24.85 mmol/24 h [17.06-32.63]. The NaRYC had the highest values of Pearson coefficient (0.613 <em>P</em> &lt; .0001), accuracy (the percentage of estimated 24 h uNa results within 30% deviation of measured 24 h uNa): 56.8%, and area under the receiver operating characteristic curve: 0.822 [0.766-0.869] as compared to other seven equations.</div></div><div><h3>Conclusion</h3><div>Although the mean bias of the results is quite acceptable, the variability observed in the 95% confidence interval makes not recommend the general use of a spot as a substitute of the 24-hour urine in order to estimate the total urine excretion of Na in a single subject basis.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 6","pages":"Pages 756-763"},"PeriodicalIF":3.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331379","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}