Hemodialysis (HD) patients are at a high risk of frailty, falls, and fractures. The Kihon checklist (KCL) consists of physical function, cognitive function, oral function, nutritional status, depressed mood, activities of daily living, and social participation. This study aimed to clarify the association between falls in HD patients and frailty as assessed using the KCL, as well as scores and each domain.
Methods
A multicenter prospective cohort study was conducted across 9 facilities. Frailty was assessed using the KCL. Falls were then monitored for 1 year. Participants were classified into 3 groups based on their KCL scores: robust, prefrailty, and frailty. In the logistic regression analysis, the dependent variables were falls, severe falls, or fractures, whereas the independent variables were group classification, KCL score, or each domain.
Results
A total of 403 HD patients (70.0 [60.0-76.0] years, 170 [42.1%] women) were analyzed. During the 1-year follow-up period, 117 (29.0%) patients experienced falls. Prefrailty (odds ratio (OR) 3.00, 95% confidence interval (CI) 1.17-7.71, P < .001) and frailty (OR 6.79, 95% CI 2.69-17.16, P < .001) were independently associated with falls compared with robust patients. Additionally, the KCL score was associated with severe falls (OR 1.15, 95% CI 1.06-1.25, P = .001) and fracture (OR 1.13, 95% CI 1.01-1.28, P = .04). By KCL domain, physical function (OR 3.46, 95% CI 2.06-5.83, P < .001) and cognitive function (OR 1.74, 95% CI 1.09-2.77, P = .02) were independently associated with falls.
Conclusions
The KCL may be a useful screening tool for estimating fall and fracture risk in this population.
目的：血液透析（HD）患者易发生虚弱、跌倒和骨折。Kihon检查表（KCL）包括身体功能、认知功能、口腔功能、营养状况、抑郁情绪、日常生活活动和社会参与。本研究旨在通过使用KCL、评分和每个域来评估HD患者跌倒和虚弱之间的关系。方法：在9个机构进行了一项多中心前瞻性队列研究。使用KCL评估虚弱程度。然后对跌倒情况进行了一年的监测。参与者根据他们的KCL得分分为三组：健全性、虚弱前和虚弱。在logistic回归分析中，因变量为跌倒、严重跌倒或骨折，自变量为分组分类、KCL评分或各域。结果：共分析403例HD患者（70.0[60.0-76.0]岁，女性170例[42.1%]）。在1年的随访期间，117例（29.0%）患者出现跌倒。与健壮的患者相比，虚弱前（OR 3.00, 95%CI 1.17-7.71, p < 0.001）和虚弱（OR 6.79, 95%CI 2.69-17.16, p < 0.001）与跌倒独立相关。此外，KCL评分与严重跌倒（OR 1.15, 95%CI 1.06 - 1.25, p = 0.001）和骨折（OR 1.13, 95%CI 1.01-1.28, p = 0.04）相关。通过KCL域，身体功能（OR 3.46, 95%CI 2.06-5.83, p < 0.001）和认知功能（OR 1.74, 95%CI 1.09-2.77, p = 0.02）与跌倒独立相关。结论：KCL可能是评估这类人群跌倒和骨折风险的有用筛查工具。
{"title":"Relationship Between Frailty, as Assessed Using the Kihon Checklist, and Falls in Hemodialysis Patients: A Multicenter Prospective Cohort Study","authors":"Nobuyuki Shirai PT, PhD , Naoto Usui PT, PhD , Daisuke Okamura PT , Yoichi Sato PT, PhD , Sho Kojima PT, PhD , Kenta Mikami PT , Mizuki Nagashima PT , Yu Shimano PT , Nobuhito Shinozaki PT , Syun Hirukawa PT , Akihiro Sakuyama PT, PhD , Yoji Yamada PT, PhD , Masakazu Saitoh PT, PhD","doi":"10.1053/j.jrn.2025.03.006","DOIUrl":"10.1053/j.jrn.2025.03.006","url":null,"abstract":"<div><h3>Objectives</h3><div><span>Hemodialysis (HD) patients are at a high risk of </span>frailty<span>, falls, and fractures. The Kihon checklist (KCL) consists of physical function, cognitive function, oral function, nutritional status, depressed mood, activities of daily living, and social participation. This study aimed to clarify the association between falls in HD patients and frailty as assessed using the KCL, as well as scores and each domain.</span></div></div><div><h3>Methods</h3><div><span>A multicenter prospective cohort study was conducted across 9 facilities. Frailty was assessed using the KCL. Falls were then monitored for 1 year. Participants were classified into 3 groups based on their KCL scores: robust, prefrailty, and frailty. In the </span>logistic regression analysis, the dependent variables were falls, severe falls, or fractures, whereas the independent variables were group classification, KCL score, or each domain.</div></div><div><h3>Results</h3><div>A total of 403 HD patients (70.0 [60.0-76.0] years, 170 [42.1%] women) were analyzed. During the 1-year follow-up period, 117 (29.0%) patients experienced falls. Prefrailty (odds ratio (OR) 3.00, 95% confidence interval (CI) 1.17-7.71, <em>P</em> < .001) and frailty (OR 6.79, 95% CI 2.69-17.16, <em>P</em> < .001) were independently associated with falls compared with robust patients. Additionally, the KCL score was associated with severe falls (OR 1.15, 95% CI 1.06-1.25, <em>P</em> = .001) and fracture (OR 1.13, 95% CI 1.01-1.28, <em>P</em> = .04). By KCL domain, physical function (OR 3.46, 95% CI 2.06-5.83, <em>P</em> < .001) and cognitive function (OR 1.74, 95% CI 1.09-2.77, <em>P</em> = .02) were independently associated with falls.</div></div><div><h3>Conclusions</h3><div>The KCL may be a useful screening tool for estimating fall and fracture risk in this population.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 5","pages":"Pages 655-662"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744139","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 : 2025-09-01DOI: 10.1053/j.jrn.2025.05.003
Jeanette M. Andrade PhD, RDN, FAND , Katherine Mullis BS , Pablo Lamino PhD
Objective
Food and nutrition insecurity may contribute to the progression of chronic kidney disease (CKD). Current metrics to measure food and nutrition security (FANS) status may not capture the nuances associated with these concepts. The purpose of this mixed method study was to examine perceptions of FANS of adults with CKD, nondialysis.
Methods
A sequential explanatory mixed-method study was conducted from March to August 2024. Participants (n = 60) completed a survey that focused on the dimensions of FANS and diet quality. A sub-section of participants (n = 23) completed an interview that explored FANS. Frequencies and descriptives were analyzed using Statistical Package for Social Science (v28). Interviews were transcribed, and deductive and inductive coding was used to determine themes using NVivo (v14).
Results
Many participants (77%) were in stage 3 of CKD based on self-reported estimated Glomerular Filtration Rate, were considered Black (47.5%) or Hispanic/Latino (45.9%), did not receive any food/government assistance (55.7%), and self-reported annual household income of $50,000 or more (70.5%). The median diet quality score was 35.5 out of 60. The themes from the interviews focused on specific aspects of food security dimensions, such as availability and accessibility, with other themes present, such as affordability, health, and support.
Conclusion
Affordability of food, health, and support were of concern for adults with CKD, regardless of income level. Traditional food security instruments need to expand to include more in-depth questions about the food and nutrition dimensions in alleviating any potential burdens that adults with CKD face in obtaining and consuming foods.
{"title":"Perceptions of Food and Nutrition Security Among Adults With chronic kidney disease, Nondialysis: A Mixed Method Study","authors":"Jeanette M. Andrade PhD, RDN, FAND , Katherine Mullis BS , Pablo Lamino PhD","doi":"10.1053/j.jrn.2025.05.003","DOIUrl":"10.1053/j.jrn.2025.05.003","url":null,"abstract":"<div><h3>Objective</h3><div>Food and nutrition insecurity may contribute to the progression of chronic kidney disease (CKD). Current metrics to measure food and nutrition security (FANS) status may not capture the nuances associated with these concepts. The purpose of this mixed method study was to examine perceptions of FANS of adults with CKD, nondialysis.</div></div><div><h3>Methods</h3><div>A sequential explanatory mixed-method study was conducted from March to August 2024. Participants (n = 60) completed a survey that focused on the dimensions of FANS and diet quality. A sub-section of participants (n = 23) completed an interview that explored FANS. Frequencies and descriptives were analyzed using Statistical Package for Social Science (v28). Interviews were transcribed, and deductive and inductive coding was used to determine themes using NVivo (v14).</div></div><div><h3>Results</h3><div>Many participants (77%) were in stage 3 of CKD based on self-reported estimated Glomerular Filtration Rate, were considered Black (47.5%) or Hispanic/Latino (45.9%), did not receive any food/government assistance (55.7%), and self-reported annual household income of $50,000 or more (70.5%). The median diet quality score was 35.5 out of 60. The themes from the interviews focused on specific aspects of food security dimensions, such as availability and accessibility, with other themes present, such as affordability, health, and support.</div></div><div><h3>Conclusion</h3><div>Affordability of food, health, and support were of concern for adults with CKD, regardless of income level. Traditional food security instruments need to expand to include more in-depth questions about the food and nutrition dimensions in alleviating any potential burdens that adults with CKD face in obtaining and consuming foods.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 5","pages":"Pages 589-597"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081797","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 : 2025-09-01DOI: 10.1053/j.jrn.2025.03.010
Laura Byham-Gray PhD, RDN, FNKF, Glenn Brietzke MS, RD, LD, CNSC, Rebecca Brody PhD, RD, LD, CNSC, Joachim Sackey PhD
{"title":"Response to Letter to the Editor: Predictors of Skeletal Muscle Index for Patients Treated With Hemodialysis","authors":"Laura Byham-Gray PhD, RDN, FNKF, Glenn Brietzke MS, RD, LD, CNSC, Rebecca Brody PhD, RD, LD, CNSC, Joachim Sackey PhD","doi":"10.1053/j.jrn.2025.03.010","DOIUrl":"10.1053/j.jrn.2025.03.010","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 5","pages":"Pages 691-692"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041707","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":"Authors’ Reply to the Letter to the Editor","authors":"Keiko Kabasawa MD, MPH, PhD, Ribeka Takachi PhD, RD, Michihiro Hosojima MD, PhD, Kazutoshi Nakamura MD, Shoichiro Tsugane MD, PhD, Yumi Ito MD, PhD, Kunihiro Matsushita MD, PhD","doi":"10.1053/j.jrn.2025.05.002","DOIUrl":"10.1053/j.jrn.2025.05.002","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 5","pages":"Pages 693-695"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096770","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}
Exercise resources and patients’ perceptions of exercise play a crucial role in influencing exercise participation among maintenance hemodialysis (MHD) patients. However, limited research has explored the availability of exercise programs, patients’ exercise perceptions, and their exercise habits. This study aimed to characterize the availability of exercise programs, patients’ exercise perception, and exercise habits, as well as to examine the associations of these factors in this population.
Methods
This multicenter cross-sectional study surveyed 722 MHD patients from 74 dialysis units across China. A structured questionnaire was used to collect data on sociodemographics, exercise habits, and responses to the Dialysis Patient-Perceived Exercise Benefits and Barriers Scale (DPEBBS) from patients. Additional information about the availability of exercise programs in dialysis units was also gathered. Data were analyzed using independent sample t-tests, linear mixed models, and multiple logistic regression analyses.
Results
Only 23.0% of dialysis units offered exercise programs. Overall, 65.7% of participants reported regular exercise. The availability of exercise programs was significantly associated with higher DPEBBS scores. MHD patients with higher DPEBBS benefits and barriers scores were more likely to exercise regularly. Furthermore, patients from dialysis units with exercise programs demonstrated significantly greater levels of exercise participation compared to those from units without such programs.
Conclusions
Less than one-fourth of dialysis units provide exercise programs for MHD patients, underscoring the need for broader implementation of these programs. Health-care providers and policymakers should prioritize promoting exercise programs, improving patients’ perceptions of exercise, and addressing barriers to increasing exercise participation among MHD patients.
{"title":"Availability of Exercise Program, Perceived Exercise Benefits and Barriers, and Exercise Habits in Maintenance Hemodialysis Patients: A Multicenter Cross-sectional Study","authors":"Huagang Hu PhD , Chanchan Wu PhD , Pui Hing Chau PhD , Edmond Pui Hang Choi PhD, MPhil, RN, FAAN","doi":"10.1053/j.jrn.2025.03.009","DOIUrl":"10.1053/j.jrn.2025.03.009","url":null,"abstract":"<div><h3>Objective</h3><div>Exercise resources and patients’ perceptions of exercise play a crucial role in influencing exercise participation among maintenance hemodialysis (MHD) patients. However, limited research has explored the availability of exercise programs, patients’ exercise perceptions, and their exercise habits. This study aimed to characterize the availability of exercise programs, patients’ exercise perception, and exercise habits, as well as to examine the associations of these factors in this population.</div></div><div><h3>Methods</h3><div>This multicenter cross-sectional study surveyed 722 MHD patients from 74 dialysis units across China. A structured questionnaire was used to collect data on sociodemographics, exercise habits, and responses to the Dialysis Patient-Perceived Exercise Benefits and Barriers Scale (DPEBBS) from patients. Additional information about the availability of exercise programs in dialysis units was also gathered. Data were analyzed using independent sample <em>t</em>-tests, linear mixed models, and multiple logistic regression analyses.</div></div><div><h3>Results</h3><div>Only 23.0% of dialysis units offered exercise programs. Overall, 65.7% of participants reported regular exercise. The availability of exercise programs was significantly associated with higher DPEBBS scores. MHD patients with higher DPEBBS benefits and barriers scores were more likely to exercise regularly. Furthermore, patients from dialysis units with exercise programs demonstrated significantly greater levels of exercise participation compared to those from units without such programs.</div></div><div><h3>Conclusions</h3><div>Less than one-fourth of dialysis units provide exercise programs for MHD patients, underscoring the need for broader implementation of these programs. Health-care providers and policymakers should prioritize promoting exercise programs, improving patients’ perceptions of exercise, and addressing barriers to increasing exercise participation among MHD patients.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 5","pages":"Pages 568-577"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006048","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 : 2025-09-01DOI: 10.1053/j.jrn.2024.12.010
Wei-Ti Wang MD, Min-Sheng Lu MD, Wei-Yang Lee MD, Ping-Chen Wang BSc, Chih-Chung Shiao MD
{"title":"Predictors of Skeletal Muscle Index for Patients Treated With Hemodialysis","authors":"Wei-Ti Wang MD, Min-Sheng Lu MD, Wei-Yang Lee MD, Ping-Chen Wang BSc, Chih-Chung Shiao MD","doi":"10.1053/j.jrn.2024.12.010","DOIUrl":"10.1053/j.jrn.2024.12.010","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 5","pages":"Pages 690-691"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025041","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 : 2025-09-01DOI: 10.1053/j.jrn.2025.03.008
Wencong Guo MD , Yancheng Song MD , Yan Sun MM , Changying Li MM , Huasheng Du MM , Qingqing You MM , Yan Cai MM , Yanhua Lang MBBS , Leping Shao MD, PhD
Objective
Diabetic kidney disease (DKD) is the most prevalent of chronic renal disease and the leading cause of end-stage renal disease worldwide, primarily attributed to the increasing prevalence of Type 2 diabetes mellitus (T2DM). We aimed to investigate potential associations between the consumption of probiotics, prebiotics, synbiotics, and yogurt and DKD, addressing a critical gap in current research concerning dietary interventions and renal health outcomes.
Methods
We conducted a cross-sectional study among adults with T2DM in the National Health and Nutrition Examination Survey from 2007 to 2016. Weighted univariate logistic regression analysis, subgroup analysis, and interaction analysis were conducted to assess the relationship between probiotics, prebiotics, synbiotics, yogurt supplements and DKD. In addition, the restricted cubic spline analysis was applied to assess potential nonlinear relationships between yogurt supplements and DKD.
Results
The study included 2,665 individuals, of whom 1,044 (39.2%) had a diagnosis of DKD. Multivariable logistic regression indicated an independent association between probiotic, prebiotic, synbiotic, or yogurt intake and a reduced risk of DKD after adjusting for covariates (odds ratio = 0.71, 95% confidence interval: 0.52-0.96, P = .03). Subgroup analysis results indicated inconsistencies in the correlations between DKD and probiotics, prebiotics, synbiotics, or yogurt. Interaction analysis showed that age, gender, urine albumin-to-creatinine ratio, estimated glomerular filtration rate, body mass index, hypertension, hyperlipidemia, or antibiotic therapy had no significantly influence on the positive correlation (all P > .05). The restricted cubic spline model indicated no nonlinear relationship between yogurt intake and DKD.
Conclusion
Our findings indicated significant inverse associations between probiotic, prebiotic, synbiotics, or yogurt supplements and DKD prevalence in T2DM patients. Further large-scale studies with extended follow-up periods are warranted to confirm these findings and develop evidence-based dietary guidelines for clinical practice.
目的：糖尿病肾病（DKD）是世界范围内最常见的慢性肾脏疾病（CKD）和终末期肾脏疾病（ESRD）的主要原因，主要归因于2型糖尿病（T2DM）的患病率增加。我们的目的是调查益生菌、益生元、合成菌、酸奶和DKD之间的潜在关联，解决当前研究中关于饮食干预和肾脏健康结局的关键空白。方法：我们对2007年至2016年参加国家健康与营养调查（NHANES）的2型糖尿病（T2DM）成人患者进行了横断面研究。采用加权单变量logistic回归分析、亚组分析和交互作用分析来评估益生菌、益生元、合成益生菌、酸奶补充剂与DKD之间的关系。此外，限制三次样条（RCS）分析应用于评估酸奶补充剂与DKD之间潜在的非线性关系。结果：本研究纳入2665例个体，其中1044例（39.2%）诊断为DKD。多变量logistic回归显示，在调整协变量后，益生菌、益生元、合成菌或酸奶摄入与DKD风险降低之间存在独立关联（or = 0.71, 95% CI: 0.52-0.96, P =0.03）。亚组分析结果显示DKD与益生菌、益生元、合成菌或酸奶之间的相关性不一致。相互作用分析显示，年龄、性别、尿白蛋白/肌酐比（ACR）、肾小球滤过率（eGFR）、体重指数、高血压、高脂血症或抗生素治疗对正相关性无显著影响（均p < 0.05）。RCS模型显示酸奶摄入量与DKD之间无非线性关系。结论：我们的研究结果表明，益生菌、益生元、合成菌或酸奶补充剂与T2DM患者DKD患病率之间存在显著的负相关。有必要进一步进行大规模的研究，延长随访期，以证实这些发现，并为临床实践制定循证饮食指南。
{"title":"Association Between Probiotic, Prebiotic, Synbiotics, and Yogurt Supplements and Diabetic Kidney Disease: The National Health and Nutrition Examination Survey 2007–2016","authors":"Wencong Guo MD , Yancheng Song MD , Yan Sun MM , Changying Li MM , Huasheng Du MM , Qingqing You MM , Yan Cai MM , Yanhua Lang MBBS , Leping Shao MD, PhD","doi":"10.1053/j.jrn.2025.03.008","DOIUrl":"10.1053/j.jrn.2025.03.008","url":null,"abstract":"<div><h3>Objective</h3><div><span><span><span>Diabetic kidney disease (DKD) is the most prevalent of </span>chronic renal disease<span> and the leading cause of end-stage renal disease worldwide, primarily attributed to the increasing prevalence of Type 2 diabetes mellitus (T2DM). We aimed to investigate potential associations between the consumption of </span></span>probiotics<span>, prebiotics, </span></span>synbiotics, and yogurt and DKD, addressing a critical gap in current research concerning dietary interventions and renal health outcomes.</div></div><div><h3>Methods</h3><div><span>We conducted a cross-sectional study among adults with T2DM in the National Health and Nutrition Examination Survey from 2007 to 2016. Weighted univariate </span>logistic regression analysis<span><span>, subgroup analysis, and interaction analysis were conducted to assess the relationship between probiotics, </span>prebiotics<span>, synbiotics, yogurt supplements and DKD. In addition, the restricted cubic spline analysis was applied to assess potential nonlinear relationships between yogurt supplements and DKD.</span></span></div></div><div><h3>Results</h3><div>The study included 2,665 individuals, of whom 1,044 (39.2%) had a diagnosis of DKD. Multivariable logistic regression indicated an independent association between probiotic, prebiotic, synbiotic, or yogurt intake and a reduced risk of DKD after adjusting for covariates (odds ratio = 0.71, 95% confidence interval: 0.52-0.96, <em>P</em><span><span><span><span> = .03). Subgroup analysis results indicated inconsistencies in the correlations between DKD and probiotics, prebiotics, </span>synbiotics, or yogurt. Interaction analysis showed that age, gender, urine albumin-to-creatinine ratio, estimated </span>glomerular filtration rate, </span>body mass index<span>, hypertension, hyperlipidemia, or antibiotic therapy had no significantly influence on the positive correlation (all </span></span><em>P</em> > .05). The restricted cubic spline model indicated no nonlinear relationship between yogurt intake and DKD.</div></div><div><h3>Conclusion</h3><div>Our findings indicated significant inverse associations between probiotic, prebiotic, synbiotics, or yogurt supplements and DKD prevalence in T2DM patients. Further large-scale studies with extended follow-up periods are warranted to confirm these findings and develop evidence-based dietary guidelines for clinical practice.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 5","pages":"Pages 616-627"},"PeriodicalIF":3.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047911","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 : 2025-07-01DOI: 10.1053/j.jrn.2024.12.009
Yunmin Han MSc , Sungjae Yoon MSc , Soomin Lee MSc , Younghwan Choi MSc , Geonhui Kim PhD , Duck-chul Lee PhD , Youngwon Kim PhD , Ga-young Lim PhD , Ria Kwon PhD , Yoosoo Chang MD, PhD , Seungho Ryu MD, PhD , Jeonggyu Kang MD, PhD , Yeon Soo Kim MD, PhD
Objective
This large cohort study aimed to examine the overall associations of physical activity (PA) and estimated cardiorespiratory fitness (eCRF) with incident chronic kidney disease (CKD).
Methods
This study included a total of 274,292 participants (mean age, 37.9 ± 8.0 years; 41% women) using data collected from the Kangbuk Samsung Health Study. The participants were categorized into three groups: PA (inactive, insufficiently active, and active) and eCRF(low, middle, high). Furthermore, subgroup analyses were conducted to examine the differences in the risks of CKD incidence by age and sex. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs).
Results
A total of 932 participants (0.34%) developed CKD. PA level was not associated with CKD risk in the overall cohort. However, younger participants (<45 years) showed lower CKD risks, with HRs of 0.53 (95% CI: 0.36-0.79) and 0.73 (95% CI: 0.53-1.00) for insufficiently active and active individuals, respectively. Similarly, men exhibited reduced CKD risks, with HRs of 0.77 (95% CI: 0.59-1.00) and 0.81 (95% CI: 0.66-1.00) in these groups. Additionally, those in the high eCRF group had a 20% reduced CKD risk (HR, 0.80; 95% CI: 0.67-0.96) compared to the low eCRF group.
Conclusions
The associations between PA or eCRF and incident CKD showed differences according to age and sex.
{"title":"Associations of Physical Activity and Cardiorespiratory Fitness With Incident Chronic Kidney Disease in a Korean Population","authors":"Yunmin Han MSc , Sungjae Yoon MSc , Soomin Lee MSc , Younghwan Choi MSc , Geonhui Kim PhD , Duck-chul Lee PhD , Youngwon Kim PhD , Ga-young Lim PhD , Ria Kwon PhD , Yoosoo Chang MD, PhD , Seungho Ryu MD, PhD , Jeonggyu Kang MD, PhD , Yeon Soo Kim MD, PhD","doi":"10.1053/j.jrn.2024.12.009","DOIUrl":"10.1053/j.jrn.2024.12.009","url":null,"abstract":"<div><h3>Objective</h3><div>This large cohort study aimed to examine the overall associations of physical activity (PA) and estimated cardiorespiratory fitness (eCRF) with incident chronic kidney disease (CKD).</div></div><div><h3>Methods</h3><div>This study included a total of 274,292 participants (mean age, 37.9 ± 8.0 years; 41% women) using data collected from the Kangbuk Samsung Health Study. The participants were categorized into three groups: PA (inactive, insufficiently active, and active) and eCRF(low, middle, high). Furthermore, subgroup analyses were conducted to examine the differences in the risks of CKD incidence by age and sex. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs).</div></div><div><h3>Results</h3><div>A total of 932 participants (0.34%) developed CKD. PA level was not associated with CKD risk in the overall cohort. However, younger participants (<45 years) showed lower CKD risks, with HRs of 0.53 (95% CI: 0.36-0.79) and 0.73 (95% CI: 0.53-1.00) for insufficiently active and active individuals, respectively. Similarly, men exhibited reduced CKD risks, with HRs of 0.77 (95% CI: 0.59-1.00) and 0.81 (95% CI: 0.66-1.00) in these groups. Additionally, those in the high eCRF group had a 20% reduced CKD risk (HR, 0.80; 95% CI: 0.67-0.96) compared to the low eCRF group.</div></div><div><h3>Conclusions</h3><div>The associations between PA or eCRF and incident CKD showed differences according to age and sex.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 4","pages":"Pages 501-509"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015114","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 : 2025-07-01DOI: 10.1053/j.jrn.2025.03.005
Laura Tavares Guimarães RD , Maryanne Zilli Canedo da Silva RD, PhD , Nayrana do Carmo Soares Reis RD, PhD , Jacqueline Costa Teixeira Caramori MD, PhD , Barbara Perez Vogt RD, PhD
Objectives
To analyze the reliability between the sarcopenia criteria proposed by the European Working Group on Sarcopenia in Older People (EWGSOP) 1 and 2 and to verify the association of clinical parameters with sarcopenia diagnosis in patients on maintenance hemodialysis.
Methods
Cross-sectional analysis including adult patients on maintenance hemodialysis. The assessment of lean mass was performed by dual-energy X-ray absorptiometry, and the appendicular lean mass index was calculated. The assessment of muscle strength was performed using a handgrip dynamometer. The cutoff values considered for sarcopenia diagnosis were proposed by the EWGSOP 1 and EWGSOP 2 criteria.
Results
124 patients were included. The frequency of sarcopenia diagnosis was higher according to EWGSOP 1 (25.8%) than according to EWGSOP 2 (12.9%). The frequency of sarcopenia diagnoses diminished in both sexes. The reliability between the two criteria was moderate (κ = 0.597; P < .001), and 87.1% of patients were classified equally by both criteria. In EWGSOP 1, the presence of diabetes and serum iron was significantly higher in the group with sarcopenia, and in EWGSOP 2 there was no such difference.
Conclusion
The frequency of sarcopenia diagnosis in patients on hemodialysis was higher by EWGSOP 1 compared to EWGSOP 2, and the reliability between the criteria was moderate. Sarcopenia diagnosed by EWGSOP 1 was associated with diabetes and serum iron, which are factors that may be associated with sarcopenia pathogenesis. EWGSOP 2 was not associated with the clinical parameters assessed.
{"title":"Reliability Between Sarcopenia Diagnosis by EWGSOP 1 and EWGSOP 2 Criteria and Association With Clinical Parameters in Maintenance Hemodialysis Patients","authors":"Laura Tavares Guimarães RD , Maryanne Zilli Canedo da Silva RD, PhD , Nayrana do Carmo Soares Reis RD, PhD , Jacqueline Costa Teixeira Caramori MD, PhD , Barbara Perez Vogt RD, PhD","doi":"10.1053/j.jrn.2025.03.005","DOIUrl":"10.1053/j.jrn.2025.03.005","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyze the reliability between the sarcopenia criteria proposed by the European Working Group on Sarcopenia in Older People (EWGSOP) 1 and 2 and to verify the association of clinical parameters with sarcopenia diagnosis in patients on maintenance hemodialysis.</div></div><div><h3>Methods</h3><div>Cross-sectional analysis including adult patients on maintenance hemodialysis. The assessment of lean mass was performed by dual-energy X-ray absorptiometry, and the appendicular lean mass index was calculated. The assessment of muscle strength was performed using a handgrip dynamometer. The cutoff values considered for sarcopenia diagnosis were proposed by the EWGSOP 1 and EWGSOP 2 criteria.</div></div><div><h3>Results</h3><div>124 patients were included. The frequency of sarcopenia diagnosis was higher according to EWGSOP 1 (25.8%) than according to EWGSOP 2 (12.9%). The frequency of sarcopenia diagnoses diminished in both sexes. The reliability between the two criteria was moderate (κ = 0.597; <em>P</em> < .001), and 87.1% of patients were classified equally by both criteria. In EWGSOP 1, the presence of diabetes and serum iron was significantly higher in the group with sarcopenia, and in EWGSOP 2 there was no such difference.</div></div><div><h3>Conclusion</h3><div>The frequency of sarcopenia diagnosis in patients on hemodialysis was higher by EWGSOP 1 compared to EWGSOP 2, and the reliability between the criteria was moderate. Sarcopenia diagnosed by EWGSOP 1 was associated with diabetes and serum iron, which are factors that may be associated with sarcopenia pathogenesis. EWGSOP 2 was not associated with the clinical parameters assessed.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 4","pages":"Pages 539-544"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665221","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}
Dark chocolate (DC) is rich in cocoa, a substance with antioxidative and antihypertensive properties. The effect of DC on renal hemodynamics is poorly understood. The aim of this randomized, placebo-controlled study was to investigate whether DC induces changes in blood pressure (BP) and renal perfusion, as assessed with Doppler ultrasound – both at rest and during sympathetic stimulation – compared to cocoa-free white chocolate (WC).
Methods
Seventeen healthy volunteers aged 42 ± 14 years (47% women) were randomized to eat 1 dose of 1 g/kg of DC (70% cocoa) or 1 g/kg of WC. The renal resistive index (RRI), a proxy of intra-renal vascular resistance, was measured just before and 2 hours after chocolate consumption. BP, heart rate, and cardiac output were measured with the Finapres NOVA hemodynamic monitoring system. At each time point, a 3-minute handgrip (HG) test was performed as sympathetic stimulus; during the HG, supplementary RRI values were measured. Two weeks later, the same exams were repeated with the other type of chocolate.
Results
DC intake decreased RRI from 0.62 ± 0.04 to 0.60 ± 0.04 (P = .039), whereas RRI did not change after the intake of WC (before: 0.62 ± 0.05, after: 0.62 ± 0.04, P = .47). DC had no effect on BP in participants consuming >50 g chocolate/week, whereas systolic blood pressure increased from 115 ± 17 to 122 ± 15 mmHg (P = .02) in nonregular chocolate eaters. HG exercise lowered the RRI from 0.62 ± 0.04 to 0.57 ± 0.05 (P = .001) and prolonged acceleration times (from 48.2 ± 8.2 to 57.8 ± 14 msec, P = .009), while increasing BP, heart rate, and cardiac output. In participants aged ≥35 years, the effect of HG exercise on RRI was attenuated by DC ingestion.
Conclusions
The ingestion of DC led to an acute reduction in RRI, suggesting intra-renal vasodilation, whereas WC had no effect. BP only increased in nonregular DC eaters, suggesting that regular DC eaters accustomed to the BP-modifying effects of DC. HG exercise led to a tardus parvus-like pattern of Doppler curves. This effect was attenuated by DC in older participants, suggesting that DC counterbalances the sympathetically induced intra-renal vasoconstriction in these volunteers.
{"title":"The Acute Effect of Dark Chocolate on Blood Pressure and Renal Hemodynamics as Assessed With Doppler Ultrasound in Healthy Volunteers","authors":"Louise Gargiulo MS, Marielle Hendriks-Balk PhD, Kenji Theiler MD, Wendy Brito BSc, Tanguy Corre, Gregoire Wuerzner MD, Menno Pruijm MD","doi":"10.1053/j.jrn.2025.02.003","DOIUrl":"10.1053/j.jrn.2025.02.003","url":null,"abstract":"<div><h3>Objective</h3><div>Dark chocolate (DC) is rich in cocoa, a substance with antioxidative and antihypertensive properties. The effect of DC on renal hemodynamics is poorly understood. The aim of this randomized, placebo-controlled study was to investigate whether DC induces changes in blood pressure (BP) and renal perfusion, as assessed with Doppler ultrasound – both at rest and during sympathetic stimulation – compared to cocoa-free white chocolate (WC).</div></div><div><h3>Methods</h3><div>Seventeen healthy volunteers aged 42 ± 14 years (47% women) were randomized to eat 1 dose of 1 g/kg of DC (70% cocoa) or 1 g/kg of WC. The renal resistive index (RRI), a proxy of intra-renal vascular resistance, was measured just before and 2 hours after chocolate consumption. BP, heart rate, and cardiac output were measured with the Finapres NOVA hemodynamic monitoring system. At each time point, a 3-minute handgrip (HG) test was performed as sympathetic stimulus; during the HG, supplementary RRI values were measured. Two weeks later, the same exams were repeated with the other type of chocolate.</div></div><div><h3>Results</h3><div>DC intake decreased RRI from 0.62 ± 0.04 to 0.60 ± 0.04 (<em>P</em> = .039), whereas RRI did not change after the intake of WC (before: 0.62 ± 0.05, after: 0.62 ± 0.04, <em>P</em> = .47). DC had no effect on BP in participants consuming >50 g chocolate/week, whereas systolic blood pressure increased from 115 ± 17 to 122 ± 15 mmHg (<em>P</em> = .02) in nonregular chocolate eaters. HG exercise lowered the RRI from 0.62 ± 0.04 to 0.57 ± 0.05 (<em>P</em> = .001) and prolonged acceleration times (from 48.2 ± 8.2 to 57.8 ± 14 msec, <em>P</em> = .009), while increasing BP, heart rate, and cardiac output. In participants aged ≥35 years, the effect of HG exercise on RRI was attenuated by DC ingestion.</div></div><div><h3>Conclusions</h3><div>The ingestion of DC led to an acute reduction in RRI, suggesting intra-renal vasodilation, whereas WC had no effect. BP only increased in nonregular DC eaters, suggesting that regular DC eaters accustomed to the BP-modifying effects of DC. HG exercise led to a tardus parvus-like pattern of Doppler curves. This effect was attenuated by DC in older participants, suggesting that DC counterbalances the sympathetically induced intra-renal vasoconstriction in these volunteers.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 4","pages":"Pages 486-493"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538023","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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