Journal of Renal Nutrition最新文献

英文中文

Serum phosphate levels and mortality in incident hemodialysis patients: a national retrospective cohort study. 血清磷酸盐水平与血液透析患者的死亡率：一项全国性回顾性队列研究。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2024-11-04 DOI: 10.1053/j.jrn.2024.10.003

Mariana Mazzei Caiado Bressan, Elisa de Albuquerque Sampaio, Ricardo de Castro Cintra Sesso, Jocemir Ronaldo Lugon

引用次数: 0

MyPlate Awareness and Engagement and Perceived and Objective Diet Quality in US Adults With Chronic Kidney Disease 美国成人慢性肾病患者对 "我的餐盘 "的认识和参与程度以及感知和客观饮食质量。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2024-11-01 DOI: 10.1053/j.jrn.2024.04.007

Josiah Thule BSA , Xue Yu MS , Maria E. Montez-Rath PhD , Glenn M. Chertow MD, MPH

Objective

Awareness of federal dietary guidelines has been associated with better perceived and objective diet quality. Little is known about the awareness of federal dietary recommendations among persons with chronic kidney disease (CKD) and the associations between recognition of guidelines, perception of diet quality, and objective quality of the diet in this population.

Design and Methods

We compared awareness of, and engagement with, MyPlate (a representation of 5 food groups from the US Department of Agriculture) along with perceived and objective diet quality, the latter assessed via Dietary Approaches to Stop Hypertension index scores, among US adults with and without CKD during 2017-2020.

Results

Among noninstitutionalized adults in the United States, 8.3% had albuminuria with normal or near-normal kidney function, 4.0% had estimated glomerular filtration rate 45-59 mL/minute/1.73 m² (CKD stage G3a) and 1.6% had estimated glomerular filtration rate <45 mL/minute/1.73 m² (CKD stages G3b/G4/G5). MyPlate awareness was lower among persons with CKD compared with those without CKD (19.6% vs. 26.4%, P < .001) and was lower among persons with more advanced CKD stages: 20.8%, 18.2%, and 16.3% in persons with CKD stages G1/G2, G3a, and G3b/G4/G5, respectively (trend P < .001). Among persons aware of MyPlate, a numerically higher proportion with CKD attempted to follow MyPlate recommendations (43.9% vs. 32.3%, P = .10); the proportion was highest among persons with moderate-to-advanced CKD (41.9%, 42.9%, and 56.9% among persons with CKD stages G1/G2, G3a, and G3b/G4/G5, respectively (trend P < .001)). Perceived and objective dietary quality (the latter based on concordance with the Dietary Approaches to Stop Hypertension diet) were slightly higher among persons with CKD relative to those without CKD.

Conclusions

Adults with CKD have lower MyPlate awareness than adults without CKD. Enhancing diet education to persons with CKD could improve diet quality and potentially ameliorate CKD-associated complications.

目的：对联邦膳食指南的认识与更好的感知和客观饮食质量有关。对于慢性肾脏病（CKD）患者对联邦膳食建议的认识，以及该人群对指南的认识、对饮食质量的感知和客观饮食质量之间的关联，我们知之甚少：设计：我们比较了 2017-2020 年期间患有和未患有 CKD 的美国成年人对 MyPlate（美国农业部的五种食物类别代表）的认知度和参与度，以及对饮食质量的感知和客观饮食质量，后者通过膳食方法阻止高血压（DASH）指数评分进行评估：在美国非住院成年人中，8.3%的人有白蛋白尿，肾功能正常或接近正常，4.0%的人估计肾小球滤过率（eGFR）为45-59 mL/min/1.73m2（CKD分期G3a），1.6%的人eGFR为2（CKD分期G3b/G4/G5）。与非慢性肾脏病患者相比，慢性肾脏病患者对 MyPlate 的认知度较低（19.6% 对 26.4%，p 结论：患有慢性肾脏病的成年人对 MyPlate 的认知度低于未患慢性肾脏病的成年人。加强对慢性肾脏病患者的饮食教育可以提高饮食质量，并有可能改善与慢性肾脏病相关的并发症。

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引用次数: 0

Opportunity to Submit Comments to the Food and Drug Administration on Phosphate Food Additive Safety Through December 6, 2024 有机会在 2024 年 12 月 6 日前就磷酸盐食品添加剂的安全性向食品和药物管理局提交意见。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2024-11-01 DOI: 10.1053/j.jrn.2024.09.003

Joyce Marcley Vergili EdD, RDN, CSR, CDN, CDCES, FAND

引用次数: 0

Emergence of Artificial Intelligence in Renal Nutrition Applications 人工智能在肾脏营养方面的应用。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2024-11-01 DOI: 10.1053/j.jrn.2024.10.002

Linda W. Moore PhD, RDN, Giacomo Garibotto MD

引用次数: 0

The 10-Item Physical Function Scale as a Sarcopenia Screening Tool for Patients on Hemodialysis 作为血液透析患者 "肌肉疏松症 "筛查工具的 10 项身体功能量表 (PF-10)。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2024-11-01 DOI: 10.1053/j.jrn.2024.05.012

Marvery P. Duarte MSc , Fábio A. Vieira PT , Victor M. Baião MSc , Jacqueline S. Monteiro MD , Aparecido P. Ferreira PhD , Antônio J. Inda-Filho MD, PhD , Otávio T. Nóbrega PhD , Heitor S. Ribeiro PhD

Objective

We investigated the accuracy of the 10-item Physical Function (PF-10) questions of the SF-36 quality of life questionnaire as a sarcopenia screening tool among patients on hemodialysis.

Methods

A cross-sectional, multicenter study that included adult patients on hemodialysis. The revised European Working Group on Sarcopenia in Older People was used to diagnose sarcopenia. The 10 questions about daily activities from the SF-36 quality of life questionnaire were used to appoint the PF-10, where the final score could range from 10 to 30, and the lower the worse the physical function. The PF-10 accuracy to identify confirmed sarcopenia (low muscle strength + low muscle mass) was assessed through a receiver operating characteristic curve and the cutoff was calculated using the Youden index.

Results

One hundred eighty-five patients were included (median 59 years; 45% female). Prevalence of confirmed sarcopenia was 31.4%. The median PF-10 score was 23 (interquartile range: 17–27) and a significant association with all sarcopenia measurements was found (all P < .05). The best cutoff calculated from the receiver operating characteristic curve was ≤26 points (area under the curve = 0.69, 95% confidence interval 0.61-0.77) with sensitivity and specificity of 96.6% and 71.0%, respectively. Moreover, patients with ≤26 points (n = 133, 72%) had a higher prevalence of low muscle strength by handgrip (53 vs. 19%; P < .001) and 5-time sit-to-stand (41 vs. 10%; P < .001), low gait speed (44 vs. 19%; P = .002), confirmed sarcopenia (39 vs. 11%; P < .001), and severe sarcopenia (26 vs. 4%; P = .001), but not low muscle mass (49 vs. 35%; P = .08), in comparison with those >26 points (n = 52, 28%).

Conclusion

The PF-10 may be a useful physical dysfunction and sarcopenia screening tool in patients on hemodialysis. A PF-10 threshold of around 26 points appeared to display the fairest accuracy for diagnosing sarcopenia.

目的：临床实践中非常需要用于评估肌肉疏松症的筛查工具。一些透析中心通常通过 36 项简表调查（SF-36）来评估生活质量，其中包括 10 个有关身体功能的问题。因此，我们研究了 10 项身体功能量表（PF-10）识别血液透析患者肌少症的准确性：方法：这是一项横断面多中心研究，研究对象包括接受血液透析的成年患者。采用欧洲老年人肌肉疏松症工作组的修订版来诊断肌肉疏松症。采用 SF-36 问卷中有关日常活动的 10 个问题来指定 PF-10，最终得分范围为 10 至 30 分，得分越低，身体功能越差。通过接收器操作特征曲线（ROC）评估了 PF-10 对确诊肌肉疏松症（低肌力+低肌肉质量）的准确性，并使用尤登指数计算了分界点：共纳入 185 名患者（中位年龄为 59 岁；45% 为女性）。证实患有肌肉疏松症的比例为 31.4%。PF-10 评分的中位数为 23（四分位数间距：10-30），与所有肌肉疏松症测量值均有显著关联（P 均小于 0.05）。根据 ROC 曲线计算得出的最佳临界值为≤ 26 分（曲线下面积 = 0.69，95% 置信区间为 0.61-0.77），灵敏度和特异度分别为 96.6% 和 71.0%。此外，≤26 分（133 人，72%）的患者手握肌力低下的发生率更高（53 对 19%；P 26 分（52 人，28%））：10项身体功能量表（PF-10）可能是血液透析患者身体功能障碍和肌肉疏松症筛查的有用工具。26分左右的PF-10临界值似乎最能准确诊断肌少症。

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引用次数: 0

Change Over Time in Pre–End-Stage Renal Disease 24-Hour Urine Creatinine as Muscle Mass Surrogate and Post–End-Stage Renal Disease Mortality 作为肌肉质量替代指标的 ESRD 前 24 小时尿肌酐随时间的变化以及 ESRD 后的死亡率。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2024-11-01 DOI: 10.1053/j.jrn.2024.03.002

Sahar Amin MD , Barry M. Wall MD , Fridtjof Thomas PhD , Kamyar Kalantar-Zadeh MD, PhD, MPH , Keiichi Sumida MD, PhD, MPH , Csaba P. Kovesdy MD

Objective

Loss of muscle mass and sarcopenia are common in chronic kidney disease (CKD) and end-stage renal disease (ESRD), and sarcopenia can worsen insidiously in patients with advancing CKD. The temporal dynamics of sarcopenia in patients with progressive loss of kidney function, and its association with future outcomes, is unclear.

Methods

In a contemporary national cohort of incident ESRD US veterans, we selected 661 patients who had at least 2 24-hour urine creatinine (24hrUC) measurements, a surrogate of muscle mass, performed during the 3-year prelude period prior to ESRD transition. We estimated 24hrUC slopes in mixed effects models. To assess the temporal dynamics of pre-ESRD changes in 24hrUC and its association with changing eGFR, we separately fitted in mixed effects models a penalized spline regression of 24hrUC on time and on eGFR. We examined the association of 24hrUC slopes with postdialysis all-cause mortality using Cox models adjusted for confounders.

Results

The mean slope of 24hrUC versus time was −78 mg/year (95% confidence interval: −102 to −54), with a steeper decline noted in the last year prior to ESRD. More severe decreases in 24hrUC were associated with higher all-cause mortality: a 100 mg/year decrease in 24hrUC was associated with a multivariable adjusted death hazard ratio of 1.41 (95% confidence interval: 1.00-1.98, P = .05).

Conclusion

Patients with advanced CKD lose a substantial proportion of their muscle mass each year during pre-ESRD prelude. Loss of muscle mass accelerates near ESRD transition, and more loss of muscle mass is associated with higher mortality after ESRD transition.

目的：肌肉质量下降和肌肉疏松症是慢性肾脏病和 ESRD 患者的常见病，在慢性肾脏病进展期，肌肉疏松症会隐性恶化。目前尚不清楚肾功能逐渐丧失患者肌肉疏松症的时间动态及其与未来预后的关系：方法：我们从美国退伍老兵的当代全国队列中挑选了 661 名患者，这些患者在转为 ESRD 之前的三年前奏期间至少进行了两次 24 小时尿肌酐（24hrUC）测量，这是肌肉质量的替代指标。我们在混合效应模型中估计了 24hrUC 的斜率。为了评估 ESRD 前 24hrUC 的时间动态变化及其与不断变化的 eGFR 的关系，我们在混合效应模型中分别拟合了 24hrUC 与时间和 eGFR 的惩罚性样条回归。我们使用经混杂因素调整的 Cox 模型研究了 24hrUC 斜率与透析后全因死亡率的关系：24hrUC与时间的平均斜率为-78毫克/年（95%CI：-102至-54），ESRD前最后一年的下降幅度更大。24hrUC下降越严重，全因死亡率越高：24hrUC每下降100毫克/年，经多变量调整后的死亡危险比为1.41（95%CI：1.00-1.98，P=0.05）：结论：晚期慢性肾功能衰竭患者在ESRD前期每年都会损失很大一部分肌肉。结论：晚期慢性肾功能衰竭患者在ESRD前奏期间每年都会损失大量肌肉，在ESRD转归期附近，肌肉质量的损失会加速，肌肉质量损失越多，ESRD转归期后的死亡率越高。

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引用次数: 0

November Meeting Announcements 十一月会议公告

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2024-11-01 DOI: 10.1053/j.jrn.2024.08.001

Mary Kay Hensley MS, RDN, FAND

引用次数: 0

Unlocking the Potential of Brewers’ Spent Grain: A Sustainable Model to Use Beer for Better Outcome in Chronic Kidney Disease 释放啤酒糟的潜力：利用啤酒改善慢性肾病治疗效果的可持续模式。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2024-11-01 DOI: 10.1053/j.jrn.2024.03.007

Babak Ghajavand MD , Carla Avesani PhD , Peter Stenvinkel MD, PhD , Annette Bruchfeld MD, PhD

The rising global incidence of chronic inflammatory diseases calls for innovative and sustainable medical solutions. Brewers’ spent grain (BSG), a byproduct of beer production, presents a unique opportunity in this regard. This review explores the multifaceted health benefits of BSG, with a focus on managing chronic kidney disease (CKD). BSG is identified as a potent prebiotic with potential as a therapeutic agent in CKD. We emphasize the role of gut dysbiosis in CKD and discuss how BSG could help mitigate metabolic derangements resulting from dysbiosis and CKD. Fermentation of BSG further enhances its positive impact on gut health. Incorporating fermented BSG as a key component in preventive health care could promote a more sustainable and healthier future. By optimizing the use of this typically discarded byproduct, we can align proactive health-care strategies with responsible resource management, benefiting both people and the environment.

全球慢性炎症性疾病的发病率不断上升，需要创新和可持续的医疗解决方案。啤酒生产的副产品--啤酒糟（BSG）在这方面提供了一个独特的机会。本综述探讨了 BSG 对健康的多方面益处，重点是慢性肾病（CKD）的治疗。BSG 被认为是一种有效的益生元，具有治疗 CKD 的潜力。我们强调了肠道菌群失调在 CKD 中的作用，并讨论了 BSG 如何有助于缓解菌群失调和 CKD 导致的代谢紊乱。发酵 BSG 可进一步增强其对肠道健康的积极影响。将发酵 BSG 作为预防性保健的一个关键组成部分，可以促进更可持续和更健康的未来。通过优化利用这种通常被丢弃的副产品，我们可以将积极的医疗保健战略与负责任的资源管理结合起来，从而造福于人类和环境。

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引用次数: 0

Creative Ways to Add Flavor to Meals Without the Salt 不放盐也能为膳食增添风味的创新方法。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2024-11-01 DOI: 10.1053/j.jrn.2024.09.002

Melissa Prest DCN, RDN

引用次数: 0

Case Study: The Weighty Issue of Treatment Options for Obese Dialysis Patients 案例研究：肥胖透析患者治疗方案的重大问题。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2024-11-01 DOI: 10.1053/j.jrn.2024.04.004

Desiree de Waal MS, RD, CD, FAND , Macaulay Onuigbo MD, MSc, FWACP, FASN, MBA , Thomas Alan Golper MD, FACP

Obesity is a complex chronic disease and common comorbidity in kidney failure and is the leading causes of death and disability in this population. Guidelines do not specifically address the preferred weight management option(s) for obesity while on dialysis. Large body size is a limiting factor for consideration of a kidney transplantation. We report on a successful bariatric surgery with a young adult after 5.5 years on dialysis with hope for a future transplant. Success was demonstrated with progressive weight loss without adverse changes in renal clinical markers accompanied by improvements in exercise tolerance and health status thereby improving her suitability for a kidney transplant. Further studies and guidelines are needed to address weight loss options for those with obesity on dialysis and want to lose weight.

肥胖是一种复杂的慢性疾病，也是肾衰竭的常见并发症，是导致肾衰竭患者死亡和残疾的主要原因。指南中没有专门针对透析期间肥胖症的首选体重管理方案。庞大的体型是考虑肾移植的一个限制因素。我们报告了一名年轻成人在透析 5.5 年后成功接受减肥手术的情况，该患者未来有望接受肾移植。手术成功的表现是体重逐渐减轻，但肾脏临床指标没有发生不良变化，同时运动耐量和健康状况也有所改善，从而提高了她接受肾移植的适宜性。我们需要进一步的研究和指导方针，来解决那些正在透析并希望减肥的肥胖患者的减肥问题。

引用次数: 0

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