Journal of Renal Nutrition最新文献

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IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-07-01 Epub Date: 2025-05-08 DOI: 10.1053/j.jrn.2025.04.003

Jill Hoyt RDN, CD, FNKF

引用次数: 0

Response Letter to Comment on: The Effect of Antihypertensive Therapy on Skeletal Muscle Mass and Bone Mineral Density in Patients With End-Stage Kidney Disease 关于“降压治疗对终末期肾病患者骨骼肌质量和骨密度的影响”评论的回复信。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-07-01 Epub Date: 2025-03-17 DOI: 10.1053/j.jrn.2025.03.003

Rena Suzukawa, Shintaro Mandai MD, PhD, Hiroko Hashimoto MD, PhD, Satomi Shikuma MD, Mai Kimura MD, Hayato Toma MD, Yuki Sakaguchi MD, Sayuka Shiraishi MD, Noriyuki Toshima MD, Motoki Hoshino MD, Moe Kimura MD, Jun Ota MD, Susumu Horiuchi MD, Susumu Adachi MD, Shinichi Uchida MD

引用次数: 0

July Meeting Announcements 7月会议公告

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-07-01 Epub Date: 2025-07-24 DOI: 10.1053/j.jrn.2025.04.002

引用次数: 0

Diet Quality Components and Gut Microbiota of Patients on Peritoneal Dialysis 腹膜透析患者饮食质量组成及肠道菌群。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-05-01 Epub Date: 2025-01-24 DOI: 10.1053/j.jrn.2025.01.001

Christiane Ishikawa Ramos PhD , Laila Santos de Andrade PhD , Renata Rodrigues Teixeira MD , Natália Barros Ferreira Pereira MD , Fabiana da Silva Lima PhD , Christian Hoffmann PhD , Lilian Cuppari PhD

Objectives

To evaluate the associations between the quality of the diet and its components and microbial diversity and composition in peritoneal dialysis (PD) patients.

Design and Methods

This cross-sectional study included PD patients for at least 3 months, aged 18-75 years and clinically stable. The Diet Quality Index (DQI), validated for the Brazilian population, is based on the energy density of 11 components (“sugar and sweets;” “beef, pork, and processed meat;” “refined grains and breads;” “animal fat;” “poultry, fish, and eggs;” “whole cereals, tubers, and roots;” “fruits”; “nonstarch vegetables;” “legumes and nuts;” “milk and dairy products;” and “vegetable oil”). A proportional score—based on the adequacy of the intake to Brazilian dietary guidelines—is calculated, and a final score ranged from 0 (worse) to 100 (better) is obtained. Fecal samples were collected at home, in a sterile material, kept refrigerated, and delivered to the clinic within 12 hours; α-diversity indices (Observed operational taxonomic units, Chao-1, Shannon’s, Gini-Simpson’s, Pielou eveness, and Faith phylogenetics) and microbial profile were determined by 16S ribosomal DNA with polymerase chain reaction-amplification and sequenced on an Illumina MiSeq platform.

Results

Forty-three participants were included (53.5% men, 52.4 ± 14.1 years, body mass index: 25.9 ± 4.1 kg/m², 30.2% had diabetes mellitus). DQI score was 50.5 (41.9-54.9). The lowest energy density was for the components “animal fat” and “whole cereals and breads, tubers, and roots,” and the highest were for “refined grains and bread” and “beef, pork, and processed meat.” Diversity indices and Enterorhabdus genus were directly associated with the energy density of the components “whole cereals and breads, tubers, and roots” and inversely with “refined grains and bread,” after adjustments for age and diabetes.

Conclusions

Even low, the intake of whole cereals, tubers, and roots has the potential to positively influence the microbiota profile in PD patients.

目的：评价腹膜透析（PD）患者饮食质量及其成分与微生物多样性和组成之间的关系。设计和方法：本横断面研究纳入年龄18-75岁且临床稳定的PD患者，时间至少3个月。巴西人的饮食质量指数（DQI）基于11种成分的能量密度(“糖和甜食”；“牛肉、猪肉及加工肉类”；“精制谷物和面包”；“动物脂肪”;“家禽、鱼和蛋”；“全谷类、块茎和块根”；“水果”;“非淀粉蔬菜”;“豆类和坚果”；“牛奶及乳制品”；“植物油”)。根据巴西膳食指南的摄入量是否足够，计算出一个比例分数，并得到一个从0（较差）到100（较好）的最终分数。在家中收集粪便样本，用无菌材料保存，并在12小时内送到诊所。α-多样性指数（OTUs、chao1、Shannon’、gini - simpson’、Pielou均匀度和faith系统发育）和微生物谱采用16S核糖体DNA进行pcr扩增，并在Illumina MiSeq平台上测序。结果：纳入43例受试者（男性53.5%,52.4±14.1岁，BMI:25.9±4.1 kg/m2，糖尿病患者30.2%）。DQI评分为50.5（41.9 ~ 54.9）。能量密度最低的成分是“动物脂肪”和“全谷物和面包、块茎和根茎”，能量密度最高的成分是“精制谷物和面包”和“牛肉、猪肉和加工肉类”。在调整了年龄和糖尿病因素后，肠道菌属的多样性指数与“全谷物和面包、块茎和根”成分的能量密度呈正相关，与“精粮和面包”成分的能量密度呈负相关。结论：即使摄入量很低，全谷物、块茎和根类食物也可能对腹膜透析患者的微生物群有积极的影响。

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引用次数: 0

Navigating Nutrition Therapy for Autosomal Dominant Polycystic Kidney Disease 常染色体显性多囊肾病（ADPKD）的营养治疗导航

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-05-01 Epub Date: 2025-03-14 DOI: 10.1053/j.jrn.2025.02.007

Diana Bruen MS, RD

引用次数: 0

May Meeting Announcements 五月会议公告

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-05-01 Epub Date: 2025-04-02 DOI: 10.1053/j.jrn.2025.03.001

Mary Kay Hensley MS, RDN, FAND, FNKF

引用次数: 0

Magnesium Supplementation Increases Urine Magnesium and Citrate in Stone Formers With Hypomagnesuria 补充镁可增加低镁尿症结石患者尿液中的镁和柠檬酸盐含量。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-05-01 Epub Date: 2024-06-18 DOI: 10.1053/j.jrn.2024.06.002

Kristina L. Penniston PhD, RDN , Mariana M. Coughlin MS , R. Allan Jhagroo MD

Objectives

To compare the effects of magnesium repletion by a foods-alone approach or by magnesium supplementation on urinary magnesium and citrate excretion in patients with urine magnesium <70 mg/day.

Methods

We reviewed medical records of patients in our stone prevention practice who were advised to start a magnesium supplement (Sup), 250-500 mg/day, or increase dietary magnesium consumption. We included adults with 24-hour urine magnesium (UMg) <70 mg, those who received magnesium recommendations (corroborated by the dietitian’s clinical notes), and those with a follow-up 24-hour urine collection ≤18 months. Urine results were assessed by group.

Results

Groups [No Sup (n = 74) and Sup (n = 56)] were not different for age, gender, stone history, malabsorption, or other clinical indices. All patients raised UMg (53-69 and 47-87 mg/day for No Sup and Sup, respectively); however, the increase was significantly higher in the Sup group. Moreover, while 88% of Sup patients achieved UMg ≥70 mg/day, only 58% in the No Sup group did so. Within-group increases in urine citrate were significant only in the Sup group.

Conclusion

Among patients with low UMg, both higher consumption from foods and magnesium supplementation significantly increased UMg. However, those who supplemented were significantly more likely to reach or exceed UMg 70 mg/day and achieved higher mean UMg. The change in urine citrate was significant only among those in the Sup group.

目的比较单纯食物补镁或镁补充剂对尿镁患者尿镁和枸橼酸盐排泄的影响：我们回顾了结石预防实践中被建议开始服用镁补充剂（Sup）（250-500 毫克/天）或增加膳食镁摄入量的患者的病历。我们纳入了 24 小时尿镁结果的成年人：无Sup组（n=74）和Sup组（n=56）]在年龄、性别、结石病史、吸收不良或其他临床指标方面没有差异。所有患者的 UMg 都有所升高（No Sup 和 Sup 的升高幅度分别为 53 至 69 毫克/天和 47 至 87 毫克/天）；但 Sup 组的升高幅度明显更高。此外，88% 的 Sup 患者 UMg 达到≥70 毫克/天，而 No Sup 组中只有 58% 的患者达到了这一水平。组内尿柠檬酸盐的增加仅在 Sup 组有显著意义：结论：在尿镁低的患者中，从食物中摄取更多的镁和补充镁都能显著提高尿镁。然而，补充镁剂的患者更有可能达到或超过镁70毫克/天，并获得更高的平均镁含量。尿液中柠檬酸盐的变化只有在 Sup 组中才有意义。

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引用次数: 0

The Discordance Between Creatinine-Based and Cystatin C-Based Estimated Glomerular Filtration Rate: A Matter of Protein Intake? 基于肌酐和胱抑素c的估测GFR之间的不一致：蛋白质摄入量的问题？

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-05-01 Epub Date: 2025-03-31 DOI: 10.1053/j.jrn.2025.03.007

Michela Saio MD, Giacomo Garibotto MD, Linda W. Moore PhD, RDN

引用次数: 0

Accuracy of Current Large Language Models and the Retrieval-Augmented Generation Model in Determining Dietary Principles in Chronic Kidney Disease 当前大型语言模型和检索增强生成模型在确定慢性肾脏疾病饮食原则中的准确性。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-05-01 Epub Date: 2025-01-24 DOI: 10.1053/j.jrn.2025.01.004

Feray Gençer Bingöl PhD , Duygu Ağagündüz PhD , Mustafa Can Bingol PhD

Objective

Large language models (LLMs) have emerged as powerful tools with significant potential for quickly accessing information in the nutrition and health, as in many fields. Retrieval-augmented generation (RAG) has been included among artificial intelligence (AI) powered chatbot structures as a framework developed to increase the accuracy and ability of LLMs. This study aimed to evaluate the accuracy of LLMs (Generative Pre-trained Transformer 4, Gemini, and Llama) and RAG in determining dietary principles in chronic kidney disease.

Design and Methods

The nutrition guideline published by the National Kidney Foundation in 2020 was used as an external information source in developed RAG model. Answers were obtained using 12 medical nutritional therapy prompts for chronic kidney disease by four chatbots. The accuracy of the 48 answers generated by the chatbots was evaluated with a 5-point Likert scale.

Results

The results showed that Gemini and RAG had the highest accuracy scores (median: 4.0), followed by Generative Pre-trained Transformer 4 (median: 2.5) and Llama (median: 1.5), respectively. When the accuracy scores were examined between the two chatbots, a significant difference was detected between all groups except Gemini and RAG.

Conclusion

These chatbots produced both completely correct answers and false information with potentially harmful clinical outcomes. Customization of LLMs in specific areas such as nutrition or the development of a nutrition-specific RAG framework by improving LLM structures with current guidelines and articles may be an important strategy to increase the accuracy of AI powered chatbots.

目的：大型语言模型（LLMs）已经成为一种强大的工具，在营养和健康等许多领域具有快速获取信息的巨大潜力。检索增强生成（RAG）已被纳入人工智能（AI）驱动的聊天机器人结构中，作为提高llm准确性和能力的框架而开发。本研究旨在评估LLMs （GPT4、Gemini和Llama）和RAG在确定慢性肾脏疾病饮食原则方面的准确性。设计与方法：采用国家肾脏基金会2020年发布的营养指南作为外部信息源，建立RAG模型。通过四个聊天机器人使用12个CKD医学营养治疗提示获得答案。由聊天机器人生成的48个答案的准确性用5分李克特量表进行了评估。结果：结果显示，Gemini和RAG的准确率得分最高（中位数：4.0），其次是GPT4（中位数：2.5）和Llama（中位数：1.5）。当检查两个聊天机器人之间的准确性分数时，除了Gemini和RAG之外，所有组之间都存在显着差异。结论：这些聊天机器人既能给出完全正确的答案，也能给出可能有害临床结果的错误信息。定制特定领域的法学硕士（如营养学）或通过使用当前指南和文章改进法学硕士结构来开发营养特定的RAG框架，可能是提高人工智能聊天机器人准确性的重要策略。

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引用次数: 0

Handheld Dynamometry Testing During Dialysis: Intrarater and Interrater Reliability Study 透析期间的手持式测力测试：内部和内部可靠性研究。

IF 3.4 3区医学 Q2 NUTRITION & DIETETICS

Journal of Renal Nutrition

Pub Date : 2025-05-01 Epub Date: 2025-01-24 DOI: 10.1053/j.jrn.2025.01.002

Eva Segura-Ortí PhD, PT , Anna Junqué-Jiménez PhD, RN , Valentin Dubuis PT , Maycon M. Reboredo PhD, PT , Vicente Benavent-Caballer PhD, PT , Noemi Valtueña-Gimeno PhD, PT , Fabricio Sciammarella Barros MSc, PT , Daniela Thomé Silva PT , Francisco J. Martinez-Olmos PhD, PT

Objectives

The aim was to assess the intrarater and interrater reliability of the handheld dynamometry testing of lower limb muscles during hemodialysis.

Methods

This is a cross-sectional study including subjects undertaking hemodialysis for at least 3 months. Handheld dynamometer measurements of hip and ankle muscle strength (N) were registered on 4 different occasions, 2 trials by raters A and 2 by raters B, to evaluate the intrarater and interrater reliability. Bland-Altman plots were constructed to examine the agreement between raters by scoring the difference between raters against the mean of both raters’ scores. The intraclass correlation coefficient was used to assess relative intrarater and interrater reliability. Absolute reliability was assessed with the minimal detectable change.

Results

Fifty-six participants (median age, 67 years) data showed high to very high relative reliability (intraclass correlation coefficients 0.75-0.98). Regarding the intrarater absolute reliability, minimal detectable change score 90% confidence interval values ranged from 27.0 to 41.6.5 N (0.14-0.26 N/kg m²) for hip muscles but increased for ankle muscles. Interrater values were wider. The mean difference between trials ranged narrowly across the two-time points for raters A (1.0-19.3 N) and for raters B (1.3 - 11.4 N). The mean difference between raters ranged from 2.4 to 13.5 N. The Bland-Altman plot revealed a systematic bias for raters A in ankle plantar flexion.

Conclusions

The assessment of the hip flexion and abduction strength during dialysis with a handheld dynamometer is reliable and safe. Normalized data provides more reliable results.

目的目的是评估血液透析期间下肢肌肉手持式测力计测试的内部和相互之间的可靠性：这是一项横断面研究，研究对象包括血液透析至少 3 个月的受试者。手持式测力计对髋部和踝部肌肉力量（N）的测量在4个不同场合进行登记，其中2次由评分者A进行，2次由评分者B进行，以评估评分者内部和评分者之间的可靠性。通过将评分者之间的差异与两位评分者评分的平均值进行比较，绘制布兰德-阿尔特曼图来检验评分者之间的一致性。类内相关系数（ICC）用于评估评分者内部和评分者之间的相对可靠性。绝对信度用最小检测变化（MDC）进行评估：56 名参与者（中位年龄 67 岁）的数据显示出较高至非常高的相对可靠性（ICC 为 0.75 至 0.98）。关于评分者内部的绝对可靠性，髋部肌肉的 MDC90 值在 27.0 至 41.6.5 N（0.14 至 0.26 N/Kg m2）之间，但踝部肌肉的 MDC90 值有所增加。评定者之间的差异值更大。评定者 A 和评定者 B 在两个时间点之间的试验平均差异范围较小（分别为 1.0 - 19.3 N 和 1.3 - 11.4 N）。布兰-阿尔特曼曲线图显示，在踝关节跖屈方面，评分员 A 存在系统性偏差。.结论在透析过程中使用手持式测力计评估髋关节屈曲和外展力量是可靠和安全的。归一化数据可提供更可靠的结果。

{"title":"Handheld Dynamometry Testing During Dialysis: Intrarater and Interrater Reliability Study","authors":"Eva Segura-Ortí PhD, PT , Anna Junqué-Jiménez PhD, RN , Valentin Dubuis PT , Maycon M. Reboredo PhD, PT , Vicente Benavent-Caballer PhD, PT , Noemi Valtueña-Gimeno PhD, PT , Fabricio Sciammarella Barros MSc, PT , Daniela Thomé Silva PT , Francisco J. Martinez-Olmos PhD, PT","doi":"10.1053/j.jrn.2025.01.002","DOIUrl":"10.1053/j.jrn.2025.01.002","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim was to assess the intrarater and interrater reliability of the handheld dynamometry testing of lower limb muscles during hemodialysis.</div></div><div><h3>Methods</h3><div>This is a cross-sectional study including subjects undertaking hemodialysis for at least 3 months. Handheld dynamometer measurements of hip and ankle muscle strength (N) were registered on 4 different occasions, 2 trials by raters A and 2 by raters B, to evaluate the intrarater and interrater reliability. Bland-Altman plots were constructed to examine the agreement between raters by scoring the difference between raters against the mean of both raters’ scores. The intraclass correlation coefficient was used to assess relative intrarater and interrater reliability. Absolute reliability was assessed with the minimal detectable change.</div></div><div><h3>Results</h3><div>Fifty-six participants (median age, 67 years) data showed high to very high relative reliability (intraclass correlation coefficients 0.75-0.98). Regarding the intrarater absolute reliability, minimal detectable change score 90% confidence interval values ranged from 27.0 to 41.6.5 N (0.14-0.26 N/kg m<sup>2</sup>) for hip muscles but increased for ankle muscles. Interrater values were wider. The mean difference between trials ranged narrowly across the two-time points for raters A (1.0-19.3 N) and for raters B (1.3 - 11.4 N). The mean difference between raters ranged from 2.4 to 13.5 N. The Bland-Altman plot revealed a systematic bias for raters A in ankle plantar flexion.</div></div><div><h3>Conclusions</h3><div>The assessment of the hip flexion and abduction strength during dialysis with a handheld dynamometer is reliable and safe. Normalized data provides more reliable results.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 3","pages":"Pages 433-442"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048761","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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