Journal of Renal Nutrition最新文献

{"title":"A Comparison Between Severity-Dependent Protocol and Fixed-Dose Regimen of Oral Vitamin D Supplementation on Correction of Hypovitaminosis D Among Dialysis Patients","authors":"Saranchana Jiampochaman MD ,&nbsp;Piyatida Chuengsaman MD ,&nbsp;Talerngsak Kanjanabuch MD ,&nbsp;Paweena Susantitaphong MD ,&nbsp;Kanda Sriudom RN ,&nbsp;Sirarat Katesomboon CDT ,&nbsp;Kamonchanok Metta CDT ,&nbsp;Somchai Eiam-Ong MD ,&nbsp;Piyawan Kittiskulnam MD","doi":"10.1053/j.jrn.2024.11.002","DOIUrl":"10.1053/j.jrn.2024.11.002","url":null,"abstract":"<div><h3>Objective</h3><div>Low vitamin D status is associated with either low muscle mass or impaired muscle function in dialysis patients. However, there is no consensus on how best to correct hypovitaminosis D, defined as serum 25-hydroxyvitamin D level &lt;30 ng/mL, in patients with end-stage kidney disease (ESKD). This study investigated the effect of different vitamin D supplementation regimens on sarcopenia outcomes in dialysis patients.</div></div><div><h3>Methods</h3><div>This was a prospective randomized controlled trial. ESKD patients treated with maintenance hemodialysis (HD) or peritoneal dialysis with low vitamin D status on a ratio of 1:1, were randomized to either receive oral ergocalciferol utilizing a severity-dependent treatment protocol for low vitamin D status suggested by the Kidney Disease Outcomes Quality Initiative as a control group or a fixed-dose regimen of 20,000 international units/week. The changes in muscle mass were measured by bioimpedance spectroscopy, muscle strength was assessed by a hand grip dynamometer, physical performance was determined by gait speed, and muscle-related biomarkers were examined.</div></div><div><h3>Results</h3><div>A total of 76 dialysis patients were randomized (HD = 43.4%). Baseline characteristics, including age, dialysis vintage, and muscle parameters were similar. After supplementation, the average serum 25-hydroxyvitamin D levels in the severity-dependent and fixed-dose groups were significantly elevated from 14.5 ± 7.3 to 27.2 ± 13.2 ng/mL, <em>P</em> &lt; .001 and from 15.1 ± 6.4 to 28.8 ± 11.5 ng/mL, <em>P</em> &lt; .001, respectively, and did not differ between groups at 6 months (<em>P</em> = .60). Despite comparable energy and protein intake, the mean bioimpedance spectroscopy-derived total body muscle mass normalized to height squared was significantly increased at 6 months in the fixed-dose group (14.5 ± 3.3 to 15.3 ± 3.0 kg/m², <em>P</em> = .03) compared with the severity-dependent protocol (13.5 ± 2.7 to 13.7 ± 2.9 kg/m², <em>P</em> = .58). In the subgroup analysis, muscle mass improvement was statistically elevated in peritoneal dialysis patients (<em>P</em> = .01) while unaltered among HD patients (<em>P</em> = .88) in the fixed-dose group. Muscle strength, gait speed, and serum insulin-like growth factor-1 level, as the mediators of muscle cell growth, were not different between the two groups at 6 months (<em>P</em> &gt; .05). Neither hypercalcemia nor hyperphosphatemia was found throughout the study.</div></div><div><h3>Conclusion</h3><div>A fixed-dose ergocalciferol supplementation demonstrates similar performance in the correction of low vitamin D status but better muscle mass improvement than a severity-dependent protocol among ESKD patients. Regular dosing intervals of weekly vitamin D supplementation appear to be a promising treatment for sarcopenia among patients undergoing dialysis.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 353-363"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645109","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 Complex Nutrition Needs of Patients With Chronic Kidney Disease and Chronic Liver Disease","authors":"Jeanette Hasse PhD, RD, LD, CNSC, CCTD,&nbsp;Giacomo Garibotto MD,&nbsp;Linda W. Moore PhD, RDN, CCRP","doi":"10.1053/j.jrn.2025.02.006","DOIUrl":"10.1053/j.jrn.2025.02.006","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 245-247"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587840","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":"Association Between Potential Renal Acid Load and 10-Year Mortality in Patients on Hemodialysis","authors":"Mai Tanaka RD ,&nbsp;Michihiro Hosojima MD, PhD ,&nbsp;Hideyuki Kabasawa MD, PhD ,&nbsp;Shin Goto MD, PhD ,&nbsp;Ichiei Narita MD, PhD","doi":"10.1053/j.jrn.2024.11.001","DOIUrl":"10.1053/j.jrn.2024.11.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Higher dietary acid load (DAL) has been linked to elevated incidence and progression of chronic kidney disease. However, the association between DAL and mortality in patients on maintenance hemodialysis (MHD) has not been evaluated.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed baseline laboratory data, self-administered diet history questionnaire results, and 10-year mortality rates in 44 patients (26 men, 67.9 ± 10.4 years) on MHD who participated in a randomized, double-blind, crossover pilot trial of rice endosperm protein supplementation, which was conducted in 2013. DAL was estimated from nutrition intake using potential renal acid load (PRAL), and patients were divided into tertiles using this score.</div></div><div><h3>Results</h3><div>During the 10-year observation period, 19 patients (43%) died. A higher PRAL score was significantly associated with higher all-cause mortality. The multivariable-adjusted hazard ratio for all-cause mortality in the highest tertile of PRAL versus the lowest tertile was 3.88 (95% confidence interval [CI], 1.10-13.61). Multiple logistic regression analysis showed a significant association between higher PRAL and lower intake of green and yellow vegetables (odds ratio, 5.40; 95% CI, 1.37-21.26) and fruits (odds ratio, 4.76; 95% CI, 1.30-16.76).</div></div><div><h3>Conclusions</h3><div>Higher PRAL is positively associated with all-cause mortality, and these associations might be affected by a lower intake of fruits and vegetables in Japanese patients on MHD.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 344-352"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640144","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":"Mediterranean-DASH Diet Intervention for Neurodegenerative Delay Diet and Psychological Problems in Maintenance Hemodialysis Patients by the Structural Equation Modeling Analysis of Malnutrition and Inflammation Markers Approach","authors":"Murat Açik PhD ,&nbsp;Aylin Bayindir Gümüş PhD ,&nbsp;Ayşe Ekici Dietetian ,&nbsp;Feray Çağiran Yilmaz PhD ,&nbsp;Mehmet Küçüksu PhD","doi":"10.1053/j.jrn.2024.09.006","DOIUrl":"10.1053/j.jrn.2024.09.006","url":null,"abstract":"<div><h3>Objective</h3><div>Although it is known that diet quality affects psychological problems in hemodialysis (HD) patients, there is need to explain the role of modifiable risk factors in this relationship. Therefore, the aim of this study was (1) to investigate the relationship between diet quality and modifiable risk factors to depression and anxiety in end-stage renal disease patients receiving maintenance HD; (2) to explore the mediating roles of modifiable factors in the relationship with diet quality to depression and anxiety.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 216 patients with end-stage renal disease receiving maintenance HD treatment. We assessed participants' dietary records for Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND) quality, Global Leadership Initiative on Malnutrition criteria for malnutrition and Hospital Anxiety and Depression Scale for psychological problems. Furthermore, biochemical findings and anthropometric measurements were performed to evaluate nutritional markers, metabolic risk factors and inflammation. We applied hierarchical regression analysis to estimate modifiable risk factors for depression and anxiety and structural-equation-modeling analysis to determine the mediating role of modifiable risk factors between diet quality and psychological problems.</div></div><div><h3>Results</h3><div>Depression symptoms were observed in 59.2% (n = 128) of the participants, whilst the rate was 35.1% (n = 76) for anxiety. Depression and anxiety were found to be negatively correlated with MIND levels after covariate adjusting model, and the rates of explanation were found to be 16.2% and 12.2%, respectively. C-reactive protein (CRP), albumin levels and the presence of malnutrition were shown to be significant predictors of depression (ΔF = 14.761 and ΔR²: 0.071 for covariate-adjusted model). Albumin levels, CRP, HD duration, and malnutrition were found to be independent predictors of anxiety (ΔF = 16.174 and ΔR²: 0.077 for covariate-adjusted model). It was found that CRP and malnutrition partially mediated the association of MIND score with depression, and CRP mediated the association with anxiety.</div></div><div><h3>Conclusion</h3><div>It was concluded that adherence to the MIND diet is associated with a better nutritional profile and reduced inflammation, which in turn may be linked to fewer psychological problems.These further studies are needed to validate and expand upon our findings.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 271-280"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's Reply Commentary: Application of ChatGPT to Support Nutritional Recommendations for Dialysis Patients—A Qualitative and Quantitative Evaluation","authors":"Lin-Chun Wang MS,&nbsp;Hanjie Zhang PhD","doi":"10.1053/j.jrn.2024.11.007","DOIUrl":"10.1053/j.jrn.2024.11.007","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Page 368"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822737","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":"Some Essential Issues Regarding the Nutritional Status of Patients at Peritoneal Dialysis Initiation","authors":"Jsun-Liang Kao MD ,&nbsp;Hsiu-Chin Lu RN ,&nbsp;Show-Ling Yu RN,&nbsp;Rong-Na Jhen MD,&nbsp;Yu-Ming Chang MD,&nbsp;Chih-Chung Shiao MD","doi":"10.1053/j.jrn.2024.12.001","DOIUrl":"10.1053/j.jrn.2024.12.001","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 2","pages":"Pages 364-365"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143829870","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":"Saltiness Perception and Sodium Intake in Patients With Chronic Kidney Disease","authors":"Elisa Russo MD,&nbsp;Giacomo Garibotto MD,&nbsp;Linda W. Moore PhD, RDN","doi":"10.1053/j.jrn.2024.12.005","DOIUrl":"10.1053/j.jrn.2024.12.005","url":null,"abstract":"","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 1","pages":"Pages 1-3"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873392","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":"Tenapanor: A Phosphate Absorption Inhibitor for the Management of Hyperphosphatemia in Patients With Kidney Failure","authors":"Kathleen M. Hill Gallant PhD, RD ,&nbsp;Stuart M. Sprague DO ,&nbsp;David P. Rosenbaum PhD ,&nbsp;David M. Spiegel MD ,&nbsp;Kenji Kozuka MS ,&nbsp;Susan Edelstein PhD ,&nbsp;Glenn M. Chertow MD, MPH","doi":"10.1053/j.jrn.2024.07.003","DOIUrl":"10.1053/j.jrn.2024.07.003","url":null,"abstract":"<div><div>Because of increased risks of cardiovascular disease and death, patients with hyperphosphatemia receiving maintenance dialysis are advised to limit phosphorus consumption and are prescribed phosphate binders in an effort to better control serum phosphate concentrations. Because of large pill size, pill burden, and tolerability issues, phosphate binder adherence is relatively poor. On ingestion, phosphate is absorbed from the intestine via transcellular or paracellular transport. Data show that inhibiting sodium-hydrogen exchanger 3 modulates paracellular phosphate absorption (the predominant pathway in humans). Tenapanor is a first-in-class, minimally absorbed, phosphate absorption inhibitor that selectively inhibits sodium-hydrogen exchanger 3, with a mechanism distinct from, and complementary to, that of phosphate binders. In phase 3 and postregistrational studies, tenapanor conferred statistically significant and clinically meaningful reductions in serum phosphate in patients receiving maintenance dialysis with hyperphosphatemia. Here, we review the available preclinical and clinical data on the effects of tenapanor on controlling intestinal phosphate absorption.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 1","pages":"Pages 25-34"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional and Inflammatory Aspects of Low Parathyroid Hormone in Maintenance Hemodialysis Patients—A Longitudinal Study","authors":"Shani Zilberman-Itskovich MD ,&nbsp;Baker Algamal MD ,&nbsp;Ada Azar BSc ,&nbsp;Shai Efrati MD ,&nbsp;Ilia Beberashvili MD","doi":"10.1053/j.jrn.2024.05.007","DOIUrl":"10.1053/j.jrn.2024.05.007","url":null,"abstract":"<div><h3>Background</h3><div>Low serum parathyroid hormone (PTH) is an accepted marker for adynamic bone disease which is characterized by increased morbidity and mortality in maintenance hemodialysis (MHD) patients. In light of the known cross-sectional associations between PTH and malnutrition-inflammation syndrome, we aimed to examine the longitudinal associations between PTH with changes in nutritional and inflammatory parameters and clinical outcomes in MHD patients with low PTH.</div></div><div><h3>Methods</h3><div>This historical prospective and longitudinal study analyzed a clinical database at a single hemodialysis center, containing the medical records of 459 MHD patients (mean age of 71.4 ± 12.9 years old, 171 women), treated between the years 2007-2020. Bone turnover, nutritional and inflammatory marker levels were recorded at 0, 6, 12, 18, 24, 30, and 36 months followed by a median of 24 additional months of clinical observations. According to previous use of vitamin D analogs and/or calcium-sensing receptor agonists, the study participants were divided into treatment-related and disease-related groups. A linear mixed effects model was adjusted for baseline demographics and clinical parameters.</div></div><div><h3>Results</h3><div>Of 459 MHD patients, 81 (17.6%) had PTH lower than 150pg/mL. Among them, 30 patients had treatment-related and 51 had disease-related low PTH. At baseline, MHD patients with treatment-related low PTH had a higher rate of diabetes compared to the disease-related group. In a linear mixed effects model, increased PTH over time was associated with decreased levels of alkaline phosphatase and C-reactive protein and with increased hemoglobin and albumin, but not the geriatric nutritional risk index at 3-year follow-up. The survival rate did not differ between the groups, with the risk of hospitalizations due to fractures being higher (HR: 4.04 with 95% CI: 1.51-10.8) in the disease-related group. Statistical significance of this association was abolished after adding C-reactive protein or alkaline phosphatase to the multivariate models.</div></div><div><h3>Conclusions</h3><div>Low serum PTH in MHD patients behaves differently depending on its cause, with a higher risk of fractures in the disease-related group. This association is dependent on inflammation. Our results should be verified in larger epidemiological studies.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 1","pages":"Pages 136-145"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288849","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":"Relationship Between High-Density Lipoprotein Cholesterol and Mortality in Elderly Hemodialysis Patients: Data From the Korean Society of Geriatric Nephrology Retrospective Cohort","authors":"Seung Hye Chu MD ,&nbsp;Eun Hee Park MD ,&nbsp;Haekyung Lee MD, PhD ,&nbsp;Yu Ah Hong MD, PhD ,&nbsp;Woo Yeong Park MD, PhD ,&nbsp;Jang-Hee Cho MD, PhD ,&nbsp;In O Sun MD, PhD ,&nbsp;Won Min Hwang MD, PhD ,&nbsp;Soon Hyo Kwon MD, PhD ,&nbsp;Jin Seok Jeon MD, PhD ,&nbsp;Hyunjin Noh MD, PhD ,&nbsp;Kyung Don Yoo MD, PhD ,&nbsp;Hyoungnae Kim MD, PhD","doi":"10.1053/j.jrn.2024.05.003","DOIUrl":"10.1053/j.jrn.2024.05.003","url":null,"abstract":"<div><h3>Objectives</h3><div>The association between high-density lipoprotein (HDL) cholesterol levels and mortality in elderly patients undergoing hemodialysis is not well established. Thus, this study investigated HDL levels and mortality in elderly Korean patients undergoing hemodialysis.</div></div><div><h3>Methods</h3><div>We recruited 1860 incident hemodialysis patients aged greater than 70 years from a retrospective cohort of the Korean Society of Geriatric Nephrology. The primary outcome measure was all-cause mortality.</div></div><div><h3>Results</h3><div>The mean age of the cohort was 77.8 years, and 1049 (56.4%) were men. When we grouped the patients into HDL cholesterol tertiles, the T1 group (HDL level &lt;30 mg/dL in men and &lt;33 mg/dL in women) had a higher proportion of patients with end-stage kidney disease due to diabetic nephropathy. During the median follow-up period of 3.1 years, 1109 (59.7%) deaths occurred. In a multivariable Cox regression model, the T1 group had a significantly higher risk of mortality (hazard ratio [HR], 1.28; 95% confidence interval, 1.10-1.50; <em>P</em> = .002) compared to the T3 group. A nonlinear analysis using a restrictive spline curve showed that low HDL cholesterol levels were associated with increased HR when HDL cholesterol levels were &lt;40 mg/dL; however, there was no association between HDL cholesterol and mortality when HDL cholesterol levels were &gt;40 mg/dL. Triglyceride/HDL ratio was not significantly associated with the risk of mortality (HR per 1 log increase, 1.08; 95% confidence interval, 0.99-1.18; <em>P</em> = .069).</div></div><div><h3>Conclusions</h3><div>Low HDL cholesterol levels are associated with an increased risk of mortality in elderly patients undergoing hemodialysis. However, there was no significant relationship between HDL cholesterol levels and mortality when levels were below 40 mg/dL. Therefore, low HDL cholesterol levels may be a useful risk factor for predicting mortality in elderly patients undergoing hemodialysis.</div></div>","PeriodicalId":50066,"journal":{"name":"Journal of Renal Nutrition","volume":"35 1","pages":"Pages 128-135"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181202","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}