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Chronic kidney disease nutrition

Pablo Antonio Ureña-Torres, Mario Cozzolino, Jordi Bover
Secondary hyperparathyroidism (SHPT) is one of the most frequent and deleterious complication of chronic kidney disease (CKD). SHPT is also one of the principal components of the now called CKD-mineral and bone disorders (MBD) syndrome. It is usually prevented and treated by vitamin D derivatives. However, the rationale for the prescription of vitamin D sterols in those patients is still a matter of hotly debates, mainly because of unsatisfactory results from numerous observational and not well-controlled studies...
March 12, 2018: Néphrologie & Thérapeutique
Eva Nüsken, Jörg Dötsch, Lutz T Weber, Kai-Dietrich Nüsken
Chronic kidney disease affects more than 10% of the population. Programming studies have examined the interrelationship between environmental factors in early life and differences in morbidity and mortality between individuals. A number of important principles has been identified, namely permanent structural modifications of organs and cells, long-lasting adjustments of endocrine regulatory circuits, as well as altered gene transcription. Risk factors include intrauterine deficiencies by disturbed placental function or maternal malnutrition, prematurity, intrauterine and postnatal stress, intrauterine and postnatal overnutrition, as well as dietary dysbalances in postnatal life...
2018: Frontiers in Pediatrics
Chou-Yueh Chang, Horng-Rong Chang, Hsing-Chun Lin, Han-Hsin Chang
Objective Vegetarian diets have been shown to increase the risk of certain nutritional deficiencies, such as iron. As a number of patients with chronic kidney disease (CKD) in Taiwan are lacto-ovo vegetarians, the aim of this study was to investigate the effects of different proportions and sources of protein in lacto-ovo vegetarian and omnivorous diets, as well as the influence of adequate dietary protein intake, on renal function and nutritional status of Taiwanese patients with stage 3 to stage 5 CKD. Methods This is a cross-sectional study...
March 13, 2018: Journal of the American College of Nutrition
Bozidarka L Zaric, Milan Obradovic, Vladan Bajic, Mohamed A Haidara, Milos Jovanovic, Esma R Isenovic
Homocysteine (Hcy) is thiol group containing the amino acid, which naturally occurs in all humans. Hcy is degraded in the body through two metabolic pathways, while a minor part is excreted through kidneys. The chemical reactions that are necessary for degradation of Hcy require the presence of the folic acid, vitamins B6 and B12. Consequently, the level of the total Hcy in the serum is influenced by the presence or absence of these vitamins. An elevated level of the Hcy, hyperhomocysteinemia (HHcy) and homocystinuria are connected with occlusive artery disease, especially in the brain, the heart, and the kidney, in addition to venous thrombosis, chronic renal failure, megaloblastic anemia, osteoporosis, depression, Alzheimer's disease, pregnancy problems, and others...
March 12, 2018: Current Medicinal Chemistry
Ye-Ping Jiang, Ying Shen, Xiao-Rong Liu
OBJECTIVE: To investigate the nutritional status of children on maintenance hemodialysis due to stage 5 chronic kidney disease (CKD) and the clinical significance of nutritional assessment indices. METHODS: A total of 21 children on maintenance hemodialysis due to stage 5 CKD were grouped according to body mass index. The nutritional status was assessed based on anthropometric parameters, biochemical parameters, inflammatory factors, residual renal function, indices of dialysis adequacy, and resting energy expenditure...
March 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Nestoras Nicolas Mathioudakis, Estelle Everett, Shuvodra Routh, Peter J Pronovost, Hsin-Chieh Yeh, Sherita Hill Golden, Suchi Saria
Objective: To develop and validate a multivariable prediction model for insulin-associated hypoglycemia in non-critically ill hospitalized adults. Research design and methods: We collected pharmacologic, demographic, laboratory, and diagnostic data from 128 657 inpatient days in which at least 1 unit of subcutaneous insulin was administered in the absence of intravenous insulin, total parenteral nutrition, or insulin pump use (index days). These data were used to develop multivariable prediction models for biochemical and clinically significant hypoglycemia (blood glucose (BG) of ≤70 mg/dL and <54 mg/dL, respectively) occurring within 24 hours of the index day...
2018: BMJ Open Diabetes Research & Care
Deidra C Crews, Tanushree Banerjee, Donald E Wesson, Hal Morgenstern, Rajiv Saran, Nilka Ríos Burrows, Desmond E Williams, Neil R Powe
BACKGROUND: Dietary acid load (DAL) contributes to the risk of CKD and CKD progression. We sought to determine the relation of DAL to racial/ethnic differences in the risk of end-stage renal disease (ESRD) among persons with CKD. METHODS: Among 1,123 non-Hispanic black (NHB) and non-Hispanic white (NHW) National Health and Nutrition Examination Survey III participants with estimated glomerular filtration rate 15-59 mL/min/1.73 m2, DAL was estimated using the Remer and Manz net acid excretion (NAEes) formula and 24-h dietary recall...
March 9, 2018: American Journal of Nephrology
M Majerczyk, P Kocełak, P Choręza, H Arabzada, A J Owczarek, M Bożentowicz-Wikarek, A Brzozowska, A Szybalska, M Puzianowska-Kuźnicka, T Grodzicki, A Więcek, M Olszanecka-Glinianowicz, J Chudek
PURPOSE: Elevated plasma concentration of retinol binding protein 4 (RBP4) has recently emerged as a potential risk factor as a component of developing metabolic syndrome (MS). Therefore, this study aimed to analyse the relationship between components of MS and concentrations of plasma RBP4 in a population of subjects 65 years and older. METHODS: The study sample consisted of 3038 (1591 male) participants of the PolSenior study, aged 65 years and older. Serum lipid profile, concentrations of RBP4, glucose, insulin, C-reactive protein, IL-6, and activity of aminotransferases were measured...
March 9, 2018: Journal of Endocrinological Investigation
Carmela Cosola, Maria Teresa Rocchetti, Adamasco Cupisti, Loreto Gesualdo
In chronic kidney disease (CKD), cardiovascular (CV) damage is present in parallel which leads to an increased risk of CV disease. Both traditional and non-traditional risk factors contribute to CV damage in CKD. The systemic role of the microbiota as a central player in the pathophysiology of many organs is progressively emerging in the literature: the microbiota is indeed involved in a complex, bi-directional network between many organs, including the kidney and heart connection, although many of these relationships still need to be elucidated through in-depth mechanistic studies...
March 5, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Brendan Bowman, Sijie Zheng, Alex Yang, Brigitte Schiller, José A Morfín, Melvin Seek, Robert S Lockridge
Dialysis care in the United States continues to move toward an emphasis on continuous quality improvement and performance benchmarking. Government- and industry-sponsored programs have evolved to assess and incentivize outcomes for many components of end-stage renal disease care. One aspect that remains largely unaddressed at a systemic level is the high-risk transition period from chronic kidney disease and acute kidney injury to permanent dialysis dependence. Incident dialysis patients experience disproportionately high mortality and hospitalization rates coupled with high costs...
March 3, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Adamasco Cupisti, Csaba P Kovesdy, Claudia D'Alessandro, Kamyar Kalantar-Zadeh
Whereas the adequate intake of potassium is relatively high in healthy adults, i.e., 4.7 g per day, a dietary potassium restriction of usually less than 3 g per day is recommended in the management of patients with reduced kidney function, especially those who tend to develop hyperkalaemia including patients who are treated with angiotensin pathway modulators. Most potassium-rich foods are considered heart-healthy nutrients with high fibre, high anti-oxidant vitamins and high alkali content such as fresh fruits and vegetables; hence, the main challenge of dietary potassium management is to maintain high fibre intake and a low net fixed-acid load, because constipation and metabolic acidosis are per se major risk factors for hyperkalaemia...
February 25, 2018: Nutrients
Lorraine S Evangelista, Won-Kyung Cho, Youngmee Kim
Obesity and chronic kidney disease (CKD) are major global health problems. There are very little data concerning the prevalence and its associated factors of obesity in non-dialyzed patients who have different stages of CKD. Therefore, in this study, we examined the prevalence of obesity and its associated factors according to the stages of CKD. We used nationwide representative data from the Korean National Health and Nutrition Examination Survey, which was conducted over a 7-year period from 2008 to 2014 by the Korea Centers for Disease Control and Prevention...
2018: PloS One
Natalino Salgado-Filho, Joyce Santos Lages, Dyego José Brito, João Victor Salgado, Gyl Eanes Silva, Alcione Miranda Santos, Francisco Chagas Monteiro-Júnior, Elisangela Milhomen Santos, Antônio Augusto Silva, Denizar Vianna Araújo, Ricardo Castro Sesso
BACKGROUND: Chronic kidney disease (CKD) is considered a serious public health problem, both in Brazil and worldwide, with an increasing number of cases observed inrecent years. Especially, CKD has been reported to be highly prevalent in those of African descent. However, Brazil lacks data from early-stage CKD population studies, and the prevalence of CKD is unknown for both the overall and African descent populations. Hence, the present study aimsto estimate the prevalence of early-stage CKD and its associated risk factors in African-Brazilians from isolated African-descent communities...
February 26, 2018: BMC Nephrology
Christian Lerch, Rukshana Shroff, Mandy Wan, Lesley Rees, Helen Aitkenhead, Ipek Kaplan Bulut, Daniela Thurn, Aysun Karabay Bayazit, Anna Niemirska, Nur Canpolat, Ali Duzova, Karolis Azukaitis, Ebru Yilmaz, Fatos Yalcinkaya, Jerome Harambat, Aysel Kiyak, Harika Alpay, Sandra Habbig, Ariane Zaloszyc, Oguz Soylemezoglu, Cengiz Candan, Alejandra Rosales, Anette Melk, Uwe Querfeld, Maren Leifheit-Nestler, Anja Sander, Franz Schaefer, Dieter Haffner
Background: We investigated the effects of nutritional vitamin D supplementation on markers of bone and mineral metabolism, i.e. serum levels of fibroblast growth factor 23 (FGF23), Klotho, bone alkaline phosphatase (BAP) and sclerostin, in two cohorts with chronic kidney disease (CKD). Methods: In all, 80 vitamin D-deficient children were selected: 40 with mild to moderate CKD from the ERGO study, a randomized trial of ergocalciferol supplementation [estimated glomerular filtration rate (eGFR) 55 mL/min/1...
February 21, 2018: Nephrology, Dialysis, Transplantation
Carmine Zoccali, Francesca Mallamaci
Intention-to-treat and per-protocol analyses provide complementary information about the usefulness of therapies. While intention-to-treat analyses of trials that tested low-protein diets remain debated, per-protocol analyses of the same trials show that low protein intake actually reduces the risk of kidney failure. Per-protocol analyses are notoriously open to bias but intention-to-treat analyses are less immaculate than commonly realized because they critically depend on adherence to the treatment being tested and therefore may not be directly relevant for informing clinical decisions when different degrees of adherence to therapy occur...
February 19, 2018: Nephrology, Dialysis, Transplantation
Ji Hee Yu, Kyungdo Han, Nam Hoon Kim, Hye Jin Yoo, Ji A Seo, Sin Gon Kim, Kyung Mook Choi, Sei Hyun Baik, Nan Hee Kim
Although sleep duration has been extensively studied in metabolic diseases, few studies have investigated the impact of sleep duration on chronic kidney disease. The aim of this study was to examine the relationship between sleep duration and albuminuria in the general population. Among 24,948 adults who participated in the 2011-2014 KNHANES, a total of 19,994 subjects were included in this analysis. Subjects were categorized into the following five groups according to self-reported sleep duration: less than 5 h, 6 h, 7 h, 8 h, and more than 9 h...
2018: PloS One
Khai Gene Leong, Jia Lian Chee, Amalia Karahalios, Annabelle Skelley, Kim Wong
Malnutrition is common in patients on hemodialysis (prevalence of 30% to 50%) and is associated with higher mortality. Lean body mass (LBM) assessment is an accurate way of assessing nutritional status. The dual-energy X-ray absorptiometry (DEXA) scan is a reliable method in assessing body compositions and LBM; however, it is expensive and largely inaccessible. Anthropometric skinfold thickness measurement (ASFM) is useful in assessing LBM. It is cheaper and accessible, but underutilized clinically. The subjective global score (SGA) is a well-established method of assessing nutritional status...
January 2018: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
D Fouque
The nutrition care of patients with chronic kidney disease (CKD) remains a central question which is permanently studied. The benefits of a dietary protein restriction are once again enlightened, either by reducing the urea found to be hyperglycemic, thus improving the peripheric insulin sensitivity, or by decreasing phosphorus and FGF23 hormone, whose reductions are respectively associated with nephroprotection and diminution of cardiovascular events. The numerous researches conducted on the gut microbiota also open promising avenues to better understand the role of this ecosystem in CKD...
June 2017: Néphrologie & Thérapeutique
Avinaash Subramaniam, Michelle Landstrom, Alice Luu, K C Hayes
Type II diabetes mellitus (T2DM) is a multifactorial disease involving complex genetic and environmental interactions. No single animal model has so far mirrored all the characteristics or complications of diabetes in humans. Since this disease represents a chronic nutritional insult based on a diet bearing a high glycemic load, the ideal model should recapitulate the underlying dietary issues. Most rodent models have three shortcomings: (1) they are genetically or chemically modified to produce diabetes; (2) unlike humans, most require high-fat feeding; (3) and they take too long to develop diabetes...
February 18, 2018: Nutrients
Robert S Venick
PURPOSE OF REVIEW: The review aims to describe in detail contemporary medical, nutritional, and psychosocial results in pediatric intestinal transplant (ITx) recipients greater than 10 years removed from their transplant, and to highlight significant long-term post-ITx challenges and complications. The review will draw from recent publications in the field, the ITx registry as well as detailed unpublished data from a large, well established single center. RECENT FINDINGS: The majority of long-term ITx survivors are off parenteral nutrition altogether, but a significant number require supplemental tube feeds to gain weight and grow properly...
February 15, 2018: Current Opinion in Organ Transplantation
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