1
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Aycart DF, Sims CA, Laborde JEA, Andrade JM. Quality characteristics and sensory evaluation of protein-rich baked snacks for adults with chronic kidney disease: a proof of concept study. J Nephrol 2024; 37:159-169. [PMID: 37796432 DOI: 10.1007/s40620-023-01772-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/18/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Adults with chronic kidney disease (CKD) have different protein requirements than the general population. Limited protein-rich baked snack options are available for CKD adults. The purpose of this proof of concept study was to develop two protein-rich baked snacks made with whey protein isolate and soy protein isolate and to evaluate their quality characteristics and sensory perceptions for adults with CKD. METHODS A control formulation was obtained from the American Association of Cereal Chemists to develop three formulations-dried milk (control), whey protein isolate and soy protein isolate at an unbaked weight of 30 g. Product quality characteristics included moisture content, water activity, shape and size, and texture profile. For the sensory perception, healthy adults (n = 101) and adults with CKD (n = 57) completed a 9-point hedonic scale for appearance, flavor, texture, and overall acceptability. RESULTS Protein content for the whey protein isolate and soy protein isolate reached 20% total weight. Despite containing similar moisture, both formulations were harder than the control (p < 0.001). Healthy participants preferred the whey protein isolate-based snack over the soy protein isolate-based snack for all attributes (p < 0.05). Differences in the same attributes were not perceived among CKD participants (p > 0.05). Open-ended responses from both healthy and CKD participants indicated that the soy protein isolate formulation was softer and sweeter compared to the whey protein isolate formulation. CONCLUSION Overall, adults with CKD preferred both the whey protein isolate-and soy protein isolate-formulated snacks. These protein-rich baked snacks can be further modified to serve as an alternative snack choice for adults with CKD and used in future clinical trials.
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Affiliation(s)
- Danielle F Aycart
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL, 32606, USA
| | - Charles A Sims
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL, 32606, USA
| | - Juan E Andrade Laborde
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL, 32606, USA
| | - Jeanette M Andrade
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL, 32606, USA.
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2
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Gai W, Lin L, Wang Y, Bian J, Tao Y. Relationship between dietary fiber and all-cause mortality, cardiovascular mortality, and cardiovascular disease in patients with chronic kidney disease: a systematic review and meta-analysis. J Nephrol 2024; 37:77-93. [PMID: 38165561 PMCID: PMC10920433 DOI: 10.1007/s40620-023-01808-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/14/2023] [Indexed: 01/04/2024]
Abstract
BACKGROUND The potential protective effects of dietary fiber against all-cause mortality, cardiovascular mortality, and cardiovascular disease in patients with chronic kidney disease have not been definitively established. To verify this relationship, a systematic review and a meta-analysis were undertaken. METHODS PubMed, The Cochrane Library, Web of Science, Embase, ProQuest, and CINAHL were used to systematically search for prospective cohort studies that investigate the association between dietary fiber and all-cause mortality, cardiovascular mortality, and cardiovascular disease in individuals with chronic kidney disease (CKD). This search was conducted up to and including March 2023. RESULTS The analysis included 10 cohort studies, with a total of 19,843 patients who were followed up for 1.5-10.1 y. The results indicated a significant negative correlation between dietary fiber and all-cause mortality among patients with CKD (HR 0.80, 95% CI 0.58-0.97, P < 0.001). Subgroup analysis further revealed that the study population and exposure factors were significantly associated with all-cause mortality (P < 0.001). Increased dietary fiber intake was associated with a reduced risk of cardiovascular mortality (HR 0.78; 95% CI 0.67-0.90) and a reduced incidence of cardiovascular disease (HR 0.87; 95% CI 0.80-0.95) among patients with CKD. CONCLUSIONS The pooled results of our meta-analysis indicated an inverse association between dietary fiber intake and all-cause mortality, cardiovascular mortality, and cardiovascular disease.
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Affiliation(s)
- Wei Gai
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, 510006, Guangdong Province, China
| | - Lihua Lin
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, 510006, Guangdong Province, China
| | - Yuxuan Wang
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, 510006, Guangdong Province, China
| | - Jia Bian
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, 510006, Guangdong Province, China
| | - Yanling Tao
- Department of Nursing, Longgang Central Hospital of Shenzhen, Shenzhen, 518116, Guangdong Province, China.
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3
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Kelly JT, Gonzalez-Ortiz A, St-Jules DE, Carrero JJ. Animal Protein Intake and Possible Cardiovascular Risk in People With Chronic Kidney Disease: Mechanisms and Evidence. ADVANCES IN KIDNEY DISEASE AND HEALTH 2023; 30:480-486. [PMID: 38453263 DOI: 10.1053/j.akdh.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Individuals with chronic kidney disease (CKD) have an increased risk of cardiovascular disease (CVD), and the kidney function is a critical determinant of this risk. CKD is also a major cause of complications and disease progression in patients with CVD. Practice guidelines suggest that CVD risk in CKD patients can be managed through healthy lifestyle and dietary behaviors. Assessing the impact of diet on heart and kidney health is complex because numerous bioactive compounds from diet may contribute to or prevent CVD or CKD via a myriad of pathways and mechanisms. The objective of this review was to provide a discussion of the mechanisms and evidence linking protein-rich foods and CVD risk in people with CKD. This review highlights the current evidence-based strategies for primary CKD prevention that incorporate a healthy dietary pattern, while tertiary prevention strategies focus on avoiding excess protein and reducing dietary acid load. The effect of protein restriction for improving CVD and CKD outcomes is conflicting; however, these approaches show no negative effects on kidney health. Low-protein and very low-protein diets are promising interventions for reducing the progression of CKD and CVD. Animal-sourced protein may be more detrimental to kidney health than plant-sourced protein due to specific acid load, amino acid composition, generation of uremic toxins, accompanying saturated fat content, low fiber composition, and higher generation of advanced glycation end-products. There are no one-size fits all nutrition prescriptions. Personalized nutrition interventions that target the unique risk factors for CVD associated with reduced kidney function are required to improve the health of people living with CKD.
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Affiliation(s)
- Jaimon T Kelly
- Centre for Online Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia; Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
| | - Ailema Gonzalez-Ortiz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Translational Research Center, Instituto Nacional de Pediatría, Mexico
| | | | - Juan Jesus Carrero
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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4
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Jayaraman P, Crouse A, Nadkarni G, Might M. A Primer in Precision Nephrology: Optimizing Outcomes in Kidney Health and Disease through Data-Driven Medicine. KIDNEY360 2023; 4:e544-e554. [PMID: 36951457 PMCID: PMC10278804 DOI: 10.34067/kid.0000000000000089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/04/2023] [Indexed: 03/24/2023]
Abstract
This year marks the 63rd anniversary of the International Society of Nephrology, which signaled nephrology's emergence as a modern medical discipline. In this article, we briefly trace the course of nephrology's history to show a clear arc in its evolution-of increasing resolution in nephrological data-an arc that is converging with computational capabilities to enable precision nephrology. In general, precision medicine refers to tailoring treatment to the individual characteristics of patients. For an operational definition, this tailoring takes the form of an optimization, in which treatments are selected to maximize a patient's expected health with respect to all available data. Because modern health data are large and high resolution, this optimization process requires computational intervention, and it must be tuned to the contours of specific medical disciplines. An advantage of this operational definition for precision medicine is that it allows us to better understand what precision medicine means in the context of a specific medical discipline. The goal of this article was to demonstrate how to instantiate this definition of precision medicine for the field of nephrology. Correspondingly, the goal of precision nephrology was to answer two related questions: ( 1 ) How do we optimize kidney health with respect to all available data? and ( 2 ) How do we optimize general health with respect to kidney data?
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Affiliation(s)
- Pushkala Jayaraman
- The Charles Bronfman Institute for Personalized Medicine Icahn School of Medicine at Mount Sinai, New York, New York
| | - Andrew Crouse
- Hugh Kaul Precision Medicine Institute, University of Alabama at Birmingham, Birmingham, Alabama
| | - Girish Nadkarni
- The Charles Bronfman Institute for Personalized Medicine Icahn School of Medicine at Mount Sinai, New York, New York
- The Mount Sinai Clinical Intelligence Center (MSCIC), Icahn School of Medicine at Mount Sinai, New York, New York
- Division of Data Driven and Digital Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
- Barbara T Murphy Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Matthew Might
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Computer Science, University of Alabama at Birmingham, Birmingham, Alabama
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5
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Raikou VD. Protein intake, chronic renal disease progression and cardiovascular morbidity. Nutr Health 2023; 29:21-23. [PMID: 35946110 DOI: 10.1177/02601060221118897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
It has been suggested that the lowering of dietary protein reduces the progression of CKD, despite it has been also reported that higher intake of total protein was associated with a lower risk of cardiovascular morbidity.The role of protein intake is equivocal in clinical outcomes including the renal and cardiovascular disease worsening, metabolic acidosis and bone abnormalities.The modification of both amount and sources of protein intake could influence the renal and cardiovascular deterioration.
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Affiliation(s)
- Vaia D Raikou
- Dpt of Nephrology, DOCTORS' Hospital, Athens, GREECE
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6
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Meremo A, Paget G, Duarte R, Bintabara D, Naicker S. Progression of chronic kidney disease among black patients attending a tertiary hospital in Johannesburg, South Africa. PLoS One 2023; 18:e0276356. [PMID: 36780543 PMCID: PMC9925074 DOI: 10.1371/journal.pone.0276356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/30/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a major public health issue worldwide and is an important contributor to the overall non-communicable disease burden. Chronic kidney disease is usually asymptomatic, and insidiously and silently progresses to advanced stages in resource limited settings. METHODOLOGY A prospective longitudinal study was carried out on black patients with CKD attending the kidney outpatient clinic at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in South Africa, between September 2019 to March 2022. Demographic and clinical data were extracted from the ongoing continuous clinic records, as well as measurements of vital signs and interviews at baseline and at follow up. Patients provided urine and blood samples for laboratory investigations as standard of care at study entry (0) and at 24 months, and were followed up prospectively for two (2) years. Data were descriptively and inferentially entered into REDcap and analysed using STATA version 17, and multivariable logistic regression analysis was used to identify predictors of CKD progression. RESULTS A total of 312 patients were enrolled into the study, 297 (95.2%) patients completed the study, 10 (3.2%) patients were lost to follow and 5 (1.6%) patients died during the study period. The prevalence of CKD progression was 49.5%, while that of CKD remission was 33% and CKD regression was 17.5%. For patients with CKD progression the median age at baseline was 58 (46-67) years, the median eGFR was 37 (32-51) mL/min/1.73 m2, median urine protein creatinine ratio (uPCR) was 0.038 (0.016-0.82) g/mmol and the median haemoglobin (Hb) was 13.1 (11.7-14.4) g/dl; 95.2% had hypertension, 40.1% patients had diabetes mellitus and 39.5% had both hypertension and diabetes mellitus. Almost half (48.3%) of patients with CKD progression had severely increased proteinuria and 45.6% had anaemia. Variables associated with higher odds for CKD progression after multivariable logistic regression analysis were severely increased proteinuria (OR 32.3, 95% CI 2.8-368.6, P = 0.005), moderately increased proteinuria (OR 23.3, 95% CI 2.6-230.1, P = 0.007), hypocalcaemia (OR 3.8, 95% CI 1.0-14.8, P = 0.047), hyponatraemia (OR 4.5, 95% CI 0.8-23.6, P = 0.042), anaemia (OR 2.1, 95% CI 1.0-4.3, P = 0.048), diabetes mellitus (OR 1.8, 95% CI 0.9-3.6, P = 0.047), elevated HbA1c (OR 1.8, 95% CI 1.2-2.8, P = 0.007) and current smoking (OR 2.8, 95% CI 0.9-8.6, P = 0.049). CONCLUSION Our study identified a higher prevalence of CKD progression in a prospective longitudinal study of black patients with CKD compared with literature reports. CKD Progression was associated with proteinuria, diabetes mellitus, elevated HbA1c, anaemia, hypocalcaemia, hyponatraemia and current smoking in a cohort of black patients with CKD who had controlled hypertension and diabetes mellitus at baseline.
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Affiliation(s)
- Alfred Meremo
- Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
- Department of Internal Medicine, School of Medicine & Dentistry, The University Dodoma, Dodoma, Tanzania
- * E-mail: ,
| | - Graham Paget
- Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Raquel Duarte
- Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Deogratius Bintabara
- Department of Community Medicine, School of Medicine & Dentistry, The University Dodoma, Dodoma, Tanzania
| | - Saraladevi Naicker
- Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
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7
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Alkhatib L, Velez Diaz LA, Varma S, Chowdhary A, Bapat P, Pan H, Kukreja G, Palabindela P, Selvam SA, Kalra K. Lifestyle Modifications and Nutritional and Therapeutic Interventions in Delaying the Progression of Chronic Kidney Disease: A Review. Cureus 2023; 15:e34572. [PMID: 36874334 PMCID: PMC9981552 DOI: 10.7759/cureus.34572] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
Chronic kidney disease (CKD) is a debilitating progressive illness that affects more than 10% of the world's population. In this literature review, we discussed the roles of nutritional interventions, lifestyle modifications, hypertension (HTN) and diabetes mellitus (DM) control, and medications in delaying the progression of CKD. Walking, weight loss, low-protein diet (LPD), adherence to the alternate Mediterranean (aMed) diet, and Alternative Healthy Eating Index (AHEI)-2010 slow the progression of CKD. However, smoking and binge alcohol drinking increase the risk of CKD progression. In addition, hyperglycemia, altered lipid metabolism, low-grade inflammation, over-activation of the renin-angiotensin-aldosterone system (RAAS), and overhydration (OH) increase diabetic CKD progression. The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend blood pressure (BP) control of <140/90 mmHg in patients without albuminuria and <130/80 mmHg in patients with albuminuria to prevent CKD progression. Medical therapies aim to target epigenetic alterations, fibrosis, and inflammation. Currently, RAAS blockade, sodium-glucose cotransporter-2 (SGLT2) inhibitors, pentoxifylline, and finerenone are approved for managing CKD. In addition, according to the completed Study of Diabetic Nephropathy with Atrasentan (SONAR), atrasentan, an endothelin receptor antagonist (ERA), decreased the risk of renal events in diabetic CKD patients. However, ongoing trials are studying the role of other agents in slowing the progression of CKD.
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Affiliation(s)
- Lean Alkhatib
- Internal Medicine, Royal Medical Services, Amman, JOR
| | | | - Samyukta Varma
- Internal Medicine, Madurai Medical College, Madurai, IND
| | - Arsh Chowdhary
- Nephrology, Smt. Kashibai Navale Medical College and General Hospital, Pune, IND
| | - Prachi Bapat
- General Medicine, Smt. Kashibai Navale Medical College and General Hospital, Pune, IND
| | - Hai Pan
- Pathology, Tianjin University of Chinese Medicine, Tianjin, CHN
| | - Geetika Kukreja
- Internal Medicine and Hematology/Oncology, Henry Ford Health System, Clinton Township, USA
| | | | | | - Kartik Kalra
- Nephrology, Geisinger Medical Center, Danville, USA
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8
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Gungor O, Kara AV, Hasbal NB, Zadeh KK. Dietary protein and muscle wasting in chronic kidney disease: new insights. Curr Opin Clin Nutr Metab Care 2023; 26:226-234. [PMID: 36942878 DOI: 10.1097/mco.0000000000000903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
PURPOSE OF REVIEW Muscle wasting is an important health problem in chronic kidney disease (CKD) patients. Protein restriction in the diet can be one of the main causes of muscle wasting in this population. In this review, we aimed to investigate the relationship between dietary protein intake and muscle wasting in CKD patients according to recent literature. RECENT FINDINGS The one of the main mechanisms responsible for the muscle wasting is the disturbances in skeletal muscle protein turnover. Muscle wasting primarily occurs when the rates of muscle protein breakdown exceed the muscle protein synthesis. Dietary protein intake represents an important role by causing a potent anabolic stimulus resulting a positive muscle protein balance. Compared to studies made in healthy populations, there are very limited studies in the literature about the relationship between dietary protein intake and muscle wasting in the CKD population. Majority of the studies showed that a more liberal protein intake is beneficial for muscle wasting in especially advanced CKD and hemodialysis population. SUMMARY Although evaluating muscle wasting in CKD patients, the amount of protein in the diet of patients should also be reviewed. Although excessive protein intake has some negative consequences on this patient group, a more liberated dietary protein intake should be taken into account in this patient group with muscle wasting and especially in dialysis patients.
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Affiliation(s)
- Ozkan Gungor
- Department of Nephrology, Medical Faculty, Kahramanmaras Sutcu Imam University, Kahramanmaras
| | - Ali Veysel Kara
- Department of Nephrology, Binali Yildirim University Mengücek Gazi Training and Research Hospital, Erzincan
| | | | - Kamyar Kalantar Zadeh
- Division of Nephrology, Hypertension and Kidney Transplantation, University of California Irvine School of Medicine, Orange, California, USA
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9
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Al-Ghamdi S, Abu-Alfa A, Alotaibi T, AlSaaidi A, AlSuwaida A, Arici M, Ecder T, El Koraie AF, Ghnaimat M, Hafez MH, Hassan M, Sqalli T. Chronic Kidney Disease Management in the Middle East and Africa: Concerns, Challenges, and Novel Approaches. Int J Nephrol Renovasc Dis 2023; 16:103-112. [PMID: 37051319 PMCID: PMC10084934 DOI: 10.2147/ijnrd.s363133] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/22/2022] [Indexed: 04/14/2023] Open
Abstract
The burden of chronic kidney disease (CKD) and other comorbidities, such as hypertension and diabetes, which increase the risk of developing CKD, is on the rise in the Middle East and Africa. The Middle East and Africa CKD (MEA-CKD) steering committee, comprising eminent healthcare specialists from the Middle East and Africa, was formed to identify and propose steps to address the gaps in the management of CKD in these regions. The current article lists the MEA-CKD steering committee meeting outcomes and evaluates the available evidence supporting the role of novel therapeutic options for patients with CKD. The need of the hour is to address the gaps in awareness and screening, early diagnosis, along with referral and management of patients at risk. Measures to bring about appropriate changes in healthcare policies to ensure access to all benefit-proven protective therapies, including novel ones, at community levels are also vital for reducing the overall burden of CKD on the healthcare system as well as governing bodies, especially in developing countries of the Middle East and Africa.
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Affiliation(s)
- Saeed Al-Ghamdi
- Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom Saudi of Arabia
| | - Ali Abu-Alfa
- Department of Nephrology and Hypertension, American University of Beirut, Beirut, Lebanon
| | - Turki Alotaibi
- Department of Transplant Nephrology, Hamed Al-Essa Organ Transplant Center, Kuwait City, Kuwait
| | - Ali AlSaaidi
- Department of Nephrology, College of Medicine, University of Baghdad, Nephrology and Transplantation Center, Medical City Complex, Baghdad, Iraq
| | | | - Mustafa Arici
- Department of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tevfik Ecder
- Department of Nephrology, Demiroglu Bilim University Faculty of Medicine, Istanbul, Turkey
| | - Ahmed F El Koraie
- Department of Internal Medicine and Nephrology, Alexandria Faculty of Medicine, Alexandria, Egypt
| | | | - Mohamed H Hafez
- Department of Nephrology and Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Hassan
- Department of Medical Affairs, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
- Correspondence: Mohamed Hassan, Department of Medical Affairs, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates, Tel +971 508187944, Email
| | - Tarik Sqalli
- Department of Nephrology, Moroccan Society of Nephrology, Casablanca, Morocco
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10
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TAO L, HE M, LU Y, ZHENG J, YE Y. Expression of sclerostin and bone morphogenetic protein-7 (BMP-7) in serum of patients with chronic kidney disease-mineral and bone disorder (CKD-MBD) and their correlation with calcium and phosphorus metabolism. FOOD SCIENCE AND TECHNOLOGY 2023. [DOI: 10.1590/fst.48822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Lijiang TAO
- Department of the Chinese People's Liberation Army, China
| | - Minjuan HE
- Department of the Chinese People's Liberation Army, China
| | - Yisheng LU
- Department of the Chinese People's Liberation Army, China
| | - Jie ZHENG
- Department of the Chinese People's Liberation Army, China
| | - Yili YE
- Taizhou Hospital of Traditional Chinese Medicine, China
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11
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Amin R, Thalluri C, Docea AO, Sharifi‐Rad J, Calina D. Therapeutic potential of cranberry for kidney health and diseases. EFOOD 2022. [DOI: 10.1002/efd2.33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Ruhul Amin
- Faculty of Pharmaceutical Science Assam Down Town University Guwahati Assam India
| | | | - Anca Oana Docea
- Department of Toxicology University of Medicine and Pharmacy of Craiova Craiova Romania
| | | | - Daniela Calina
- Department of Clinical Pharmacy University of Medicine and Pharmacy of Craiova Craiova Romania
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12
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Yamashita T, Sato T, Yamamoto K, Abiko A, Nishizawa K, Matsuda M, Ebihara Y, Maehana T, Tanaka T, Yano T, Kobayashi H. Successful therapeutic strategy for a patient with obese end-stage kidney disease by simultaneous laparoscopic sleeve gastrectomy and implantation of a buried peritoneal dialysis catheter: A case report. Front Med (Lausanne) 2022; 9:926652. [PMID: 36213646 PMCID: PMC9537543 DOI: 10.3389/fmed.2022.926652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
For morbidly obese patients with end-stage kidney disease (ESKD), there are often difficulties in accessing, implementing, and maintaining kidney replacement therapy (KRT). Although recent weight-loss surgery has the potential to solve these problems, its therapeutic strategy and appropriate perioperative management for morbidly obese patients with ESKD have not been established. Here, we describe the case history of a 47-year-old man diagnosed with ESKD due to obesity-related glomerulopathy with an uncorrected estimated glomerular filtration rate (eGFR) of 16.1 ml/min. He hoped for kidney transplantation but was not eligible due to his high body mass index (BMI) (36.9 kg/m2). Therefore, a combination strategy for both attaining weight loss and preparing for KRT was needed. We performed modified laparoscopic sleeve gastrectomy (LSG) combined with a buried catheter for peritoneal dialysis (PD), which resulted in reduction of multiple surgical invasions while simultaneously preparing for PD. After these operations, his body mass dropped to below 30.0 kg/m2, making him a candidate for kidney transplantation, while maintaining PD. Finally, he was able to have kidney transplantation with success. Collectively, in this case, our novel therapeutic approach was able to avoid multiple surgeries, to assist catheter insertion by laparoscopy, and to provide optimal KRT for an obese patient with ESKD. Simultaneous LSG and implantation of a buried PD catheter may be a promising strategy for morbidly obese patients with ESKD.
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Affiliation(s)
- Tomohisa Yamashita
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Nephrology, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
- *Correspondence: Tomohisa Yamashita,
| | - Tatsuya Sato
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kazuyuki Yamamoto
- Department of Surgery, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
| | - Atsuko Abiko
- Department of Diabetic and Endocrinologic Medicine, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
| | - Keitaro Nishizawa
- Department of Nephrology, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
| | - Masahiro Matsuda
- Department of Nephrology, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
| | - Yuma Ebihara
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Takeshi Maehana
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshiaki Tanaka
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hironori Kobayashi
- Department of Nephrology, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
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13
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Mishra M, Nichols L, Dave AA, Pittman EH, Cheek JP, Caroland AJV, Lotwala P, Drummond J, Bridges CC. Molecular Mechanisms of Cellular Injury and Role of Toxic Heavy Metals in Chronic Kidney Disease. Int J Mol Sci 2022; 23:ijms231911105. [PMID: 36232403 PMCID: PMC9569673 DOI: 10.3390/ijms231911105] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 01/10/2023] Open
Abstract
Chronic kidney disease (CKD) is a progressive disease that affects millions of adults every year. Major risk factors include diabetes, hypertension, and obesity, which affect millions of adults worldwide. CKD is characterized by cellular injury followed by permanent loss of functional nephrons. As injured cells die and nephrons become sclerotic, remaining healthy nephrons attempt to compensate by undergoing various structural, molecular, and functional changes. While these changes are designed to maintain appropriate renal function, they may lead to additional cellular injury and progression of disease. As CKD progresses and filtration decreases, the ability to eliminate metabolic wastes and environmental toxicants declines. The inability to eliminate environmental toxicants such as arsenic, cadmium, and mercury may contribute to cellular injury and enhance the progression of CKD. The present review describes major molecular alterations that contribute to the pathogenesis of CKD and the effects of arsenic, cadmium, and mercury on the progression of CKD.
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Affiliation(s)
- Manish Mishra
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA 31207, USA
| | - Larry Nichols
- Department of Pathology and Clinical Sciences Education, Mercer University School of Medicine, Macon, GA 31207, USA
| | - Aditi A. Dave
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA 31207, USA
| | - Elizabeth H Pittman
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA 31207, USA
| | - John P. Cheek
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA 31207, USA
| | - Anasalea J. V. Caroland
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA 31207, USA
| | - Purva Lotwala
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA 31207, USA
| | - James Drummond
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA 31207, USA
| | - Christy C. Bridges
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA 31207, USA
- Correspondence: ; Tel.: +1-(478)-301-2086
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de Morais TLSA, de Souza KSC, de Lima MAF, Pereira MG, de Almeida JB, de Oliveira AMG, Sena-Evangelista KCM, de Rezende AA. Effects of an individualized nutritional intervention on kidney function, body composition, and quality of life in kidney transplant recipients: Study protocol for a randomized clinical trial. PLoS One 2022; 17:e0272484. [PMID: 35925872 PMCID: PMC9352089 DOI: 10.1371/journal.pone.0272484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 07/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Proteinuria after kidney transplantation (KTx) has been a frequent problem due to several factors, high protein intake being one of them. Individualized nutritional intervention in the late post-KTx period can promote the improvement or the reduction of risks associated with the parameters of evaluation of kidney function, body composition, and quality of life in individuals submitted to KTx.
Methods
This is a single-center, randomized and stratified clinical trial. The study will be conducted in a university hospital in northeastern Brazil with 174 individuals aged ≥19 years submitted to KTx and followed up for 12 months. Assessments will take place at 3-month intervals (T0, T3, T6, T9, and T12). The patients will be allocated to intervention and control groups by random allocation. The intervention group will receive individualized nutritional interventions with normoproteic diets (1.0 g/kg) after 60 days of KTx whereas the controls will receive the standard nutritional guidance for the post-KTx period. The primary efficacy variable is the change from baseline in log proteinuria assessed with the urinary albumin/creatinine ratio. Secondary efficacy variables include body composition, anthropometry, quality of life assessment and physical activity, lipid profile and glycemic control. Ninety-two subjects per group will afford 70% power to detect a difference of 25% between groups in log proteinuria. Primary efficacy analysis will be on the modified intention-to-treat population with between-groups comparison of the change from baseline in log proteinuria by analysis of covariance.
Discussion
The study will assess the effects of an individualized nutritional intervention on proteinuria 12 months after KTx.
Trial registration
REBEC (RBR-8XBQK5).
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Affiliation(s)
| | - Karla Simone Costa de Souza
- Department of Clinical and Toxicological Analysis, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Mabelle Alves Ferreira de Lima
- Postgraduate Program in Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Maurício Galvão Pereira
- Division of Nephrology, Department of Integrated Medicine, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - José Bruno de Almeida
- Division of Nephrology, Department of Integrated Medicine, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Antônio Manuel Gouveia de Oliveira
- Postgraduate Program in Health Sciences, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Karine Cavalcanti Mauricio Sena-Evangelista
- Postgraduate Program in Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Adriana Augusto de Rezende
- Postgraduate Program in Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Department of Clinical and Toxicological Analysis, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- * E-mail:
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15
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Kwon YJ, Lee HS, Park GE, Kim HM, Lee JJ, Kim WJ, Lee JW. The Association Between Total Protein Intake and All-Cause Mortality in Middle Aged and Older Korean Adults With Chronic Kidney Disease. Front Nutr 2022; 9:850109. [PMID: 35445069 PMCID: PMC9014017 DOI: 10.3389/fnut.2022.850109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/25/2022] [Indexed: 11/15/2022] Open
Abstract
Background and Aims Over the past decades, the optimum protein intake for patients with chronic kidney disease (CKD) has been an important, controversial issue. Dietary protein restriction has been commonly recommended for patients with CKD for preserving kidney function. However, evidence of the associations between long-term protein intake and mortality is not consistent in patients with CKD. Therefore, we aimed to examine the associations between total protein intake and all-cause mortality in Korean adults with CKD. Methods From three sub-cohorts of the Korean Genome and Epidemiology Study (KoGES) starting from 2001, total 3,892 participants with eGFR < 60 mL/min/1.73 m2 (CKD stage 3–5) were included in this study. Dietary data were collected using food-frequency questionnaires at baseline. Deaths were followed from 2001 to 2019. Cox proportional hazards regression model was used to evaluate the association between protein intake and all-cause mortality. Results During a median follow-up (min-max) of 11.1 years (0.3–15.1), 602 deaths due to all causes of mortality were documented. After adjustment for covariates, higher total protein intake was not associated with all-cause mortality [highest vs. lowest quintile of total protein intake (g/kg/day) and proportion (%) (Q5 vs. Q1), HR = 1.14 (0.75–1.72), and HR = 0.87 (0.67–1.13)] in CKD stage 3–5 patients. Conclusion Dietary protein intake was not associated with mortality from all causes in patients with CKD. Further research is needed to establish optimal protein intake levels and examine the impact of the dietary source of protein on various health outcomes and mortality in CKD.
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Affiliation(s)
- Yu-Jin Kwon
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, South Korea
| | - Go Eun Park
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyung-Mi Kim
- Department of Food and Nutrition, Dongduck Women's University, Seoul, South Korea
| | - Jung Joo Lee
- Nutrition Team, Yongin Severance Hospital, Yongin, South Korea
| | - Woo Jeong Kim
- Department of Nutrition Service, Gangnam Severance Hospital, Seoul, South Korea
| | - Ji-Won Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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16
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Notaras S, Lambert K, Perz J, Makris A. Diet in the management of non-dialysis dependent chronic kidney disease: perceptions and practices of health professionals. BMC Nephrol 2022; 23:158. [PMID: 35459131 PMCID: PMC9034530 DOI: 10.1186/s12882-022-02790-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background Therapeutic strategies, including dietary intervention, to target non-dialysis dependent Chronic Kidney Disease (CKD) progression have been at the forefront of recent renal research. Nephrologists and other renal health professionals are key stakeholders in the dietary management of patients with non-dialysis dependent CKD and referrals to dietetic services. The aims of this study were to explore (i) health professional perceptions regarding the role of diet in managing non-dialysis dependent CKD, and (ii) health professional practices regarding the provision of dietary advice and referrals to dietetic services. Methods A 31-item online survey was emailed to members of professional renal networks and associations in Australia and New Zealand. Data was analysed descriptively. Categorical variables were assessed to determine associations between referral frequency, demographic variables, health professional role (non-dietetic versus dietetic) and perceptions of the role of diet. Results Overall, 189 health professionals completed the survey. Nephrologists (42%), renal nurses (29%) and renal dietitians (24%) were the most common respondents. Non-dietetic health professionals rated the importance of diet in the management of non-dialysis dependent CKD significantly lower than renal dietitians (73% versus 98% ranked as very-extremely important, p = 0.002). Fifty percent of non-dietetic health professionals referred patients to renal dietetic services never or 0–25% of the time. Reasons for not referring included perceptions there is a lack of evidence that diet reduces CKD progression, perceptions that patients will not adhere to dietary recommendations, and a desire to reduce visit burden for patients. Barriers to accessing dietetic services were perceived to be significant and include lengthy wait times and inadequate dietetic staffing. Conclusion Inconsistencies exist between non-dietetic health professionals and dietitians regarding the importance of diet in non-dialysis dependent CKD. Referral practices appear to be influenced by beliefs about the evidence base and perceptions regarding the ability of dietitians to meet referral demand. Raising awareness for non-dietetic health professionals working in nephrology regarding the evidence on diet and CKD progression is needed. An improved understanding of this evidence base may improve knowledge and referral patterns. Further, an increase in renal dietetic staffing is recommended to enhance patient access to services. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-022-02790-y.
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Affiliation(s)
- Stephanie Notaras
- School of Medicine, Western Sydney University, Building 30, Campbelltown NSW, Campbelltown, 2560, Australia.
| | - Kelly Lambert
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Building 41, Wollongong, NSW, 2522, Australia
| | - Janette Perz
- Translational Health Research Institute, Western Sydney University, Building 3, David Pilgrim Avenue, Campbelltown, NSW, 2560, Australia
| | - Angela Makris
- School of Medicine, Western Sydney University, Building 30, Campbelltown NSW, Campbelltown, 2560, Australia
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