Next Article in Journal
Choline, Other Methyl-Donors and Epigenetics
Next Article in Special Issue
Nutrients Turned into Toxins: Microbiota Modulation of Nutrient Properties in Chronic Kidney Disease
Previous Article in Journal
Trace Elements in Parenteral Nutrition: Considerations for the Prescribing Clinician
Previous Article in Special Issue
Eating Like a Rainbow: The Development of a Visual Aid for Nutritional Treatment of CKD Patients. A South African Project
Article Menu
Issue 5 (May) cover image

Export Article

Open AccessArticle
Nutrients 2017, 9(5), 444; doi:10.3390/nu9050444

Non-Traditional Aspects of Renal Diets: Focus on Fiber, Alkali and Vitamin K1 Intake

1
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56126, Italy
2
Department of Emergency and Organ Transplantation—Nephrology, Dialysis and Transplantation Unit, University of Bari Aldo Moro, Bari, 70124, Italy
3
San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, University of Milano, Milano, 20153, Italy
4
National Research Council (CNR), Institute of Clinical Physiology (IFC), Pisa and Department of Medicine, University of Padua, Padua, 35122, Italy
*
Author to whom correspondence should be addressed.
Received: 27 February 2017 / Revised: 16 April 2017 / Accepted: 20 April 2017 / Published: 29 April 2017
(This article belongs to the Special Issue Nutrition and Chronic Kidney Disease)
View Full-Text   |   Download PDF [729 KB, uploaded 16 May 2017]   |  

Abstract

Renal diets for advanced chronic kidney disease (CKD) are structured to achieve a lower protein, phosphate and sodium intake, while supplying adequate energy. The aim of this nutritional intervention is to prevent or correct signs, symptoms and complications of renal insufficiency, delaying the start of dialysis and preserving nutritional status. This paper focuses on three additional aspects of renal diets that can play an important role in the management of CKD patients: the vitamin K1 and fiber content, and the alkalizing potential. We examined the energy and nutrients composition of four types of renal diets according to their protein content: normal diet (ND, 0.8 g protein/kg body weight (bw)), low protein diet (LPD, 0.6 g protein/kg bw), vegan diet (VD, 0.7 g protein/kg bw), very low protein diet (VLPD, 0.3 g protein/kg bw). Fiber content is much higher in the VD and in the VLPD than in the ND or LPD. Vitamin K1 content seems to follow the same trend, but vitamin K2 content, which could not be investigated, might have a different pattern. The net endogenous acid production (NEAP) value decreases from the ND and LPD to the vegetarian diets, namely VD and VLPD; the same finding occurred for the potential renal acid load (PRAL). In conclusion, renal diets may provide additional benefits, and this is the case of vegetarian diets. Namely, VD and VLPD also provide high amounts of fibers and Vitamin K1, with a very low acid load. These features may have favorable effects on Vitamin K1 status, intestinal microbiota and acid-base balance. Hence, we can speculate as to the potential beneficial effects on vascular calcification and bone disease, on protein metabolism, on colonic environment and circulating levels of microbial-derived uremic toxins. In the case of vegetarian diets, attention must be paid to serum potassium levels. View Full-Text
Keywords: Renal diets; Vitamin K1; PRAL; fiber; gut microbiota; uremic toxins; low protein diet, renal nutrition, metabolic acidosis; CKD Renal diets; Vitamin K1; PRAL; fiber; gut microbiota; uremic toxins; low protein diet, renal nutrition, metabolic acidosis; CKD
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Scifeed alert for new publications

Never miss any articles matching your research from any publisher
  • Get alerts for new papers matching your research
  • Find out the new papers from selected authors
  • Updated daily for 49'000+ journals and 6000+ publishers
  • Define your Scifeed now

SciFeed Share & Cite This Article

MDPI and ACS Style

Cupisti, A.; D'Alessandro, C.; Gesualdo, L.; Cosola, C.; Gallieni, M.; Egidi, M.F.; Fusaro, M. Non-Traditional Aspects of Renal Diets: Focus on Fiber, Alkali and Vitamin K1 Intake. Nutrients 2017, 9, 444.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Nutrients EISSN 2072-6643 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top