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Caloric Intake in Renal Patients: Repercussions on Mineral Metabolism

1
Department Medicina y Cirugia Animal, University of Cordoba, 14071 Cordoba, Spain
2
Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University of Cordoba, 14004 Cordoba, Spain
*
Author to whom correspondence should be addressed.
These two authors contributed equally to this work.
Nutrients 2021, 13(1), 18; https://doi.org/10.3390/nu13010018
Received: 12 November 2020 / Revised: 15 December 2020 / Accepted: 19 December 2020 / Published: 23 December 2020
(This article belongs to the Special Issue Renal Nutrition and Metabolism)
The aim of this paper is to review current knowledge about how calorie intake influences mineral metabolism focussing on four aspects of major interest for the renal patient: (a) phosphate (P) handling, (b) fibroblast growth factor 23 (FGF23) and calcitriol synthesis and secretion, (c) metabolic bone disease, and (d) vascular calcification (VC). Caloric intake has been shown to modulate P balance in experimental models: high caloric intake promotes P retention, while caloric restriction decreases plasma P concentrations. Synthesis and secretion of the phosphaturic hormone FGF23 is directly influenced by energy intake; a direct correlation between caloric intake and FGF23 plasma concentrations has been shown in animals and humans. Moreover, in vitro, energy availability has been demonstrated to regulate FGF23 synthesis through mechanisms in which the molecular target of rapamycin (mTOR) signalling pathway is involved. Plasma calcitriol concentrations are inversely proportional to caloric intake due to modulation by FGF23 of the enzymes implicated in vitamin D metabolism. The effect of caloric intake on bone is controversial. High caloric intake has been reported to increase bone mass, but the associated changes in adipokines and cytokines may as well be deleterious for bone. Low caloric intake tends to reduce bone mass but also may provide indirect (through modulation of inflammation and insulin regulation) beneficial effects on bone. Finally, while VC has been shown to be exacerbated by diets with high caloric content, the opposite has not been demonstrated with low calorie intake. In conclusion, although prospective studies in humans are needed, when planning caloric intake for a renal patient, it is important to take into consideration the associated changes in mineral metabolism. View Full-Text
Keywords: diet; calories; mineral metabolism; kidney disease diet; calories; mineral metabolism; kidney disease
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MDPI and ACS Style

Vidal, A.; Ríos, R.; Pineda, C.; López, I.; Raya, A.I.; Aguilera-Tejero, E.; Rodríguez, M. Caloric Intake in Renal Patients: Repercussions on Mineral Metabolism. Nutrients 2021, 13, 18. https://doi.org/10.3390/nu13010018

AMA Style

Vidal A, Ríos R, Pineda C, López I, Raya AI, Aguilera-Tejero E, Rodríguez M. Caloric Intake in Renal Patients: Repercussions on Mineral Metabolism. Nutrients. 2021; 13(1):18. https://doi.org/10.3390/nu13010018

Chicago/Turabian Style

Vidal, Angela, Rafael Ríos, Carmen Pineda, Ignacio López, Ana I. Raya, Escolástico Aguilera-Tejero, and Mariano Rodríguez. 2021. "Caloric Intake in Renal Patients: Repercussions on Mineral Metabolism" Nutrients 13, no. 1: 18. https://doi.org/10.3390/nu13010018

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