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Nutrition and Metabolism in Chronic Kidney Diseases

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Metabolism".

Deadline for manuscript submissions: closed (25 November 2024) | Viewed by 5802

Special Issue Editors


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Guest Editor
Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125 Messina, Italy
Interests: glomerulonephritis; hemodialysis; nutrition in renal disease; vascular access; vitamin D
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125 Messina, Italy
Interests: antioxidant; clinical nephrology; chronic kidney disease; hemodialysis; blood pressure
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125 Messina, Italy
Interests: clinical nephrology; chronic kidney disease; glomerulonephritis; diabetic kidney disease; hypertension; thrombotic microangiopathies; renal tubular acidosis; acute kidney injury; dialysis; vitamin D; vascular access
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Chronic kidney disease (CKD) is defined by the presence of abnormalities in kidney structure and/or function for at least three months. A decline in renal function tends to progress toward end-stage renal disease in many patients, with timings and modalities that vary according to the underlying causes and concomitant diseases, as well as lifestyles and diets.

Nutritional therapy has a fundamental role in the prevention of CKD progression. In particular, a low-protein diet has been demonstrated to reduce hyperfiltration in the residual functioning nephrons and proteinuria. A proper dietary regimen also contributes to preventing and/or controlling the signs, symptoms and complications of CKD, including sodium and fluid retention, arterial hypertension, hyperkalemia, hyperphosphatemia and metabolic acidosis, simultaneously preventing protein–caloric malnutrition. Several dietary regimens have been proposed for this purpose, but the most successful diet plan with which to control CKD progression is still a matter of debate.

Considering the success of the previous Special Issue entitled "Nutrition and Metabolism in Kidney Diseases", we are pleased to announce that we are launching a second Special Issue on this topic.

This Special Issue is open for original articles and reviews focusing on nutrition and metabolism in patients with CKD on both conservative and dialysis treatments. The aim is to examine the current state of research and propose potential advances in knowledge to ameliorate the management and improve the clinical outcomes in CKD patients.

Prof. Dr. Domenico Santoro
Dr. Valeria Cernaro
Dr. Guido Gembillo
Guest Editors

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • low-protein diet
  • chronic kidney disease
  • metabolic acidosis
  • hyperphosphatemia
  • arterial hypertension
  • hyperkalemia
  • malnutrition–inflammation complex syndrome

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Published Papers (3 papers)

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Research

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11 pages, 890 KiB  
Article
Association Between Nutritional Status and Early Postoperative Infection Risk in Kidney Transplant Patients
by Elena González García, Tamara Arroyo, Mercedes Galván, María José Becerra, Margarita Gallego, Israel Mauro, Yanieli Hernández, Almudena Pérez-Torres, María Ovidia López Oliva, María José Santana and Carlos Jiménez
Nutrients 2025, 17(11), 1935; https://doi.org/10.3390/nu17111935 - 5 Jun 2025
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Abstract
Malnutrition is one of the stronger predictors of morbi-mortality in end-stage kidney disease patients. Moreover, malnutrition in hospitalized patients severely affects multiple clinical outcomes, increasing the risk of complications. The Nutritional Risk Index and Geriatric Nutritional Risk Index are indexes used to evaluate [...] Read more.
Malnutrition is one of the stronger predictors of morbi-mortality in end-stage kidney disease patients. Moreover, malnutrition in hospitalized patients severely affects multiple clinical outcomes, increasing the risk of complications. The Nutritional Risk Index and Geriatric Nutritional Risk Index are indexes used to evaluate the risk of malnutrition in hospitalized adults, which have been validated for dialysis patients and have been reported to be a validated prognostic index of nutrition-related morbidity and mortality. Objectives: The aim of this study is to evaluate the prevalence of early postoperative infections and their possible relationship with malnutrition in renal transplantation. Methods: We conducted a retrospective observational study, including all patients who received a kidney transplant, a total of 140, between January 2020 and December 2023, at a tertiary-level Spanish hospital. Results: The average GNRI was 110.1 ± 11.6, equivalent to adequate nutrition, and only 16.4% of patients were at risk of malnutrition. The mean NRI was 111.4 ± 11.8, equivalent to no risk of malnutrition, and only 17.2% of patients had a moderate-to-severe risk of malnutrition. A total of 30 patients (21.4%) required oral nutritional supplementation at discharge, especially modular protein supplements (86.7%), and 52 patients (37.1%) presented an infection during their stay. The most frequent infections were urinary tract infections (69.8% of the total). Malnutrition calculated by the GNRI or NRI correlated to a longer postoperative hospital stay and a higher rate of infectious complications (p < 0.05). Conclusions: Malnourished patients have a higher risk of early postoperative complications, including infection, and a longer hospitalization stay. The evaluation of nutritional status for the diagnosis and treatment of malnutrition is strongly recommended in ESKD patients on the waiting list for a kidney transplant. Full article
(This article belongs to the Special Issue Nutrition and Metabolism in Chronic Kidney Diseases)
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10 pages, 1088 KiB  
Article
Keto Analogues in Patients with Chronic Kidney Disease with or Without Kidney Transplantation
by Patrícia Kleinová, Tímea Blichová, Karol Graňák, Andrej Kollár, Matej Vnučák and Ivana Dedinská
Nutrients 2024, 16(23), 4001; https://doi.org/10.3390/nu16234001 - 22 Nov 2024
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Abstract
Background: Keto analogues in combination with a (very) low-protein diet significantly reduces the progression to end-stage kidney disease. The question of their benefit and safety for kidney transplant recipients remains. This study aimed to show the renoprotective effect and safety of the use [...] Read more.
Background: Keto analogues in combination with a (very) low-protein diet significantly reduces the progression to end-stage kidney disease. The question of their benefit and safety for kidney transplant recipients remains. This study aimed to show the renoprotective effect and safety of the use of this method in patients with chronic kidney disease and a kidney transplantation. Materials: This was a retrospective monocentric study conducted by the transplant nephrology department in Martin, in which patients with chronic kidney disease, with or without kidney transplant therapy, who received a low-protein diet and supplementation with keto analogues were included (n = 59). The changes in their glomerular filtration rate, proteinemia, calcaemia, weight, and glycaemia and the side effects associated with a low-protein diet and keto analogue use were studied in the patients with chronic kidney disease with or without kidney transplantation. Results: The kidney transplant recipients had a significantly more advanced stage of chronic kidney disease (p = 0.0001) than the non-transplanted patients at the time of the prescription of the keto analogues (p = 0.0001). Furthermore, the kidney transplant recipients had a significantly longer follow-up period (p = 0.0001), with a difference of 27 months within subgroups. During the observed period, we recorded a decrease in glomerular filtration, but without statistical significance. In our group, we did not confirm a significant occurrence of adverse effects associated with a low-protein diet and keto analogues. Conclusion: Keto analogues reduce the progression of chronic kidney disease and stabilise glomerular filtration in patients with chronic kidney disease. Based on our analysis, treatment with keto analogues is effective and safe for kidney transplant recipients after kidney transplantation. Full article
(This article belongs to the Special Issue Nutrition and Metabolism in Chronic Kidney Diseases)
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15 pages, 1469 KiB  
Systematic Review
The Impact of Combined Nutrition and Exercise Interventions in Patients with Chronic Kidney Disease
by Manon de Geus, Manouk Dam, Wesley J. Visser, Karin J. R. Ipema, Anneke M. E. de Mik-van Egmond, Michael Tieland, Peter J. M. Weijs and Hinke M. Kruizenga
Nutrients 2024, 16(3), 406; https://doi.org/10.3390/nu16030406 - 30 Jan 2024
Cited by 4 | Viewed by 3249
Abstract
Combined nutrition and exercise interventions potentially improve protein-energy wasting/malnutrition-related outcomes in patients with chronic kidney disease (CKD). The aim was to systematically review the effect of combined interventions on nutritional status, muscle strength, physical performance and QoL. MEDLINE, Cochrane, Embase, Web of Science [...] Read more.
Combined nutrition and exercise interventions potentially improve protein-energy wasting/malnutrition-related outcomes in patients with chronic kidney disease (CKD). The aim was to systematically review the effect of combined interventions on nutritional status, muscle strength, physical performance and QoL. MEDLINE, Cochrane, Embase, Web of Science and Google Scholar were searched for studies up to the date of July 2023. Methodological quality was appraised with the Cochrane risk-of-bias tool. Ten randomized controlled trials (nine publications) were included (334 patients). No differences were observed in body mass index, lean body mass or leg strength. An improvement was found in the six-minute walk test (6-MWT) (n = 3, MD 27.2, 95%CI [7 to 48], p = 0.008), but not in the timed up-and-go test. No effect was found on QoL. A positive impact on 6-MWT was observed, but no improvements were detected in nutritional status, muscle strength or QoL. Concerns about reliability and generalizability arise due to limited statistical power and study heterogeneity of the studies included. Full article
(This article belongs to the Special Issue Nutrition and Metabolism in Chronic Kidney Diseases)
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