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Micronutrient Deficiencies and Chronic Kidney Disease

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Micronutrients and Human Health".

Deadline for manuscript submissions: closed (20 October 2023) | Viewed by 17130

Special Issue Editor


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Guest Editor
Department of Cardiology and Nephrology, Rhein-Maas Klinikum, Würselen, Germany
Interests: vitamin K and oral anticoagulation; CKD-mineral and bone disorder; cardiorenal syndrome; heart failure; FGF23; sclerostin; calciphylaxis

Special Issue Information

Dear Colleagues,

Deficiencies in various micronutrients contribute substantially to the disease burden in patients with chronic kidney disease. They are among the driving forces of increased morbidity and mortality in this patient cohort. The topic of micronutrient deficiency encompasses a wide range of diseases, including disturbed metabolism and homeostasis of trace elements, minerals, and substrates on one side and vitamin deficiencies on the other. This Special Issue of the Nutrients named “Micronutrient Deficiencies and Chronic Kidney Disease” will target this wide variety of conditions. We are soliciting review articles, original work, or meta-analyses presenting an overview of the epidemiology (the magnitude of the problem) and pathophysiology or summarizing state-of-the-art treatment options regarding replenishment. This Special Issue will focus on but not be limited to anemia, bone disease, and cardiovascular health in patients with chronic kidney disease.

Dr. Vincent M. Brandenburg
Guest Editor

Manuscript Submission Information

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Keywords

  • vitamin K
  • vitamin D
  • vitamin B12
  • folic acid
  • vitamin C
  • magnesium
  • selenium, zinc, copper
  • iron

Published Papers (6 papers)

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Editorial

Jump to: Research, Review

3 pages, 206 KiB  
Editorial
Chronic Kidney Disease—State of Either “Too Much” or “Too Little”
by Vincent Mathias Brandenburg and Turgay Saritas
Nutrients 2023, 15(7), 1587; https://doi.org/10.3390/nu15071587 - 24 Mar 2023
Cited by 1 | Viewed by 1065
Abstract
Chronic kidney disease (CKD) is a world-wide phenomenon with an increasing incidence and prevalence [...] Full article
(This article belongs to the Special Issue Micronutrient Deficiencies and Chronic Kidney Disease)

Research

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14 pages, 699 KiB  
Article
Effect of Menaquinone-7 Supplementation on Arterial Stiffness in Chronic Hemodialysis Patients: A Multicenter Randomized Controlled Trial
by Nuanjanthip Naiyarakseree, Jeerath Phannajit, Wichai Naiyarakseree, Nanta Mahatanan, Pagaporn Asavapujanamanee, Sookruetai Lekhyananda, Supat Vanichakarn, Yingyos Avihingsanon, Kearkiat Praditpornsilpa, Somchai Eiam-Ong and Paweena Susantitaphong
Nutrients 2023, 15(11), 2422; https://doi.org/10.3390/nu15112422 - 23 May 2023
Cited by 3 | Viewed by 2762
Abstract
Background: There is a very high prevalence of subclinical vitamin K deficiency in patients requiring hemodialysis (HD), and this problem is associated with vascular calcification and arterial stiffness. Vitamin K2 (MK-7) supplementation can improve vitamin K status in HD patients. However, the benefits [...] Read more.
Background: There is a very high prevalence of subclinical vitamin K deficiency in patients requiring hemodialysis (HD), and this problem is associated with vascular calcification and arterial stiffness. Vitamin K2 (MK-7) supplementation can improve vitamin K status in HD patients. However, the benefits of vitamin K supplementation on arterial stiffness have still not been established. The present study was conducted to evaluate the efficacy of menaquinone-7 (MK-7) supplementation on arterial stiffness in chronic HD patients. Methods: This open-label multicenter randomized clinical trial was conducted in 96 HD patients who had arterial stiffness, defined by high carotid femoral pulse wave velocity (cfPWV ≥ 10 m/s). The patients were randomly assigned to receive oral MK-7 (375 mcg once daily) for 24 weeks (n = 50) or standard care (control group; n = 46). The change in cfPWV was the primary outcome. Results: Baseline parameters were comparable between the two groups. There was no significant difference in the change in cPWV at 24 weeks between the MK-7 group and standard care [−6.0% (−20.2, 2.3) vs. −6.8% (−19.0, 7.3), p = 0.24]. However, we found that MK-7 significantly decreased cPWV in patients with diabetes [−10.0% (−15.9, −0.8) vs. 3.8% (−5.8, 11.6), p = 0.008]. In addition, the MK-7 group had a lower rate of arterial stiffness progression, compared to controls (30.2% vs. 39.5%, p = 0.37), especially in diabetes patients (21.4% vs. 72.7%, p = 0.01). No serious adverse events were observed during the 24 weeks. Conclusion: Vitamin K supplements provided a beneficial impact in lowering the rate of arterial stiffness progression in chronic hemodialysis patients with diabetes. Possible benefits on cardiovascular outcomes require further investigation. Full article
(This article belongs to the Special Issue Micronutrient Deficiencies and Chronic Kidney Disease)
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13 pages, 351 KiB  
Article
Further Evidence on Trace Element Imbalances in Haemodialysis Patients—Paired Analysis of Blood and Serum Samples
by Rui Azevedo, Davide Gennaro, Mary Duro, Edgar Pinto and Agostinho Almeida
Nutrients 2023, 15(8), 1912; https://doi.org/10.3390/nu15081912 - 15 Apr 2023
Cited by 1 | Viewed by 1592
Abstract
Previous studies have shown that haemodialysis patients have an increased risk of trace element imbalances. Most studies have determined the concentration of trace elements in serum only, but most trace elements are not uniformly distributed between plasma and blood cells, which justifies separate [...] Read more.
Previous studies have shown that haemodialysis patients have an increased risk of trace element imbalances. Most studies have determined the concentration of trace elements in serum only, but most trace elements are not uniformly distributed between plasma and blood cells, which justifies separate analysis of the different compartments. In this study, we determined both the serum and whole blood concentration of a wide panel of trace elements (Li, B, Mn, Co, Ni, Cu, Zn, Se, Rb, Sr, Mo, Cd, Pb) in haemodialysis patients and compared them with those of a control group. Whole blood and serum samples were collected during routine laboratory testing of patients undergoing chronic haemodialysis. For comparison purposes, samples from individuals with normal renal function were also analysed. Statistically significant differences (p < 0.05) were found between the two groups for whole blood concentrations of all analysed elements except Zn (p = 0.347). For serum, the difference between groups was statistically significant for all elements (p < 0.05). This study confirms that patients on haemodialysis tend to present significant trace element imbalances. By determining the concentration of trace elements in both whole blood and serum, it was shown that chronic haemodialysis may affect intra- and extracellular blood compartments differently. Full article
(This article belongs to the Special Issue Micronutrient Deficiencies and Chronic Kidney Disease)
15 pages, 7362 KiB  
Article
Magnesium Improves Cardiac Function in Experimental Uremia by Altering Cardiac Elastin Protein Content
by Xoana Barros, Xenia Friesen, Vincent Mathias Brandenburg, Elisa Anamaria Liehn, Sonja Steppan, Fabian Kiessling, Rafael Kramann, Jürgen Floege, Thilo Krüger and Nadine Kaesler
Nutrients 2023, 15(6), 1303; https://doi.org/10.3390/nu15061303 - 7 Mar 2023
Viewed by 2264
Abstract
Cardiovascular complications are accompanied by life-threatening complications and represent the major cause of death in patients with chronic kidney disease (CKD). Magnesium is important for the physiology of cardiac function, and its deficiency is common in CKD. In the present study, we investigated [...] Read more.
Cardiovascular complications are accompanied by life-threatening complications and represent the major cause of death in patients with chronic kidney disease (CKD). Magnesium is important for the physiology of cardiac function, and its deficiency is common in CKD. In the present study, we investigated the impact of oral magnesium carbonate supplementation on cardiac function in an experimental model of CKD induced in Wistar rats by an adenine diet. Echocardiographic analyses revealed restoration of impaired left ventricular cardiac function in animals with CKD. Cardiac histology and real-time PCR confirmed a high amount of elastin protein and increased collagen III expression in CKD rats supplemented with dietary magnesium as compared with CKD controls. Both structural proteins are crucial in maintaining cardiac health and physiology. Aortic calcium content increased in CKD as compared with tissue from control animals. Magnesium supplementation numerically lowered the increases in aortic calcium content as it remained statistically unchanged, compared with controls. In summary, the present study provides evidence for an improvement in cardiovascular function and aortic wall integrity in a rat model of CKD by magnesium, as evidenced by echocardiography and histology. Full article
(This article belongs to the Special Issue Micronutrient Deficiencies and Chronic Kidney Disease)
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16 pages, 1494 KiB  
Article
Micronutrients and Renal Outcomes: A Prospective Cohort Study
by Chun-Yu Chen, Chun-Hui Chiu, I-Wen Wu, Heng-Jung Hsu, Yih-Ting Chen, Cheng-Kai Hsu, Heng-Chih Pan, Chin-Chan Lee and Chiao-Yin Sun
Nutrients 2022, 14(15), 3063; https://doi.org/10.3390/nu14153063 - 26 Jul 2022
Cited by 5 | Viewed by 2496
Abstract
Background: Micronutrients are essential in maintaining normal human physiology. Data regarding the association between micronutrients and renal outcomes in chronic kidney disease (CKD) are lacking. Methods: This prospective observational cohort study enrolled 261 patients with CKD stages 1–5 and 30 subjects with normal [...] Read more.
Background: Micronutrients are essential in maintaining normal human physiology. Data regarding the association between micronutrients and renal outcomes in chronic kidney disease (CKD) are lacking. Methods: This prospective observational cohort study enrolled 261 patients with CKD stages 1–5 and 30 subjects with normal renal function. Baseline serum zinc (Zn), selenium (Se), chromium, manganese, and copper, and laboratory tests were performed at enrolment. The primary endpoint was the presence of end-stage renal disease (ESRD) requiring long-term renal replacement therapy. Results: The median follow-up periods of renal and non-renal survivals were 67.78 and 29.03 months, respectively. Multiple linear regression showed that Zn and Se (β ± SE: 24.298 ± 8.616, p = 0.005; 60.316 ± 21.875, p = 0.006, respectively) levels were positively correlated with renal function. Time to ESRD was significantly longer for those with Zn levels ≥1287.24 ng/g and Se levels ≥189.28 ng/g (both p < 0.001). Cox regression analysis identified a higher Zn level as an independently negative predictor of ESRD after adjusting for renal function (hazard ratio, 0.450, p = 0.019). Conclusion: Serum Se and Zn concentrations are positively associated with renal function and better renal outcomes. A higher Zn concentration could independently predict better renal survival. Full article
(This article belongs to the Special Issue Micronutrient Deficiencies and Chronic Kidney Disease)
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Review

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15 pages, 1617 KiB  
Review
Vitamin K and Hallmarks of Ageing: Focus on Diet and Gut Microbiome
by Lu Dai, Denise Mafra, Paul G. Shiels, Tilman M. Hackeng, Peter Stenvinkel and Leon J. Schurgers
Nutrients 2023, 15(12), 2727; https://doi.org/10.3390/nu15122727 - 12 Jun 2023
Viewed by 3987
Abstract
Vitamin K and vitamin K-dependent proteins have been reported to be associated with a large spectrum of age-related diseases. While most of these associations have been deduced from observational studies, solid evidence for the direct impact of vitamin K on cellular senescence remains [...] Read more.
Vitamin K and vitamin K-dependent proteins have been reported to be associated with a large spectrum of age-related diseases. While most of these associations have been deduced from observational studies, solid evidence for the direct impact of vitamin K on cellular senescence remains to be proven. As vitamin K status reflects the complexity of interactions between dietary intake, gut microbiome activity and health, we will demonstrate the pivotal role of the diet-microbiome-health axis in human ageing and exemplify how vitamin K is implicated therein. We propose that food quality (i.e., food pattern) should be highlighted beyond the quantity of total vitamin K intake. Instead of focusing on a single nutrient, exploring a healthy diet containing vitamin K may be more strategic. As such, healthy eating patterns can be used to make dietary recommendations for the public. Emerging evidence suggests that dietary vitamin K is a modulator of the diet-microbiome-health axis, and this needs to be incorporated into the investigation of the impact of vitamin K on gut microbial composition and metabolic activities, along with host health outcomes. In addition, we highlight several critical caveats that need to be acknowledged regarding the interplay between diet, vitamin K, gut microbiome and host health that is pivotal for elucidating the role of vitamin K in ageing and responding to the urgent call of healthy eating concerning public health. Full article
(This article belongs to the Special Issue Micronutrient Deficiencies and Chronic Kidney Disease)
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