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Nutrients
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Hormonal and Nutritional Disorders in Kidney Failure
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Hormonal and Nutritional Disorders in Kidney Failure

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

Deadline for manuscript submissions: closed (20 June 2023) | Viewed by 17607

Special Issue Editors

Prof. Dr. Stanisław Niemczyk

E-Mail Website1 Website2
Guest Editor
Department of Internal Medicine, Nephrology and Dialysis, Military Institute of Medicine, Szaserów Street 128, Warsaw, 04-141 Poland
Interests: nephrology; transplantology; endocrinology; geriatrics; hydration status; nutritional status; renal failure; ESRD; cardiovascular dysfunction; acute kidney injury; vasculitis; protein energy wasting; hormonal disorders in renal failure; hemodialysis; peritoneal dialysis
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Dorota Szostak-Węgierek

E-Mail Website
Guest Editor
Department of Clinical Dietetics, Faculty of Health Sciences, Medical University of Warsaw, E. Ciołka Str. 7, 01-445 Warsaw, Poland
Interests: nutrition; dietetics; nutritional epidemiology; cardiovascular diseases; dyslipidemia; diabetes; obesity; pregnancy; aging
Special Issues, Collections and Topics in MDPI journals
Dr. Aleksandra Rymarz

E-Mail Website1 Website2
Guest Editor
Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine, 04-141 Warsaw, Poland
Interests: nutritional status in chronic kidney disease; body composition; protein-energy-wasting; endocrinological disorders in chronic kidney disease; small-vessel vasculitis; immunosuppressive treatment

Special Issue Information

Dear Colleagues,

We are inviting researchers to submit original research or review papers concerning hormonal and nutritional disorders in chronic kidney disease (CKD). Publications may involve CKD patients over the course of maintenance treatment or those undergoing renal replacement therapy, including kidney transplantation.

Nutritional status is one of the most important prognostic factors in chronic kidney disease patients. The prevalence of protein-energy wasting (PEW) is relatively high among CKD patients, ranging from 11 to 54%. Therefore, research on PEW, its pathogenesis, prevention, diagnosis and treatment is crucial. Many etiologic factors contribute to PEW development, including hormonal disorders, which can potentially be treated.

PEW promotes and accelerates the development of atherosclerosis, resulting in excessive mortality in CKD patients due to cardiovascular disease. This process is especially exacerbated during dialysis treatment. Therefore, papers considering nutritional status evaluation and interventions in the context of cardiovascular disease are of particular interest for this Special Issue.

In patients with chronic kidney disease, diabetes is a leading cause of renal impairment and end-stage renal disease. Diabetes, as a very common concomitant disease and the main cause of both CKD and cardiovascular disease, also demands significant attention. Another challenge facing the treatment of CKD patients is the development of proper dietary interventions before and during hemodialysis treatment, especially regarding protein intake.There are many diagnostic procedures for PEW evaluation in CKD patients. In clinical trials, a great number of these are considered; however, strict recommendations are still lacking and there are significant discrepancies among obtained results, necessitating further study on this topic.    

This Special Issue will present the latest studies presenting novel results and future perspectives for the abovementioned areas.

We welcome the submission of original research, reviews and expert opinions. We are primarily interested in papers focused on protein-energy wasting, sarcopenia, body composition, hormonal disorders such as testosterone deficiency, secondary and tertiary hyperparathyroidism and insulin resistance in chronic kidney disease patients.

Prof. Dr. Stanisław Niemczyk
Prof. Dr. Dorota Szostak-Węgierek
Dr. Aleksandra Rymarz
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

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

  • protein-energy wasting (PEW)
  • malnutrition
  • dietary treatment
  • clinical nutrition
  • adipocytokines
  • hormonal disorders
  • testosterone
  • insulin resistance
  • parathormone (PTH)
  • hyperparathyroidism
  • renal failure
  • chronic kidney disease
  • body composition
  • sarcopenia
  • muscle mass
  • fat mass
  • lean tissue mass
  • nephrotic syndrome
  • diabetes
  • atherosclerosis
  • haemodialysis
  • peritoneal dialysis
  • kidney transplantation
  • bioimpedance
  • anthropometric measurements
  • biomarkers

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Published Papers (5 papers)

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Research

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14 pages, 510 KiB  
Article
Malnutrition and Erythropoietin Resistance among Patients with End-Stage Kidney Disease: Where Is the Perpetrator of Disaster?
by Wiktoria Feret, Krzysztof Safranow, Ewa Kwiatkowska, Aleksandra Daniel and Kazimierz Ciechanowski
Nutrients 2022, 14(24), 5318; https://doi.org/10.3390/nu14245318 - 14 Dec 2022
Cited by 5 | Viewed by 2658
Abstract
Background: Hemodialyzed patients with poor erythropoietin response tend to have low volume of visceral adipose tissue and score high on malnutrition-inflammation score. This study investigates in-depth the role of leptin and chosen cytokines in the development of malnutrition-inflammation syndrome (MIS) and erythropoietin resistance. [...] Read more.
Background: Hemodialyzed patients with poor erythropoietin response tend to have low volume of visceral adipose tissue and score high on malnutrition-inflammation score. This study investigates in-depth the role of leptin and chosen cytokines in the development of malnutrition-inflammation syndrome (MIS) and erythropoietin resistance. Methods: Eighty-one hemodialyzed patients with erythropoietin-treated anemia were enrolled in the study. Their body composition was measured. Erythropoietin resistance index was calculated. Blood samples for leptin, IL-6, IL-18, TNF-alpha, and IL-1-alpha serum levels were drawn. Results: Leptin showed negative correlation with erythropoietin resistance index (ERI), whilst IL-6 showed the opposite. IL-6 seemed to be linked more to HD parameters and vintage, while TNF-alpha and leptin were more dependent on body composition. IL-18 and IL-1-alpha did not affect nutritional parameters nor ERI. Conclusion: Modulation of adipokine- and cytokine-related signaling is a promising target in tempering malnutrition in hemodialyzed, and thus achieving better outcomes in anemia treatment. Large clinical studies that target the inflammatory response in hemodialysis, especially regarding IL-6, TNF-alpha, and leptin, would be of great worth. Full article
(This article belongs to the Special Issue Hormonal and Nutritional Disorders in Kidney Failure)
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9 pages, 280 KiB  
Article
Vitamin K1 and K2 in the Diet of Patients in the Long Term after Kidney Transplantation
by Małgorzata Kluch, Patrycja Bednarkiewicz, Magdalena Orzechowska, Piotr Grzelak and Ilona Kurnatowska
Nutrients 2022, 14(23), 5070; https://doi.org/10.3390/nu14235070 - 29 Nov 2022
Cited by 1 | Viewed by 2611
Abstract
Vitamin K, especially its K2 form, is considered to be a protective factor against developing vascular changes and bone lesions that are common complications in kidney transplant (KTx) recipients. There is a growing number of studies showing that KTx patients are at risk [...] Read more.
Vitamin K, especially its K2 form, is considered to be a protective factor against developing vascular changes and bone lesions that are common complications in kidney transplant (KTx) recipients. There is a growing number of studies showing that KTx patients are at risk of vitamin K deficiency. The aim of this study was to evaluate the intake of vitamin K1 and K2 in the diet of patients in the late period after KTx. During a routine visit at one outpatient transplantation clinic in Central Europe, a diet survey questionnaire was filled in by 151 clinically stable KTx recipients and compared with medical history, anthropometric measurements and laboratory tests. Mean vitamin K1 intake was 120.9 ± 49 μg/day and vitamin K2 (MK, menaquinone) intake 28.69 ± 11.36 μg/day, including: MK-4: 25.9 ± 9.9 μg/day; MK-5: 0.1 ± 0.2 μg/day; MK-6: 0.2 ± 0.4 μg/day; MK-7: 0.2 ± 0.23 μg/day; MK-8: 1 ± 1.9 μg/day; MK-9: 0.9 ± 2.3 μg/day; and MK-10: 0.2 ± 0.5 μg/day. Our study showed that KTx recipients’ diets contained adequate amounts of vitamin K1, whereas the intake of vitamin K2 seemed insufficient. Full article
(This article belongs to the Special Issue Hormonal and Nutritional Disorders in Kidney Failure)

Review

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14 pages, 2420 KiB  
Review
Focusing on Phosphorus Loads: From Healthy People to Chronic Kidney Disease
by Mengjing Wang, Jiaying Zhang, Kamyar Kalantar-Zadeh and Jing Chen
Nutrients 2023, 15(5), 1236; https://doi.org/10.3390/nu15051236 - 28 Feb 2023
Cited by 6 | Viewed by 3420
Abstract
Phosphorus is an essential micromineral with a key role in cellular metabolism and tissue structure. Serum phosphorus is maintained in a homeostatic range by the intestines, bones, and kidneys. This process is coordinated by the endocrine system through the highly integrated actions of [...] Read more.
Phosphorus is an essential micromineral with a key role in cellular metabolism and tissue structure. Serum phosphorus is maintained in a homeostatic range by the intestines, bones, and kidneys. This process is coordinated by the endocrine system through the highly integrated actions of several hormones, including FGF23, PTH, Klotho, and 1,25D. The excretion kinetics of the kidney after diet phosphorus load or the serum phosphorus kinetics during hemodialysis support that there is a “pool” for temporary phosphorus storage, leading to the maintenance of stable serum phosphorus levels. Phosphorus overload refers to a state where the phosphorus load is higher than is physiologically necessary. It can be caused by a persistently high-phosphorus diet, renal function decline, bone disease, insufficient dialysis, and inappropriate medications, and includes but is not limited to hyperphosphatemia. Serum phosphorus is still the most commonly used indicator of phosphorus overload. Trending phosphorus levels to see if they are chronically elevated is recommended instead of a single test when judging phosphorus overload. Future studies are needed to validate the prognostic role of a new marker or markers of phosphorus overload. Full article
(This article belongs to the Special Issue Hormonal and Nutritional Disorders in Kidney Failure)
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12 pages, 340 KiB  
Review
Nutrition Disturbances and Metabolic Complications in Kidney Transplant Recipients: Etiology, Methods of Assessment and Prevention—A Review
by Monika Górska and Ilona Kurnatowska
Nutrients 2022, 14(23), 4996; https://doi.org/10.3390/nu14234996 - 24 Nov 2022
Cited by 7 | Viewed by 3661
Abstract
Nutrition disturbances occur at all stages of chronic kidney disease and progress with the decrease of the kidney filtration rate. Kidney transplantation (KTx) as the best form of kidney replacement therapy poses various nutritional challenges. Prior to transplantation, recipients often present with mild [...] Read more.
Nutrition disturbances occur at all stages of chronic kidney disease and progress with the decrease of the kidney filtration rate. Kidney transplantation (KTx) as the best form of kidney replacement therapy poses various nutritional challenges. Prior to transplantation, recipients often present with mild to advanced nutrition disturbances. A functioning allograft not only relieves uremia, acidosis, and electrolyte disturbances, but also resumes other kidney functions such as erythropoietin production and vitamin D3 metabolism. KTx recipients represent a whole spectrum of undernutrition and obesity. Since following transplantation, patients are relieved of most dietary restrictions and appetite disturbances; they resume old nutrition habits that result in weight gain. The immunosuppressive regimen often predisposes them to dyslipidemia, glucose intolerance, and hypertension. Moreover, most recipients present with chronic kidney graft disease at long-term follow-ups, usually in stages G2–G3T. Therefore, the nutritional status of KTx patients requires careful monitoring. Appropriate dietary and lifestyle habits prevent nutrition disturbances and may improve kidney graft function. Despite many nutritional guidelines and recommendations targeted at chronic kidney disease, there are few targeted at KTx recipients. We aimed to provide a brief review of nutrition disturbances and known nutritional recommendations for kidney transplant recipients based on the current literature and dietary trends. Full article
(This article belongs to the Special Issue Hormonal and Nutritional Disorders in Kidney Failure)
17 pages, 394 KiB  
Review
Testosterone Deficiency as One of the Major Endocrine Disorders in Chronic Kidney Disease
by Katarzyna Romejko, Aleksandra Rymarz, Hanna Sadownik and Stanisław Niemczyk
Nutrients 2022, 14(16), 3438; https://doi.org/10.3390/nu14163438 - 21 Aug 2022
Cited by 17 | Viewed by 4078
Abstract
Reduced testosterone concentration is nowadays thought to be one of the main endocrine disorders in chronic kidney disease (CKD). It is caused by the dysfunction of the hypothalamic-pituitary-gonadal axis. The role of testosterone is multifactorial. Testosterone is responsible not only for reproductive processes, [...] Read more.
Reduced testosterone concentration is nowadays thought to be one of the main endocrine disorders in chronic kidney disease (CKD). It is caused by the dysfunction of the hypothalamic-pituitary-gonadal axis. The role of testosterone is multifactorial. Testosterone is responsible not only for reproductive processes, but it is a hormone which increases bone and muscle mass, improves lipid profile, insulin sensitivity, erythropoiesis, reduces blood pressure, and ameliorates mood and perception. The implications of hypogonadism in CKD are infertility and loss of libido, reduction of muscle mass and strength, disorders in bone mineralization, the development of sarcopenia and protein energy wasting (PEW), progression of atherosclerosis, increased visceral adiposity, insulin resistance, and anaemia. Reduced testosterone serum concentrations in CKD are associated with increased mortality rate. Testosterone supplementation improves sexual functions, reduces the level of inflammatory markers and blood pressure, stimulates muscle protein synthesis, improves insulin sensitivity and lipid profile, and increases muscle mass, bone mineral density, and haemoglobin concentration. It positively affects mood and well-being. The modes of testosterone supplementation are intramuscular injections, subcutaneous pellets, and percutaneous methods—patches and gels. Successful kidney transplantation may improve gonadal function and testosterone production, however, half of men with low testosterone concentrations before kidney transplantation do not restore hormonal function. Full article
(This article belongs to the Special Issue Hormonal and Nutritional Disorders in Kidney Failure)
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