Submit to Nutrients Review for Nutrients Propose a Special Issue

Journal Browser

► Journal Browser

The Impact of Nutrition Monitoring and Intervention on Quality of Life in of Chronic Kidney Disease Patients at Different Stage

Print Special Issue Flyer
Special Issue Editors
Special Issue Information
Keywords
Published Papers

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

Deadline for manuscript submissions: closed (31 October 2022) | Viewed by 26122

Share This Special Issue

Special Issue Editor

Prof. Dr. Guillermina Barril

E-Mail Website
Guest Editor

Nephrology Department, Hospital Universitario La Princesa, 28006 Madrid, Spain
Interests: nutritional status; inflammation body composition; chronic kidney disease; parenteral nutrition
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Advanced CKD prior to RRT (GFR measured by CKD EPI ≤ 30mL/min/1.73m2) is a key stage in monitoring the nutritional status of kidney patients for early diagnosis and nutritional intervention toward preventing PEW and cachexia. PEW, frailty, and sarcopenia are closely interrelated, especially in elderly patients, and it is sometimes difficult to separate which aspects are age-related and which are a consequence of advanced CKD. It must be taken into account that the nutritional status at the start of renal replacement therapy determines the prognosis, together with other factors, in the first two years of dialysis. Although age is an independent factor for frailty and sarcopenia, both can appear in CKD patients of any age, so assessing strength, muscle mass, and functionality are very important because even if CKD progresses, the patient can have a normal life if they can maintain mass, strength, and functionality, which results in improved quality of life and prevents dependency. For all this, it is in the advanced CKD stage prior to RRT when we must carefully manage the nutritional status and body composition, since anything that is left unoptimized will lead to dialysis and reversibility, creating a more difficult situation for the patient.

Hence, given the multiple tools that exist for diagnosis, we have established this Special Issue to highlight the risk factors to focus on in maintaining an adequate quality of life for CKD patients, even in cases of disease progression

Prof. Dr. Guillermina Barril
Guest Editor

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

chronic kidney disease
dialysis
nutritional status
nutrients
protein and energy intake
diabetes kidney disease
kidney transplantation

Published Papers (10 papers)

Download All Papers

Research

Jump to: Review

10 pages, 288 KiB

Open AccessArticle

Mediterranean Diet and Chronic Kidney Disease (CKD): A Practical Approach

by Almudena Pérez-Torres, Alberto Caverni-Muñoz and Elena González García

Nutrients 2023, 15(1), 97; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15010097 - 25 Dec 2022

Cited by 13 | Viewed by 4982

Abstract

Chronic kidney disease has become a serious public health issue, as well as others health problems such as hypertension, DM, and obesity. Mediterranean diet (MD) can reduce the risk of cardiovascular disease and cancer and can lead to weight loss in obesity. There are studies that suggest that MD could be the diet of choice for patients with CKD for its influence on endothelial function, inflammation, lipid profile and blood pressure. There are few studies that tell us how to adapt MD to this group of patients. This review aims to offer a practical approach to Mediterranean diet adaptation as nutritional treatment in CKD patients. Full article

(This article belongs to the Special Issue The Impact of Nutrition Monitoring and Intervention on Quality of Life in of Chronic Kidney Disease Patients at Different Stage)

11 pages, 286 KiB

Open AccessFeature PaperArticle

Assessment of the Nutritional Status and Quality of Life in Chronic Kidney Disease and Kidney Transplant Patients: A Comparative Analysis

by Weronika Pawlaczyk, Lukasz Rogowski, Joanna Kowalska, Małgorzata Stefańska, Tomasz Gołębiowski, Oktawia Mazanowska, Claire Gerall, Magdalena Krajewska, Mariusz Kusztal and Wioletta Dziubek

Nutrients 2022, 14(22), 4814; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14224814 - 14 Nov 2022

Cited by 4 | Viewed by 2222

Abstract

Background: Chronic kidney disease (CKD) can significantly influence a patient’s nutritional status, leading to malnutrition. Malnutrition is associated with an increase in morbidity and hospital admissions, as well as a decrease in functional status. All these factors impact emotional, physical, and psychosocial health, leading to a lower quality of life (QOL). The aim of the study was to assess the nutritional status and QOL in patients with CKD compared to patients after kidney transplantation and determine what factors influence nutritional status and QOL in this patient population. Methods: The study included 167 patients: 39 pre-dialysis patients—group 1; 65 dialysis patients—group 2; 63 kidney transplant patients—group 3. Patients completed the Kidney Disease Quality of Life questionnaire (KDQoL) and the Mini Nutritional Assessment questionnaire (MNA). Results: A comparative analysis of the QOL of patients in the three study groups showed no statistically significant differences in the overall KDQoL scores. Factors that affected quality of life included the designated group, determined by disease status, MNA score, patient age, and WHR. Nearly 1/3 of patients from groups 2 and 3 were at risk of malnutrition. Conclusions: A systematic assessment of nutritional status and monitoring of QOL should be integrated into the standard management guidelines for CKD patients. Full article

(This article belongs to the Special Issue The Impact of Nutrition Monitoring and Intervention on Quality of Life in of Chronic Kidney Disease Patients at Different Stage)

12 pages, 1193 KiB

Open AccessArticle

Impact of the Nutrition–Inflammation Status on the Functionality of Patients with Chronic Kidney Disease

by Ángel Nogueira, Graciela Álvarez and Guillermina Barril

Nutrients 2022, 14(22), 4745; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14224745 - 10 Nov 2022

Cited by 1 | Viewed by 1622

Abstract

Functional capacity of chronic kidney disease (CKD) patients is compromised by their nutrition-inflammation status. We evaluated the functional capacity of advanced chronic kidney disease (ACKD) patients and the influence of the nutrition-inflammation status. In a cross-sectional study, which included ACKD patients from the nephrology department of the Hospital Universitario de la Princesa in Madrid, Spain, we assessed: functional capacity with the Short Physical Performance Battery (SPPB) test, interpreting a result <7 in the test as low functionality; body composition with monofrequency bioimpedance; muscular strength with hand grip strength; nutritional and inflammatory status using biochemical parameters and the Malnutrition Inflammation Scale (MIS). A total of 255 patients with ACKD were evaluated, 65.8% were men, their mean age was 70.65 ± 11.97 years and 70.2% of the patients had an age >65 years. The mean score of SPPB was 8.50 ± 2.81 and 76.4% of the patients presented a score ≥7, with a higher percentage in the group of men. The percentage of patients with limitations increased with age. The patients with SPPB values higher than 7 showed high values of albumin and low soluble C-reactive protein (s-CRP) and MIS. We found better functionality in well-nourished patients. A multivariate logistic regression model established an association of high albumin values with a better functional capacity (OR: 0.245 CI: 0.084–0.714 p < 0.010), while another model showed an association between CRP values and decreased functionality (OR: 1.267 CI: 1.007–1.594 p = 0.044). Conclusion: nutritional status and body composition influence on the functional capacity of patients with ACKD. Full article

(This article belongs to the Special Issue The Impact of Nutrition Monitoring and Intervention on Quality of Life in of Chronic Kidney Disease Patients at Different Stage)

► Show Figures

Figure 1

14 pages, 701 KiB

Open AccessArticle

Ketoanalogues Supplemental Low Protein Diet Safely Decreases Short-Term Risk of Dialysis among CKD Stage 4 Patients

by Chieh-Li Yen, Pei-Chun Fan, Jia-Jin Chen, George Kuo, Ching-Chung Hsiao, Chao-Yu Chen, Yi-Ran Tu, Hsiang-Hao Hsu, Yung-Chang Chen and Chih-Hsiang Chang

Nutrients 2022, 14(19), 4020; https://doi.org/10.3390/nu14194020 - 28 Sep 2022

Cited by 4 | Viewed by 2254

Abstract

Background: Rigid dietary controls and pill burden make a very-low protein (0.3–0.4 g/kg body weight per day), vegetarian diet supplemented with ketoanalogues of amino acids (sVLPD) hard to follow in the long-term. This study aimed to evaluate whether a ketoanalogue supplemental low-protein diet (sLPD) (0.6 g/kg body weight per day) could also reduce the risks of dialysis among CKD stage 4 patients. Methods: Patients aged >20 years with a diagnosis of stage 4 CKD who subsequently received ketosteril treatment, which is the most commonly used ketoanalogue of essential amino acids, between 2003 and 2018 were identified from the Chang Gung Research Database (CGRD). Then, these individuals were divided into two groups according to the continuation of ketosteril for more than three months or not. The primary outcome was ESKD requiring maintenance dialysis. Results: With one-year follow-up, the continuation group (n = 303) exhibited a significantly lower incidence of new-onset end-stage kidney disease (ESKD) requiring maintenance dialysis (6.8% vs. 10.4%, hazard ratio [HR]: 0.62, 95% confidence interval [CI]: 0.41–0.94) in comparison to the discontinuation group (n = 238). Conclusions: This study demonstrated that initiating sLPDs since CKD stage 4 may additionally reduce the short-term risks of commencing dialysis without increasing CV events, infections, or mortality. Full article

(This article belongs to the Special Issue The Impact of Nutrition Monitoring and Intervention on Quality of Life in of Chronic Kidney Disease Patients at Different Stage)

► Show Figures

Figure 1

15 pages, 1569 KiB

Open AccessArticle

Nutritional Predictors of Mortality after 10 Years of Follow-Up in Patients with Chronic Kidney Disease at a Multidisciplinary Unit of Advanced Chronic Kidney Disease

by Guillermina Barril, Angel Nogueira, Graciela Alvarez-García, Almudena Núñez, Carmen Sánchez-González and Mar Ruperto

Nutrients 2022, 14(18), 3848; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14183848 - 17 Sep 2022

Cited by 8 | Viewed by 2080

Abstract

Nutritional monitoring in advanced chronic kidney disease (ACKD) units provides personalized care and improves clinical outcomes. This study aimed to identify mortality risk factors in chronic kidney disease (CKD) patients on nutritional follow-up in the multidisciplinary ACKD unit. A retrospective cross-sectional observational study was conducted in 307 CKD patients’ stage 3b, 4–5 followed-up for 10 years. Clinical and nutritional monitoring was performed by malnutrition-inflammation score (MIS), biochemical parameters (s-albumin, s-prealbumin, and serum C-reactive protein (s-CRP), body composition measured by bioelectrical impedance analysis (BIA), anthropometry, and handgrip strength measurements. The sample was classified into non-survivors, survivors, and censored groups. Of the 307 CKD patients, the prevalence of protein-energy wasting (PEW) was 27.0% using MIS > 5 points, s-CRP > 1 mg/dL was 19.20%, and 27.18% died. Survivors had higher significant body cell mass (BCM%) and phase angle (PA). Survival analyses significantly showed that age > 72 years, MIS > 5 points, s-prealbumin ≤ 30 mg/dL, PA ≤ 4°, and gender-adjusted handgrip strength (HGS) were associated with an increased risk of mortality. By univariate and multivariate Cox regression, time on follow-up (HR:0.97), s-prealbumin (HR:0.94), and right handgrip strength (HR:0.96) were independent predictors of mortality risk at 10 years of follow-up in the ACKD unit. Nutritional monitoring in patients with stage 3b, 4–5 CKD helps to identify and treat nutritional risk early and improve adverse mortality prognosis. Full article

(This article belongs to the Special Issue The Impact of Nutrition Monitoring and Intervention on Quality of Life in of Chronic Kidney Disease Patients at Different Stage)

► Show Figures

Figure 1

15 pages, 1164 KiB

Open AccessArticle

Nutritional Status, Body Composition, and Inflammation Profile in Older Patients with Advanced Chronic Kidney Disease Stage 4–5: A Case-Control Study

by Mar Ruperto and Guillermina Barril

Nutrients 2022, 14(17), 3650; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14173650 - 03 Sep 2022

Cited by 6 | Viewed by 2251

Abstract

Nutritional status is a predictor of adverse outcomes and mortality in patients with advanced chronic kidney disease (ACKD). This study aimed to explore and evaluate risk factors related to nutritional status, body composition, and inflammatory profile in patients with ACKD compared with age- and sex-matched controls in a Mediterranean cohort of the Spanish population. Out of 200 volunteers recruited, 150 participants (64%) were included, and a case-control study was conducted on 75 ACKD patients (stages 4–5), matched individually with controls at a ratio of 1:1 for both age and sex. At enrolment, demographic, clinical, anthropometric, and laboratory parameters were measured. Bioimpedance analysis (BIA) was used to assess both body composition and hydration status. ACKD patients had lower body cell mass (BCM%), muscle mass (MM%) phase angle (PA), s-albumin, and higher C-reactive protein (s-CRP) than controls (at least, p < 0.05). PA correlated positively with BCM% (cases: r = 0.84; controls: r = 0.53, p < 0.001), MM% (cases: r = 0.65; controls: r = 0.31, p < 0.001), and inversely with s-CRP (cases: r = −0.30, p < 0.001; controls: r = −0.31, p = 0.40). By univariate and multivariate conditional regression analysis, total body water (OR: 1.186), extracellular mass (OR: 1.346), s-CRP (OR: 2.050), MM% (OR: 0.847), PA (OR: 0.058), and s-albumin (OR: 0.475) were significantly associated among cases to controls. Nutritional parameters and BIA-derived measures appear as prognostic entities in patients with stage 4–5 ACKD compared to matched controls in this Mediterranean cohort. Full article

(This article belongs to the Special Issue The Impact of Nutrition Monitoring and Intervention on Quality of Life in of Chronic Kidney Disease Patients at Different Stage)

► Show Figures

Figure 1

11 pages, 1714 KiB

Open AccessArticle

Prevalence of Protein-Energy Wasting in Dialysis Patients Using a Practical Online Tool to Compare with Other Nutritional Scores: Results of the Nutrendial Study

by Marta Arias-Guillén, Silvia Collado, Elisabeth Coll, Jordi Carreras, Loreley Betancourt, Bárbara Romano, Marisol Fernández, Verónica Duarte, Julia Garro, Jordi Soler, Juan Carlos González and Jordi Calabia

Nutrients 2022, 14(16), 3375; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14163375 - 17 Aug 2022

Cited by 5 | Viewed by 2558

Abstract

This cross-sectional study aims to explore the prevalence of protein-energy wasting (PEW) in dialysis patients in Catalonia, Spain, using a new and practical online tool which enables rapid calculation and comparison with other nutritional scores. Methods: A web tool (Nutrendial) was created to introduce different variables and automatically calculate PEW, Malnutrition inflammation Score (MIS) and Subjective Global Assessment (SGA) in 1389 patients (88% in haemodialysis (HD)), 12% in peritoneal dialysis (PD) from different regions of Catalonia. Results: A prevalence of 23.3% (26% HD, 10.2% PD) of PEW was found, with a mean MIS score of 6 and SGA score of C in 7% of the patients. ROC analysis showed MIS as the best nutritional score to diagnose PEW (AUC 0.85). Albumin delivered lower diagnostic precision (AUC 0.77) and sensitivity (66%). A cut off point of 7 (86% sensitivity and 75% specificity) for MIS and 3.7 mg/dL for albumin were found to predict the appearance of PEW in this population. SGA B or C showed an 87% sensitivity and 55% specificity to diagnose PEW. Very low nutritional intervention (14%) was recorded with this tool in patients with PEW. Conclusions: This new online tool facilitated the calculation of PEW, enabling different professionals—including nephrologists, dieticians and nurses—to efficiently obtain insights into the nutritional status of the Catalonian dialysis population and implement the required nutritional interventions. MIS is the score with more sensitivity to diagnose PEW. Full article

(This article belongs to the Special Issue The Impact of Nutrition Monitoring and Intervention on Quality of Life in of Chronic Kidney Disease Patients at Different Stage)

► Show Figures

Figure 1

10 pages, 1103 KiB

Open AccessArticle

Association of Abnormal Iron Status with the Occurrence and Prognosis of Peritoneal Dialysis-Related Peritonitis: A Longitudinal Data-Based 10-Year Retrospective Study

by Xiangwen Diao, Zhiwei Zheng, Chunyan Yi, Peiyi Cao, Hongjian Ye, Ruihua Liu, Jianxiong Lin, Wei Chen, Haiping Mao, Fengxian Huang and Xiao Yang

Nutrients 2022, 14(8), 1613; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14081613 - 13 Apr 2022

Cited by 2 | Viewed by 1938

Abstract

This retrospective study investigated the effect of iron status on peritonitis by analyzing longitudinal iron parameters in peritoneal dialysis (PD) patients. Patients who received PD at our center from 1 January 2006 to 31 December 2015 were included and followed up until 31 December 2017. According to the joint quartiles of baseline transferrin saturation and ferritin, iron status was categorized as reference iron status (RIS), absolute iron deficiency (AID), functional iron deficiency (FID), and high iron status (HIS). Generalized estimating equations and Cox regression models with time-dependent covariates were used. A total of 1258 PD patients were included; 752 (59.8%) were male, with a mean (±standard deviation) age of 47.4 (±14.9) years. During a median follow-up period of 35.5 (interquartile range, 18.4–60.0) months, 450 (34.3%) patients had 650 episodes of peritonitis. By analyzing longitudinal data, patients with AID were independently positively associated with the occurrence (adjusted odds ratio (AOR) = 1.45) and treatment failure of peritonitis (adjusted hazard ratio (AHR) = 1.85). Patients with HIS were positively associated with the treatment failure of peritonitis (AHR = 2.70). Longitudinal AID and HIS were associated with the episodes and poor prognosis of peritonitis. Active clinical monitoring and correction of iron imbalance in patients with PD are needed. Full article

(This article belongs to the Special Issue The Impact of Nutrition Monitoring and Intervention on Quality of Life in of Chronic Kidney Disease Patients at Different Stage)

► Show Figures

Figure 1

Review

Jump to: Research

11 pages, 296 KiB

Open AccessReview

Dietary Aspects and Drug-Related Side Effects in Autosomal Dominant Polycystic Kidney Disease Progression

by Borja Quiroga and Roser Torra

Nutrients 2022, 14(21), 4651; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14214651 - 03 Nov 2022

Cited by 1 | Viewed by 1701

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is the most commonly inherited kidney disease. In the absence of targeted therapies, it invariably progresses to advanced chronic kidney disease. To date, the only approved treatment is tolvaptan, a vasopressin V2 receptor antagonist that has been demonstrated to reduce cyst growth and attenuate the decline in kidney function. However, it has various side effects, the most frequent of which is aquaresis, leading to a significant discontinuation rate. The strategies proposed to combat aquaresis include the use of thiazides or metformin and a reduction in the dietary osmotic load. Beyond the prescription of tolvaptan, which is limited to those with a rapid and progressive decline in kidney function, dietary interventions have been suggested to protect against disease progression. Moderate sodium restriction, moderate protein intake (up to 0.8 g/kg/day), avoidance of being overweight, and increased water consumption are recommended in ADPKD guidelines, though all with low-grade evidence. The aim of the present review is to critically summarize the evidence on the effect of dietary modification on ADPKD and to offer some strategies to mitigate the adverse aquaretic effects of tolvaptan. Full article

(This article belongs to the Special Issue The Impact of Nutrition Monitoring and Intervention on Quality of Life in of Chronic Kidney Disease Patients at Different Stage)

15 pages, 660 KiB

Open AccessReview

Fibre Intake in Chronic Kidney Disease: What Fibre Should We Recommend?

by Secundino Cigarrán Guldris, Juan Antonio Latorre Catalá, Ana Sanjurjo Amado, Nicolás Menéndez Granados and Eva Piñeiro Varela

Nutrients 2022, 14(20), 4419; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14204419 - 21 Oct 2022

Cited by 8 | Viewed by 2930

Abstract

Chronic kidney disease (CKD) is a major global health problem that challenges all patients’ healthcare needs. Fibre consumption benefits kidney patients by acting preventively on associated risk factors, improving intestinal microbiota composition or reducing metabolic acidosis and inflammation. In this review, we focus on increasing fibre consumption and the quality of fibre to recommend, in addition to increasing the consumption of foods that naturally have it in their design, that can resort to fortified foods or fibre supplements. The Western nutritional practice, which is low in fibre and rich in animal proteins, saturated fats, sodium, and sugar, increases the risk of mortality in these patients. On the contrary, patterns with higher consumption of fibre and vegetable proteins, such as the Mediterranean, vegetarian, or Plant dominant low protein diet (PLADO), seem to have a preventive effect on the associated risk factors and influence CKD progression. Until now, the use of fibre supplements has not achieved an evident impact on clinical results. Fibre-rich foods contain other nutrients that reduce cardiovascular risk. Promoting diets richer in vegetables and guaranteeing adequate energy and protein intake is a challenge for the multidisciplinary teams involved in the standard of care for CKD. Full article

(This article belongs to the Special Issue The Impact of Nutrition Monitoring and Intervention on Quality of Life in of Chronic Kidney Disease Patients at Different Stage)

► Show Figures