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Dietary Interventions in Chronic Kidney Disease

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

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 16806

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Special Issue Editor

Dr. Ion Alexandru Bobulescu

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Guest Editor

Department of Cell Biology and Biochemistry, Texas Tech University Health Sciences Center, Lubbock, TX 79409, USA
Interests: molecular mechanisms of kidney injury and chronic kidney disease; role of iron in kidney disease; renal lipid metabolism and lipotoxicity; gut microbiota and the kidney; proximal tubule ion transport; renal handling and (patho)physiologic roles of uric acid

Special Issue Information

Dear Colleagues,

Chronic kidney disease (CKD) affects approximately one in every ten people worldwide, and is the cause of death for millions across the globe each year. In spite of major advances over the past decades, the mechanisms that contribute to the onset and progression of CKD remain incompletely understood, and our armamentarium of therapies for CKD patients remains relatively limited.

Because of its unique role in waste product excretion and whole-body fluid, mineral and acid-base homeostasis, the normal kidney is exquisitely sensitive and responsive to changes in dietary composition. The onset and progression of CKD add layers of complexity to the interplay between diet and the kidney, and there is mounting evidence that patients with CKD may benefit from dietary modifications aimed at improving symptoms, slowing progression, and preventing complications. However, there is still no consensus about optimal strategies for dietary intervention in CKD, taking into consideration each patient’s genetic, clinical, environmental, and sociodemographic characteristics.

In this Special Issue of Nutrients, we invite contributions dealing with various aspects of nutrition and dietary interventions in patients with CKD, including – but not limited to – papers on dietary phosphorus, sodium, potassium, acid-base, and protein intake. We welcome original research articles (clinical, translational or basic research), as well as meta-analyses and reviews.

Dr. Ion Alexandru Bobulescu
Guest Editor

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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

chronic kidney disease
dietary phosphorus
dietary potassium
dietary sodium
dietary protein

Published Papers (3 papers)

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Research

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12 pages, 1551 KiB

Open AccessArticle

Advanced Chronic Kidney Disease with Low and Very Low GFR: Can a Low-Protein Diet Supplemented with Ketoanalogues Delay Dialysis?

by Chieh-Li Yen, Pei-Chun Fan, Cheng-Chia Lee, George Kuo, Kun-Hua Tu, Jia-Jin Chen, Tao-Han Lee, Hsiang-Hao Hsu, Ya-Chun Tian and Chih-Hsiang Chang

Nutrients 2020, 12(11), 3358; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12113358 - 31 Oct 2020

Cited by 8 | Viewed by 3662

Abstract

Background: Previous studies have demonstrated that dietary therapy can delay the initiation of dialysis, but little research has investigated whether patients with very poor renal function would benefit from a dietary therapy. Methods: This study was performed by using the Chang Gung Research Database (CGRD), which is based on the largest medical system in Taiwan. Patients with estimated glomerular filtration rates (eGFR) < 15 mL/min/1.73 m² between 2001 and 2015 with more than 3 months of low-protein diet supplemented with ketoanalogues (sLPD) were extracted (Ketosteril group). We then assigned five patients without any sLPD to match one patient of the Ketosteril group (comparison group). Both groups were followed up for 1 year for the initiation of dialysis and rates of major adverse cardiac and cerebrovascular events (MACCEs). Results: The Ketosteril group (n = 547), compared with the comparison group (n = 2735), exhibited a lower incidence of new-onset dialysis (40.2% vs. 44.4%, subdistribution hazard ratio (SHR): 0.80, 95% confidence interval (CI): 0.70–0.91) and MACCEs (3.7% vs. 5.9%, HR: 0.61, 95% CI: 0.38–0.97). The beneficial effect of an sLPD did not differ in patients with a baseline eGFR < 5 mL/min/1.73 m². Conclusion: Even among patients with extremely low eGFR, sLPD treatment can safely delay the need for dialysis. Full article

(This article belongs to the Special Issue Dietary Interventions in Chronic Kidney Disease)

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11 pages, 1163 KiB

Open AccessArticle

Risk Reduction for End-Stage Renal Disease by Dietary Guidance Using the Gustatory Threshold Test for Salty Taste

by Yuki Ota, Mineaki Kitamura, Kiyokazu Tsuji, Kenta Torigoe, Ayuko Yamashita, Shinichi Abe, Kumiko Muta, Tadashi Uramatsu, Yoko Obata, Junya Furutani, Miwa Takashima, Hiroshi Mukae and Tomoya Nishino

Nutrients 2020, 12(9), 2703; https://0-doi-org.brum.beds.ac.uk/10.3390/nu12092703 - 04 Sep 2020

Cited by 3 | Viewed by 2133

Abstract

Educational hospitalization of patients with chronic kidney disease (CKD) may slow the progression of renal dysfunction. However, the educational aspect that is more effective has not been identified to date. In this study, patients with CKD were evaluated for gustatory threshold for salty taste and received augmented salt reduction guidance under educational hospitalization at Nagasaki University Hospital from October 2016. In total, 277 eligible patients were enrolled and hospitalized from 2012 to 2019 (mean age of 69.2 years; men comprised 62.1%). We compared 141 patients (Group A) who were educated in the hospital after October 2016 and 136 patients (Group B) who received standard education in the hospital before October 2016. The changes in the estimated glomerular filtration rate (ΔeGFR) after hospitalization and dialysis induction rate within one year after hospitalization were evaluated. The ΔeGFR was significantly improved in Group A compared to Group B (A: 1.05 mL/min/1.73 m²/month, B: 0.55 mL/min/1.73 m²/month; p = 0.02). The dialysis induction rate was significantly lower in Group A than in Group B (A: 8.5%, B: 15.5%; p = 0.001). These trends were also observed by multivariate analyses. In conclusion, educational hospitalization with enhanced salt reduction guidance may reduce the risk of end-stage renal disease. Full article

(This article belongs to the Special Issue Dietary Interventions in Chronic Kidney Disease)

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Review

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17 pages, 1067 KiB

Open AccessReview

Eat Your Broccoli: Oxidative Stress, NRF2, and Sulforaphane in Chronic Kidney Disease

by Scott E. Liebman and Thu H. Le

Nutrients 2021, 13(1), 266; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13010266 - 18 Jan 2021

Cited by 30 | Viewed by 10295

Abstract

The mainstay of therapy for chronic kidney disease is control of blood pressure and proteinuria through the use of angiotensin-converting enzyme inhibitors (ACE-Is) or angiotensin receptor blockers (ARBs) that were introduced more than 20 years ago. Yet, many chronic kidney disease (CKD) patients still progress to end-stage kidney disease—the ultimate in failed prevention. While increased oxidative stress is a major molecular underpinning of CKD progression, no treatment modality specifically targeting oxidative stress has been established clinically. Here, we review the influence of oxidative stress in CKD, and discuss regarding the role of the Nrf2 pathway in kidney disease from studies using genetic and pharmacologic approaches in animal models and clinical trials. We will then focus on the promising therapeutic potential of sulforaphane, an isothiocyanate derived from cruciferous vegetables that has garnered significant attention over the past decade for its potent Nrf2-activating effect, and implications for precision medicine. Full article

(This article belongs to the Special Issue Dietary Interventions in Chronic Kidney Disease)

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