Blog
About
Search
Advanced search

0
views
45
references
 Top references
7
cited by
 Most cited
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
1 collections
    0
    shares
      182
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found

      Nutritional Therapy, Phosphate Control and Renal Protection

      Author(s): a , b , *

      Publication date (Electronic):

      Journal: Nephron Clinical Practice

      Publisher: S. Karger AG

      Keywords: Chronic kidney disease, Phosphate, Nutrition

      Read this article at

      ScienceOpenPublisherPubMed
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Dietary management of chronic kidney disease (CKD) focusses on limiting the intake of substances that might accumulate to toxic levels (such as potassium, phosphorus or salt) and, although still a matter of debate for some, restricting dietary protein to retard kidney damage. Recent evidence brings the opportunity to revisit the role of a healthy diet on disease progression and on some of the cardiometabolic complications of moderate/advanced CKD, such as inflammation or oxidative stress control. This review provides a brief overview of dietary strategies that delay CKD progression and CKD complications, and discusses currently limited data addressing the development of malnutrition and protein-energy wasting before dialysis initiation.

          Related collections

          Most cited references 45

          • Record: found
          • Abstract: not found
          • Article: not found

          Guidelines for the management of chronic kidney disease.

           Philip McFarlane,  Adeera Levin,  Peter Senior … (2008)
          Article 0 comments Cited 88 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Vegetarian compared with meat dietary protein source and phosphorus homeostasis in chronic kidney disease.

             Sharon Moe,  Miriam P Zidehsarai,  Mary Chambers … (2011)
            Patients with advanced chronic kidney disease (CKD) are in positive phosphorus balance, but phosphorus levels are maintained in the normal range through phosphaturia induced by increases in fibroblast growth factor-23 (FGF23) and parathyroid hormone (PTH). This provides the rationale for recommendations to restrict dietary phosphate intake to 800 mg/d. However, the protein source of the phosphate may also be important. We conducted a crossover trial in nine patients with a mean estimated GFR of 32 ml/min to directly compare vegetarian and meat diets with equivalent nutrients prepared by clinical research staff. During the last 24 hours of each 7-day diet period, subjects were hospitalized in a research center and urine and blood were frequently monitored. The results indicated that 1 week of a vegetarian diet led to lower serum phosphorus levels and decreased FGF23 levels. The inpatient stay demonstrated similar diurnal variation for blood phosphorus, calcium, PTH, and urine fractional excretion of phosphorus but significant differences between the vegetarian and meat diets. Finally, the 24-hour fractional excretion of phosphorus was highly correlated to a 2-hour fasting urine collection for the vegetarian diet but not the meat diet. In summary, this study demonstrates that the source of protein has a significant effect on phosphorus homeostasis in patients with CKD. Therefore, dietary counseling of patients with CKD must include information on not only the amount of phosphate but also the source of protein from which the phosphate derives.
            Article 0 comments Cited 86 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Timing of onset of CKD-related metabolic complications.

               Bruno Fouqueray,  Cédric Gauci,  Jean-Philippe Haymann … (2008)
              Chronic kidney disease (CKD) guidelines recommend evaluating patients with GFR <60 ml/min per 1.73 m(2) for complications, but little evidence supports the use of a single GFR threshold for all metabolic disorders. We used data from the NephroTest cohort, including 1038 adult patients who had stages 2 through 5 CKD and were not on dialysis, to study the occurrence of metabolic complications. GFR was measured using renal clearance of (51)Cr-EDTA (mGFR) and estimated using two equations derived from the Modification of Diet in Renal Disease study. As mGFR decreased from 60 to 90 to <20 ml/min per 1.73 m(2), the prevalence of hyperparathyroidism increased from 17 to 85%, anemia from 8 to 41%, hyperphosphatemia from 1 to 30%, metabolic acidosis from 2 to 39%, and hyperkalemia from 2 to 42%. Factors most strongly associated with metabolic complications, independent of mGFR, were younger age for acidosis and hyperphosphatemia, presence of diabetes for acidosis, diabetic kidney disease for anemia, and both male gender and the use of inhibitors of the renin-angiotensin system for hyperkalemia. mGFR thresholds for detecting complications with 90% sensitivity were 50, 44, 40, 39, and 37 ml/min per 1.73 m(2) for hyperparathyroidism, anemia, acidosis, hyperkalemia, and hyperphosphatemia, respectively. Analysis using estimated GFR produced similar results. In summary, this study describes the onset of CKD-related complications at different levels of GFR; anemia and hyperparathyroidism occur earlier than acidosis, hyperkalemia, and hyperphosphatemia.
              Article 0 comments Cited 83 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Journal
                Journal ID (publisher-id): NEC
                Journal ID (nlm-ta): Nephron Clin Pract
                Journal ID (doi): 10.1159/issn.1660-2110
                Title: Nephron Clinical Practice
                Publisher: S. Karger AG
                ISSN (Electronic): 1660-2110
                Publication date Subscription-year: 2014
                Publication date (Print): April 2014
                Publication date (Electronic): 11 January 2014
                Volume: 126
                Issue: 1
                Pages: 1-7
                Affiliations
                aDivision of Nephrology and Center for Molecular Medicine, Karolinska Institute, Stockholm, Sweden; bDepartment of Health Sciences, Renal Division, San Paolo Hospital, University of Milan, Milan, Italy
                Author notes
                *Mario Cozzolino, MD, PhD, Renal Division and Laboratory of Experimental Nephrology, Dipartimento di Scienze della Salute, Università di Milano, Via A. di Rudinì 8, IT-20142 Milan (Italy), E-Mail mario.cozzolino@unimi.it
                Article
                Publisher ID: 357679 Other ID: Nephron Clin Pract 2014;126:1-7
                DOI: 10.1159/000357679
                PubMed ID: 24434650
                Copyright statement: © 2014 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Pages: 7
                Product
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/357679
                Categories
                Subject: Minireview

                Data availability:

                ScienceOpen disciplines: Cardiovascular Medicine, Nephrology

                Keywords: Nutrition, Phosphate, Chronic kidney disease

                Comments

                Comment on this article

                Similar content 182

                See all similar

                Cited by 7

                See all cited by

                Most referenced authors 1,063

                See all reference authors