scholarly journals Dietary Protein, Kidney Function and Mortality: Review of the Evidence from Epidemiological Studies

Nutrients ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 196 ◽  
Author(s):  
Giancarlo Bilancio ◽  
Pierpaolo Cavallo ◽  
Carolina Ciacci ◽  
Massimo Cirillo
Keyword(s):  
Kidney Function ◽  
Protein Intake ◽  
Substantial Reduction ◽  
Epidemiological Studies ◽  
World Health ◽  
Normal Kidney ◽  
Ideal Weight ◽  
Normal Kidney Function ◽  
Kidney Function Decline

The World Health Organization recommends a minimum requirement of 0.8 g/day protein/kg ideal weight. Low protein diets are used against kidney failure progression. Efficacy and safety of these diets are uncertain. This paper reviews epidemiological studies about associations of protein intake with kidney function decline and mortality. Three studies investigated these associations; two reported data on mortality. Protein intake averaged >60 g/day and 1.2 g/day/kg ideal weight. An association of baseline protein intake with long-term kidney function decline was absent in the general population and/or persons with normal kidney function but was significantly positive in persons with below-normal kidney function. Independent of kidney function and other confounders, a J-curve relationship was found between baseline protein intake and mortality due to ≈35% mortality excess for non-cardiovascular disease in the lowest quintile of protein intake, a quintile where protein intake averaged <0.8 g/day/kg ideal weight. Altogether, epidemiological evidence suggests that, in patients with reduced kidney function, protein intakes of ≈0.8 g/d/kg ideal weight could limit kidney function decline without adding non-renal risks. Long-term lower protein intake could increase mortality. In most patients, an intake of ≈0.8 g/day/kg would represent a substantial reduction of habitual intake considering that average intake is largely higher.

scholarly journals Osteoporosis after heart transplantation with reference to immunosuppression and renal function

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
E L Lofdahl ◽  
G R Radegran
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Heart Transplantation ◽  
Immunosuppressive Therapy ◽  
Kidney Function ◽  
Normal Kidney ◽  
Normal Kidney Function ◽  
Ckd Stage ◽  
Negative Predictor

Abstract Background Osteoporosis is commonly found in heart transplantation (HT) recipients, and may develop as an adverse effect of the immunosuppressive therapy, as well as be a consequence of factors associated with heart failure prior to HT. Chronic kidney disease (CKD) is furthermore, like osteoporosis, frequently found in the HT patient population, and may also arise as a side-effect of the immunosuppressive therapy. Aims and method We sought to describe the bone mineral density (BMD) evolution, predictors of osteoporosis, and survival, as well as incidence of osteoporosis in relation to CKD up to 10 years after HT. The project was conducted as a retrospective cohort study including patients who underwent HT at an age of at least 20 years between January 1988 and June 2016 at our center. The project was approved by the local ethics board (approval nos. 2010/114, 2011/777, 2014/92). Results Pre-transplant BMD was a negative predictor of osteoporosis during the first post-operative year, with a HR of 0.13 (95% CI 0.063; 0.26; P&lt;0.001) and 0.54 (95% CI 0.34; 0.85; P&lt;0.001) in the lumbar spine and femoral neck, respectively, adjusted for age, gender, BMI, and immunosuppressive therapy. Similarly, pre-transplant BMD was a negative predictor of osteoporosis also up to 10 years after HT, with a HR of 0.19 (95% CI 0.11; 0.32; P&lt;0.001) and 0.55 (95% CI 0.39; 0.78; P=0.001), in the lumbar spine and femoral neck, respectively, adjusted for age, gender, BMI, and immunosuppressive therapy. CKD stage 3 or worse before HT was associated with a greater gain in BMD after HT compared with CKD stage less than 3 or normal kidney function (−2.5% [−5.6; 0.6] versus −6.6% [−8.8;-4.5], P=0.029), and was not associated with osteoporosis (Figure 1). Also, the cumulative incidence of osteoporosis in the lumbar spine after HT was higher in the group with CKD stage less than 3 or normal kidney function. Conclusions The greatest drop in BMD occurs within the first year after HT. Short- and long-term incidence of osteoporosis is positively associated with pre-transplant bone strength, suggesting that early initiation of osteoporosis preventive treatment, pharmacologically and non-pharmacologically, may be beneficial in preventing long- and short-term fracture-related morbidity and morbidity after HT. Moreover, CKD stage 3 or worse before HT was associated with higher lumbar BMD after HT, and was not a predictor of osteoporosis. CKD stage less than 3 or normal kidney function before HT exhibited a greater BMD loss in the lumbar spine. Finally, the change in GFR during the first postoperative year was not associated with long-term BMD loss or osteoporosis. FUNDunding Acknowledgement Type of funding sources: Foundation. Main funding source(s): Anna-Lisa & Sven-Erik Lundgren's Foundation and ALF's Foundations, Lund, Sweden Figure 1

scholarly journals Social Isolation Is Associated With Rapid Kidney Function Decline and the Development of Chronic Kidney Diseases in Middle-Aged and Elderly Adults: Findings From the China Health and Retirement Longitudinal Study (CHARLS)

2021 ◽  
Vol 8 ◽  
Author(s):  
Weiran Zhou ◽  
Yang Li ◽  
Yichun Ning ◽  
Shaomin Gong ◽  
Nana Song ◽  
...  
Keyword(s):  
Renal Function ◽  
Longitudinal Study ◽  
Kidney Function ◽  
Social Isolation ◽  
Secondary Outcome ◽  
Rapid Decline ◽  
Normal Kidney ◽  
Middle Aged ◽  
Normal Kidney Function ◽  
Kidney Function Decline

Background: There is limited evidence on the relationship between social isolation and renal outcomes. To address this gap, this study estimated the prospective relationship of social isolation with rapid kidney function decline and the development of chronic kidney disease (CKD) in middle-aged and elderly Chinese with normal kidney function.Methods: We analyzed data from 3,031 participants aged ≥ 45 years with baseline estimated glomerular filtration rates (eGFR) ≥ 60 ml/min/1.73 m2. All data were obtained from the 2011 and 2015 waves of the Chinese Longitudinal Study of Health and Retirement (CHARLS). eGFR was estimated based on a combination of serum creatinine and cystatin C. The primary outcome was rapid decline in renal function, as defined by an eGFR decrease of &gt; 5 ml/min/1.73 m2 per year, while the secondary outcome was the development of CKD, as defined by an eGFR decrease to a level &lt; 60 ml/min/1.73 m2.Results: During the follow-up of 4 years, 258 (8.5%) participants experienced a rapid decline in renal function, while 87 (2.9%) developed CKD. In the fully adjusted model, high social isolation was significantly related to an increased risk of experiencing a rapid decline in renal function (OR 1.805, 95% CI 1.310–2.487) and CKD onset (OR 1.842, 95% CI 1.084–3.129). Among the five components of social isolation, being unmarried, not participating in social activities, and living alone independently predicted declined renal function.Conclusions: Social isolation is significantly associated with the risk of rapid eGFR decline and CKD onset in middle-aged and older adults with normal kidney function in China.

scholarly journals Early relapse rate determines further relapse risk: results of a 5-year follow-up study on pediatric CFH-Ab HUS

2020 ◽  
Author(s):  
Johannes Hofer ◽  
Magdalena Riedl Khursigara ◽  
Markus Perl ◽  
Thomas Giner ◽  
Alejandra Rosales ◽  
...  
Keyword(s):  
Kidney Function ◽  
Disease Onset ◽  
Factor H ◽  
Complement Factor ◽  
Normal Kidney ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Normal Kidney Function

Abstract Background The complement factor H antibody (CFH-Ab)–associated hemolytic uremic syndrome (HUS) forms a distinct subgroup within the complement-mediated HUS disease spectrum. The autoimmune nature of this HUS subgroup implies the potential benefit of a targeted immunosuppressive therapy. Data on long-term outcome are scarce. Methods This observational study evaluates the clinical outcome of 19 pediatric CFH-Ab HUS patients from disease onset until their 5-year follow-up. Results All but one relapse occurred during the first 2 years, and patients who had no relapse within the first 6 months were relapse-free until the end of the observation period. Kidney function at disease onset determines long-term kidney function: all individuals with normal kidney function at disease onset had normal kidney function after 5 years, and all patients with reduced kidney function at onset had impaired kidney function at the last follow-up. Level of CFH-Ab titer at disease onset was not correlated with a higher risk of recurrences or worse long-term outcome after 5 years. Resolution of CFH-Ab titers after 5 years was common. Conclusions CFH-Ab HUS patients have a varied overall long-term course. Early relapses are common, making close surveillance during the first years essential, regardless of the initial CFH-Ab titer.

2104-P: Serum Phosphorus Levels Are Associated with the Metabolic Syndrome and Adiponectin Levels in Nondiabetic Women with Normal Kidney Function

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 2104-P
Author(s):  
YUKA NATSUKI ◽  
TOMOAKI MORIOKA ◽  
YOSHINORI KAKUTANI ◽  
YUKO YAMAZAKI ◽  
MASAFUMI KURAJOH ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Kidney Function ◽  
Serum Phosphorus ◽  
Normal Kidney ◽  
Normal Kidney Function ◽  
The Metabolic Syndrome ◽  
Phosphorus Levels

scholarly journals Correlation between Serum Calcium and Phosphate with Coronary Artery Calcium Scores on Cardiac MSCT Examination

2019 ◽  
Vol 15 (2) ◽  
pp. 120
Author(s):  
Rosita Kai ◽  
Bachtiar Murtala ◽  
Andi Alfian Zainuddin ◽  
Muzakkir Amin ◽  
Muhammad Ilyas
Keyword(s):  
Coronary Artery ◽  
Kidney Function ◽  
Serum Calcium ◽  
Coronary Artery Calcium ◽  
Cross Sectional Study ◽  
Serum Phosphate ◽  
Normal Kidney ◽  
Cross Sectional ◽  
Normal Kidney Function ◽  
The Relationship

Increased serum calcium and phosphate associated with cardiovascular disease in patients with chronic kidney disease, but research on the relationship between coronary artery calcium scores with serum calcium and phosphate in individuals with normal kidney function is lacking. We explore the relationship of serum calcium and phosphate levels with coronary atherosclerosis as assessed by cardiac Multislice Computed Tomography (MSCT) in individuals with normal kidney function. This study aims to assess the correlation of calcium level scores on cardiac MSCT examination with serum calcium and phosphate levels, and assess the association with risk factors for coronary heart disease. This study was a cross-sectional study of 40 subjects who underwent cardiac MSCT examination with normal kidney function, at RSUP Dr. Wahidin Sudirohusodo Makassar during the March-July 2019 period. The results showed an correlation between coronary artery calcium scores with calcium and serum phosphate (serum calcium r = 0.67, serum phosphate r = 0.53, p <0.05).

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