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Eating Habits and Chronic Kidney Disease: Epidemiological and Interventional Aspects

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

Deadline for manuscript submissions: closed (25 May 2023) | Viewed by 15142

Special Issue Editor


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Guest Editor
1. Nephrol Unit, University of Milan, Via Commenda 15, I-20122 Milan, Italy
2. Fdn IRCCS Ca Granda Osped Maggiore Policlin Milan, Nephrol Dialysis & Renal Transplant Unit, Via Commenda 15, I-20122 Milan, Italy
Interests: chronic kidney disease; renal transplantation; nutrition; low-protein diet; micronutrients
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Special Issue Information

Dear Colleagues,

Dietary habits are influenced by geographical, ethnic, socio-cultural, and economic factors. In recent decades, we have accumulated a growing body of epidemiological evidence of the possible relationships between dietary habits and a wide range of acute and chronic non-communicable diseases, including most chronic kidney diseases (CKDs).

The multifaced interplay between dietary habits and CKDs includes (but is not limited to) a too high or too low intake of one or more of the usual nutritive components, including water and salts; excessive consumption of products containing sweeteners, dyes and preservatives; the continued consumption of herbal products; unjustified use of vitamin supplements and/or elementary nutritional products, etc.

Nephrologists are used to intervening in the advanced stages of CKD to adjust the intake of critical dietary components (animal proteins, salt) due to reduced kidney function.

However, given the growing interest in the preventive aspects and early correction of eating habits in the context of CKD, we considered it useful to start with a Special Issue of Nutrients that could consider both the epidemiological aspects, highlighting the relationship between eating habits and CKD, and possible experiences of preventive or therapeutic intervention in a clinical context.

Prof. Dr. Piergiorgio Messa
Guest Editor

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Keywords

  • dietary habit
  • chronic kidney disease
  • prevention
  • dietary supplements
  • epidemiology

Published Papers (5 papers)

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Research

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11 pages, 1609 KiB  
Article
Serum Anti-Aging Protein α-Klotho Mediates the Association between Diet Quality and Kidney Function
by Qingqing Cai, Shixian Hu, Cancan Qi, Jiawei Yin, Shulan Xu, Fan Fan Hou and An Li
Nutrients 2023, 15(12), 2744; https://doi.org/10.3390/nu15122744 - 14 Jun 2023
Cited by 2 | Viewed by 1840
Abstract
Adherence to healthy dietary patterns is associated with a reduced risk of kidney dysfunction. Nevertheless, the age-related mechanisms that underpin the relationship between diet and kidney function remain undetermined. This study aimed to investigate the mediating role of serum α-Klotho, an anti-aging protein, [...] Read more.
Adherence to healthy dietary patterns is associated with a reduced risk of kidney dysfunction. Nevertheless, the age-related mechanisms that underpin the relationship between diet and kidney function remain undetermined. This study aimed to investigate the mediating role of serum α-Klotho, an anti-aging protein, in the link between a healthy diet and kidney function. A cross-sectional study was conducted on a cohort of 12,817 individuals aged between 40 and 79 years who participated in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016. For each participant, the Healthy Eating Index 2015 (HEI-2015) score was calculated as a measure of a healthy dietary pattern. Creatinine-based estimated glomerular filtration rate (eGFR) was used to assess kidney function. Multivariable regression models were used to analyze the association between the standardized HEI-2015 score and eGFR after adjusting for potential confounders. Causal mediation analysis was performed to assess whether serum α-Klotho influenced this association. The mean (±SD) eGFR of all individuals was 86.8 ± 19.8 mL/min per 1.73 m2. A high standardized HEI-2015 score was associated with a high eGFR (β [95% CI], 0.94 [0.64–1.23]; p < 0.001). The mediation analysis revealed that serum α-Klotho accounted for 5.6–10.5% of the association of standardized overall HEI-2015 score, total fruits, whole fruits, greens and beans, and whole grain with eGFR in the NHANES. According to the results from the subgroup analysis, serum α-Klotho exerted a mediating effect in the participants aged 60–79 years and in males. A healthy diet may promote kidney function by up-regulating serum anti-aging α-Klotho. This novel pathway suggests important implications for dietary recommendations and kidney health. Full article
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12 pages, 1451 KiB  
Article
Association between Consumption of Dietary Supplements and Chronic Kidney Disease Prevalence: Results of the Korean Nationwide Population-Based Survey
by Yina Fang, Hwasun Lee, Serhim Son, Sewon Oh, Sang-Kyung Jo, Wonyong Cho and Myung-Gyu Kim
Nutrients 2023, 15(4), 822; https://doi.org/10.3390/nu15040822 - 05 Feb 2023
Cited by 2 | Viewed by 4056
Abstract
Despite the enormous global market of dietary supplements, the impact of dietary supplements on kidney disease is still unclear. Based on the National Health and Nutrition Examination Survey from 2015 to 2017, this study evaluated the association between dietary supplement and chronic kidney [...] Read more.
Despite the enormous global market of dietary supplements, the impact of dietary supplements on kidney disease is still unclear. Based on the National Health and Nutrition Examination Survey from 2015 to 2017, this study evaluated the association between dietary supplement and chronic kidney disease (CKD) in 13,271 Korean adults. Among the dietary supplements, vitamin and mineral intake was the highest at 61.41%, followed by omega-3 fatty acids at 11.85%, and ginseng at 7.99%. The prevalence of CKD was significantly higher in those who consumed amino acids and proteins, ginseng and red ginseng, and herbal medicine (plant extract)-berries than in those who did not. Conversely, patients who consumed probiotic supplements had a significantly lower prevalence of CKD than those who did not. In the population without CKD risk factors or history of CKD, the prevalence of CKD was high in the group consuming ginseng and red ginseng. After adjusting for covariates, the herbal medicine (plant extract)-berry group showed an independent association with CKD incidence. In conclusion, it is suggested that dietary supplements may affect kidney function. Further large-scale cohort studies are required to elucidate the exact effects of each dietary supplement on CKD. Full article
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Review

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15 pages, 1971 KiB  
Review
Vitamin D and Calcium Supplementation and Urolithiasis: A Controversial and Multifaceted Relationship
by Piergiorgio Messa, Giuseppe Castellano, Simone Vettoretti, Carlo Maria Alfieri, Domenico Giannese, Vincenzo Panichi and Adamasco Cupisti
Nutrients 2023, 15(7), 1724; https://doi.org/10.3390/nu15071724 - 31 Mar 2023
Cited by 2 | Viewed by 3454
Abstract
Patients with urolithiasis, and particularly those with hypercalciuria, frequently have a marked reduction of bone mineral content up to the levels of osteoporosis, with a significant increase in bone fracture risk. For these reasons, the indication to prescribe vitamin D and/or calcium supplementations [...] Read more.
Patients with urolithiasis, and particularly those with hypercalciuria, frequently have a marked reduction of bone mineral content up to the levels of osteoporosis, with a significant increase in bone fracture risk. For these reasons, the indication to prescribe vitamin D and/or calcium supplementations is very frequent in such patients. On the other hand, both calcium supplementation, and even more vitamin D therapy, can worsen the risk of developing urolithiasis by increasing calcium, phosphate, and oxalate urinary excretion. Despite the clinical and practical relevance of this issue, the evidence on this topic is scarce and contradictory. Therefore, some concerns exist about how and whether to prescribe such supplements to a patient with a history of kidney stones. In this narrative review, we resume some pivotal pathophysiological concepts strictly related to the dealt topic, and we draw some considerations and personal opinions on the pros and cons of such prescriptions. Finally, we share with the reader our pragmatic algorithm for handling the urolithiasis risk in patients who have strong indications to be prescribed vitamin D and calcium supplementations. Full article
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15 pages, 484 KiB  
Review
Unravelling the Complex Relationship between Diet and Nephrolithiasis: The Role of Nutrigenomics and Nutrigenetics
by Viola D’Ambrosio, Pietro Manuel Ferraro, Gianmarco Lombardi, Simonetta Friso and Giovanni Gambaro
Nutrients 2022, 14(23), 4961; https://doi.org/10.3390/nu14234961 - 23 Nov 2022
Cited by 6 | Viewed by 2550
Abstract
Nephrolithiasis is an increasingly prevalent condition, especially in high income countries, and is associated with high morbidity. Extraordinary progress in genetics made the identification of genetic forms of nephrolithiasis possible. These genetic diseases are usually rare and do not account for the most [...] Read more.
Nephrolithiasis is an increasingly prevalent condition, especially in high income countries, and is associated with high morbidity. Extraordinary progress in genetics made the identification of genetic forms of nephrolithiasis possible. These genetic diseases are usually rare and do not account for the most common forms of nephrolithiasis that are the result of several factors such as environment, dietary habits, and predisposing genes. This knowledge has shaped what we classify as nephrolithiasis, a condition that is now recognized as systemic. How and to what extent all these factors interact with one another and end in kidney stone formation, growth, and recurrence is not completely understood. Two new research fields have recently been trying to give some answers: nutrigenomics and nutrigenetics. These fields have the aim of understanding the intricate diet/genome interface that influences gene expression regulation mainly through epigenetic mechanisms and results in specific medical conditions such as cancer, metabolic syndrome, and cardiovascular diseases. Epigenetics seems to play a crucial role and could represent the link between environmental factors, that we are constantly exposed to, and risk factors for nephrolithiasis. In this systematic review, we summarize all the available evidence of proven or hypothesized epigenetic mechanisms related to nephrolithiasis. Full article
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Other

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10 pages, 753 KiB  
Concept Paper
Mediterranean Dietary Pattern Adjusted for CKD Patients: The MedRen Diet
by Claudia D’Alessandro, Domenico Giannese, Vincenzo Panichi and Adamasco Cupisti
Nutrients 2023, 15(5), 1256; https://doi.org/10.3390/nu15051256 - 02 Mar 2023
Cited by 3 | Viewed by 2774
Abstract
A number of studies in the general population showed that healthy dietary patterns, such as the Mediterranean Diet, can improve or prevent the development of several chronic diseases and are associated with a significant reduction in all-cause and cardiovascular mortality. The Mediterranean diet [...] Read more.
A number of studies in the general population showed that healthy dietary patterns, such as the Mediterranean Diet, can improve or prevent the development of several chronic diseases and are associated with a significant reduction in all-cause and cardiovascular mortality. The Mediterranean diet may also have favorable effects for the prevention of chronic kidney disease (CKD), but no evidence of renoprotection exists in CKD patients. The Mediterranean Renal (MedRen) diet is an adaptation of the Mediterranean diet recommendations comprising a quantitative reduction in the RDA values of protein, salt and phosphate intake for the general population. Hence, MedRen supplies 0.8 g/Kg of protein, 6 g of salt and less than 800 mg of phosphate daily. Obviously, there is a preference for products of plant origin, which contain more alkali, fibers, unsaturated fatty acids than animal-based food. The MedRen diet can be implemented easily in mild-to-moderate stages of CKD with good results, both in terms of adherence to prescriptions and metabolic compensation. In our opinion, it should be the first step of CKD stage 3 nutritional management. This paper describes the features and reports our experience in the implementation of the MedRen diet as an early nutritional approach to CKD. Full article
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