A Review of Dietary Intake Studies in Maintenance Dialysis Patients
Protein-energy wasting affects many maintenance dialysis patients (MDPs) and decreases survival. Suboptimal dietary energy intake (DEI) and dietary protein intake (DPI), secondary to reduced dietary intake (DI), are important risk factors in the development of protein-energy wasting. Multiple investigations of DEI and DPI in MDPs have occurred but few authors have synthesized these data. A comprehensive review of DI studies in MDPs was completed with the purpose of providing timely data on DI in MDPs until updated clinical practice guidelines for nutrition in nephrology care are published. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - January 13, 2015 Category: Urology & Nephrology Authors: Mona Therrien, Laura Byham-Gray, Judith Beto Tags: Review Article Source Type: research

Diabetic Nephropathy and Proximal Tubular Damage
Diabetic nephropathy (DN) is a major cause of uremia in developed societies. Inflammation is emerging as an important mechanism for its pathogenesis and progression. Herein, we review 4 recently described cellular receptors that have been shown to mediate diabetic interstitial kidney disease. Peroxisome proliferator-activated receptor-γ attenuates STAT-1 activation and has shown promise in renoprotection. Its clinical utility is limited mainly by fluid retention through upregulation of sodium–hydrogen exchanger-3 and aquaporin-1 channels in the proximal tubule. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - January 8, 2015 Category: Urology & Nephrology Authors: Sydney C.W. Tang, Wai Han Yiu, Miao Lin, Kar Neng Lai Tags: ICURT PROCEEDINGS Source Type: research

Analysis of Different Thermal Processing Methods of Foodstuffs to Optimize Protein, Calcium, and Phosphorus Content for Dialysis Patients
To analyze how different thermal processing methods affect the protein, calcium, and phosphorus content of hospital food served to dialysis patients and to generate recommendations for preparing menus that optimize nutritional content while minimizing the risk of hyperphosphatemia. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - January 8, 2015 Category: Urology & Nephrology Authors: Ivica Vrdoljak, Ines Panjkota Krbavčić, Martina Bituh, Tea Vrdoljak, Zoran Dujmić Tags: Original Research Source Type: research

Food Intake Assessment of Elderly Patients on Hemodialysis
To investigate whether the dietary intake of elderly patients on hemodialysis (HD) is lower than that of elderly individuals with normal renal function. In addition, we also assessed whether the dietary intake of elderly on HD is lower on the dialysis day (DD) than on nondialysis days (non-DD). (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - January 6, 2015 Category: Urology & Nephrology Authors: Aline Moutinho Martins, Juliana Cordeiro Dias Rodrigues, Fernanda Galvão de Oliveira Santin, Flavia dos Santos Barbosa Brito, Annie Seixas Bello Moreira, Roberto Alves Lourenço, Carla Maria Avesani Tags: Original Research Source Type: research

Endothelial Progenitor Cells and Asymmetric Dimethylarginine After Renal Transplantation
In this study, we tested the hypothesis that elevated ADMA and decreased EPC can be positively influenced with regular physical exercise early after Tx. Blood samples for analysis of ADMA and EPC were obtained from randomly selected 64 patients after Tx who agreed to participate in a supervised aerobic exercise program for 6 months (group I). (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - January 6, 2015 Category: Urology & Nephrology Authors: Vladimír Teplan, Andrea Mahrová, Ivana Králová-Lesná, Jaroslav Racek, Ivo Valkovský, Milena Štollová Tags: ICURT PROCEEDINGS Source Type: research

Nephroprotective Action of Renin-Angiotensin-Aldosterone System Blockade in Chronic Kidney Disease Patients: The Landscape After ALTITUDE and VA NEPHRON-D Trails
The intervention in the renin-angiotensin-aldosterone system (RAAS) is currently the most effective strategy that combines blood pressure lowering and renoprotection. Several large, randomized, controlled trials evidenced the renoprotective potential of the angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) in nephropathies of almost any etiology. Mineralocorticoid receptor antagonists and direct renin inhibitor, aliskiren, as add-on treatments to standard therapy including the optimal dose of ACEIs or ARBs reduce albuminuria or proteinuria and slow development of renal dysfunction...
Source: Journal of Renal Nutrition - January 6, 2015 Category: Urology & Nephrology Authors: Boleslaw Rutkowski, Leszek Tylicki Tags: ICURT Proceedings Source Type: research

Endocrine and Metabolic Changes Affecting Cardiovascular Disease in Dialysis Patients
Protein–energy wasting plays an important role in the increased risk of mortality from cardiovascular disease in people with end-stage renal disease. Because protein–energy wasting is a condition of imbalance between anabolism and catabolism, endocrine and metabolic alterations that regulate such balance should be the possible target of intervention. Subjects with end-stage renal disease exhibit various changes in thyroid function, gonadal hormones, adrenal androgen, glucose metabolism, dyslipidemia, fatty acid composition, cholesterol absorption, and vitamin D. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - January 1, 2015 Category: Urology & Nephrology Authors: Tetsuo Shoji, Masanori Emoto, Yoshiki Nishizawa, Masaaki Inaba Tags: Icurt Proceedings Source Type: research

Recent Advances in Understanding the Pathogenesis of Atherosclerosis in CKD Patients
A need exists for developing new therapies to improve cardiovascular outcomes in end-stage kidney disease. Three new areas that address novel pathophysiological mechanisms and/or therapeutic approaches toward cardiovascular events in chronic kidney disease patients include the use of an anti-inflammatory agent, the role of catalytic iron, and protein carbamylation. In preliminary studies, hydroxychloroquine, which has multiple anti-inflammatory properties, preserved vascular compliance for the aorta and major vessels, as well as reduced the extent of severity of atherosclerosis in ApoE−/− mice. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - January 1, 2015 Category: Urology & Nephrology Authors: Sudhir V. Shah, Ashutosh M. Shukla, Chhanda Bose, Alexei G. Basnakian, Mohan Rajapurkar Tags: Icurt Proceedings Source Type: research

Indoxyl Sulfate Upregulates Prorenin Expression via Nuclear Factor-κB p65, Signal Transducer and Activator of Transcription 3, and Reactive Oxygen Species in Proximal Tubular Cells
We have recently found that indoxyl sulfate induces prorenin expression in proximal tubular cells. The present study aimed to determine whether nuclear factor-κB (NF-κB) p65, signal transducer and activator of transcription 3 (Stat3), and reactive oxygen species are involved in indoxyl sulfate–induced prorenin expression in cultured human proximal tubular cells (HK-2 cells). Effects of indoxyl sulfate on prorenin expression were determined using HK-2 cells with small interfering RNAs (siRNAs) specific to NF-κB p65 and Stat3, N-acetylcysteine, an antioxidant, and diphenyleneiodonium, an inhibitor of ...
Source: Journal of Renal Nutrition - December 31, 2014 Category: Urology & Nephrology Authors: Shinichi Saito, Maimaiti Yisireyili, Hidehisa Shimizu, Hwee-Yeong Ng, Toshimitsu Niwa Tags: ICURT PROCEEDINGS Source Type: research

Cardiorenal Syndrome: Role of Protein-Bound Uremic Toxins
Renal impairment is a strong independent risk factor associated with poor prognosis in cardiovascular disease patients. Renal dysfunction is likely contributed by progressive renal structural damage. Accurate detection of kidney injury in a timely manner as well as increased knowledge of the pathophysiology and mechanisms underlying this injury is of great importance in developing therapeutic interventions for combating renal complications at an early stage. Regarding the role of uremic solutes in the pathophysiology of cardiorenal syndrome, a number of further studies are warranted. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - December 31, 2014 Category: Urology & Nephrology Authors: Suree Lekawanvijit, Henry Krum Tags: ICURT PROCEEDINGS Source Type: research

Bioimpedance Can Solve Problems of Fluid Overload
Bioimpedance (BI) techniques for measuring normal hydration status (NHS) can be generally classified as (1) by frequency as single frequency at 50 kHz, BI analysis, and multifrequency BI spectroscopy and (2) by method as whole body (wrist to ankle) measurement and calf BI spectroscopy. The aim of this article was to review current BI methods for clinical practice in patients with end-stage of kidney disease. BI vector analysis using whole-body single-frequency BI at 50 kHz may be useful for population studies to indicate a range of degree of fluid loading and of nutritional status. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - December 31, 2014 Category: Urology & Nephrology Authors: Samer R. Abbas, Fansan Zhu, Nathan W. Levin Tags: Icurt Proceedings Source Type: research

Timing of Dialysis Initiation: When to Start? Which Treatment?
During the late 1990s early initiation of dialysis was introduced on a large scale and between 1996 and 2008, the percentage of patients with an estimated glomerular filtration rate (eGFR) above 10 mL/minute starting dialysis rose from 25% to 54% in the United States. However, several subsequent studies showed no survival benefit for patients commencing dialysis earlier. One possible explanation for the negative results could be that eGFR may be a flawed index; s-creatinine is lower in patients with muscle wasting or fluid overload and these vulnerable patients with high comorbidity burden often start “early&rdq...
Source: Journal of Renal Nutrition - December 31, 2014 Category: Urology & Nephrology Authors: Paul Leurs, Anna Machowska, Bengt Lindholm Tags: ICURT PROCEEDINGS Source Type: research

Role of Uremic Toxins in Erythropoiesis-Stimulating Agent Resistance in Chronic Kidney Disease and Dialysis Patients
Patients with advanced chronic kidney disease are exposed to uremic toxins. In addition to causing uremic symptoms, uremic toxins accelerate the progression of renal failure. Indoxyl sulfate (IS) increases oxygen consumption in tubules, aggravating hypoxia of the kidney, and progression of the kidney disease. IS also induces endoplasmic reticulum stress and thereby contributes the progression of cellular damages in tubular epithelial cells. Hypoxia-inducible factor (HIF) is a master transcriptional regulator of adaptive responses against hypoxia and regulates expression of erythropoietin (EPO). (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - December 30, 2014 Category: Urology & Nephrology Authors: Masaomi Nangaku, Imari Mimura, Junna Yamaguchi, Yoshiki Higashijima, Takehiko Wada, Tetsuhiro Tanaka Tags: Icurt Proceedings Source Type: research

Restoration of Parathyroid Function After Change of Phosphate Binder From Calcium Carbonate to Lanthanum Carbonate in Hemodialysis Patients With Suppressed Serum Parathyroid Hormone
Control of phosphate is the most critical in the treatment of chronic kidney disease with mineral and bone disorder (CKD-MBD). Because calcium-containing phosphate binder to CKD patients is known to induce adynamic bone disease with ectopic calcification by increasing calcium load, we examined the effect of lanthanum carbonate (LaC), a non-calcium containing phosphate binder, to restore bone turnover in 27 hemodialysis patients with suppressed parathyroid function (serum intact parathyroid hormone [iPTH] ≦ 150 pg/mL). (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - December 30, 2014 Category: Urology & Nephrology Authors: Masaaki Inaba, Senji Okuno, Harumi Nagayama, Shinsuke Yamada, Eiji Ishimura, Yasuo Imanishi, Shigeichi Shoji Tags: Icurt Proceedings Source Type: research

January Meeting Announcements
January 26-29, 2015 9th Asia Pacific Conference on Clinical Nutrition (APCCN 2015), Shangri-La, Kuala Lumpur, Malaysia. Visit www.apccn2015.org.my or call +603- 2162 0566. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - December 29, 2014 Category: Urology & Nephrology Tags: Announcements Source Type: research

Passing the Gavel
As the 2015 begins, I have the honor of welcoming new leadership to the Council on Renal Nutrition (CRN). (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - December 29, 2014 Category: Urology & Nephrology Authors: Lisa Gutekunst Tags: Message From the Chairperson Source Type: research

Dressing Renal Patients for Success, Ranch-Style
The popularity of ranch salad dressing in America is hard to argue. Ranch has been the best-selling salad dressing in the United States for nearly 25 years.1-3 Additionally, its presence is global with sales across the United States and in more than 30 countries.4 (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - December 29, 2014 Category: Urology & Nephrology Authors: Julie Hulsebus-Colvin Tags: Product Update Source Type: research

Masthead
(Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - December 29, 2014 Category: Urology & Nephrology Source Type: research

Editorial Board
(Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - December 29, 2014 Category: Urology & Nephrology Source Type: research

Table of Contents
(Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - December 29, 2014 Category: Urology & Nephrology Source Type: research

Guidelines for Contributing Authors
(Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - December 29, 2014 Category: Urology & Nephrology Source Type: research

Erythropoiesis-Stimulating Agents: Dose and Mortality Risk
Hypo-responsiveness to erythropoiesis-stimulating agents (ESAs) has been associated with increased mortality in end-stage renal disease patients. It is not clear if this effect is related to the elevated ESAs dosage for targeting hemoglobin levels or underlying morbid conditions that lead to ESA resistance. We retrospectively evaluated from 2008 to death or December 2011, 28 consecutive incident hemodialysis patients. We identified 2 cohort of patients based on their mean annual ESAs dosage. The correlation between data was evaluated with the Spearman's rho test. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - December 16, 2014 Category: Urology & Nephrology Authors: Guido Bellinghieri, Carmela Giuseppina Condemi, Salvatore Saitta, Gianluca Trifirò, Sebastiano Gangemi, Vincenzo Savica, Michele Buemi, Domenico Santoro Tags: Icurt Proceedings Source Type: research

Uremic Toxins, Oxidative Stress, and Renal Fibrosis: An Interwined Complex
The prevalence of end-stage renal diseases is currently on the rise globally, and finding the way to curb this tide is urgently needed. Tubulointerstitial fibrosis is a common pathway for essentially all the nephropathy categories known to date, and the manifestations of renal fibrosis include excessive deposition of extracellular matrix with distortion of renal microstructures and functional deterioration. Uremic toxins have been gradually found to play an important role in the development of progressive renal fibrosis, with protein-bound indoxyl sulfate, p-cresol, and p-cresyl sulfate receiving the most attention. (Sourc...
Source: Journal of Renal Nutrition - December 12, 2014 Category: Urology & Nephrology Authors: Chia-Ter Chao, Chih-Kang Chiang Tags: Icurt Proceedings Source Type: research

Recent Topics on Podocytes and Aldosterone
We reported that podocyte impairment underlied the early glomerulopathy in animal models of lifestyle-related diseases, such as hypertension and metabolic syndrome. Accumulating evidence suggests that overactivation of the aldosterone–mineralocorticoid receptor (MR) system has harmful effects on podocytes. We found that MR signaling was enhanced in such lifestyle-related diseases with podocyte injury and proteinuria, which were ameliorated by MR antagonist. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - December 12, 2014 Category: Urology & Nephrology Authors: Miki Nagase Tags: Icurt Proceedings Source Type: research

Insulin Resistance as a Therapeutic Target for Chronic Kidney Disease
Insulin resistance (IR) is a prevalent metabolic feature in chronic kidney disease (CKD). Postreceptor insulin-signaling defects have been observed in uremia. A decrease in the activity of phosphatidylinositol 3-kinase appears critical in the pathophysiology of CKD-associated IR. Lipotoxicity due to ectopic accumulation of lipid moieties has recently emerged as another mechanism by which CKD and/or associated metabolic disorders may lead to IR through impairment of various insulin-signaling molecules. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - December 12, 2014 Category: Urology & Nephrology Authors: Daniel Teta Tags: Icurt Proceedings Source Type: research

Vitamin D Receptor Polymorphism in Chronic Kidney Disease Patients With Complicated Cardiovascular Disease
Several studies indicate a relationship between vitamin D and cardiovascular disease. Pleiotropic actions of vitamin D and its analogs are mediated by vitamin D receptor (VDR). VDRs have been identified in almost all tissues, including vascular smooth muscle cells, cardiomyocytes, and endothelial cells. The FokI and BsmI polymorphisms of the VDR gene are regarded as strong markers of disturbed vitamin D signaling pathway. Studies investigating the relationship between VDR genotypes and left ventricular hypertrophy revealed a highly significant association with the BsmI Bb heterozygous genotype. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - December 12, 2014 Category: Urology & Nephrology Authors: Domenico Santoro, Silvia Lucisano, Giorgia Gagliostro, Angela Alibrandi, Salvatore Benvenga, Riccardo Ientile, Guido Bellinghieri, Michele Buemi, Daniela Caccamo Tags: Icurt Proceedings Source Type: research

Clinical Trials in Uremia—Time to Reappraise
The construct of any road map of the progress of medical knowledge reveals a long and tortuous road, full of errors, misapprehensions, blind alleys, and a perpetual shuffling between authority, heresy, and reason; but one of continuous growth and steady progress, albeit at variable pace and achievement at different periods of history. Numerous factors account for this cumulative progress, notable among which are the transmission, scientification, and mathematization of medical knowledge that ultimately account for the progressive evolution of medical care over time, from its primitive beginnings in antiquity to its present...
Source: Journal of Renal Nutrition - December 10, 2014 Category: Urology & Nephrology Authors: Garabed Eknoyan Tags: ICURT PROCEEDINGS Source Type: research

Correlation Between Nutritional Markers and Appetite Self-Assessments in Hemodialysis Patients
Protein–energy malnutrition is among the comorbidities that most strongly affect the prognosis of patients with chronic kidney disease. Anorexia, defined as a loss of desire to eat, is one cause of such malnutrition. Tools that evaluate appetite and the correlation between appetite and nutritional parameters require further study. To evaluate the appetite status in patients from 2 hemodialysis clinics in Fortaleza, Brazil and the correlations between appetite (evaluated in the past week and in the past 4 weeks) and demographic, laboratory, and nutritional parameters. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - December 9, 2014 Category: Urology & Nephrology Authors: Claudia M.C. Oliveira, Marcos Kubrusly, André. T. Lima, Danielle M. Torres, Natasha M.R. Cavalcante, Antônio L.C. Jerônimo, Thiago. C.B. Oliveira Tags: Original Research Source Type: research

Vitamin E Intake and Risk of Renal Cell Carcinoma: A Meta-Analysis of 7 Case–Control Studies
Vitamin E intake may reduce the risk of renal cell carcinoma, but the results were inconsistent. Hence, we conducted a meta-analysis to assess the association between dietary vitamin E intake and the risk of renal cell carcinoma. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - November 25, 2014 Category: Urology & Nephrology Authors: Yonggang Shang, Shanhong Yi, Dong Cui, Guangwei Han, Chengcheng Liu Tags: Original Research Source Type: research

The Nutritional Status of Patients Starting Specialized Predialysis Care
To examine the prevalence of and risk factors for malnutrition at the start of specialized predialysis care. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - November 25, 2014 Category: Urology & Nephrology Authors: Gjalt J. Westland, Diana C. Grootendorst, Nynke Halbesma, Friedo W. Dekker, Cornelis A. Verburgh Tags: Original Research Source Type: research

Intradialytic Protein Supplementation Reduces Inflammation and Improves Physical Function in Maintenance Hemodialysis Patients
This study sought to determine if oral supplementation with soy or whey protein during dialysis treatment reduces inflammation and improves physical function and body composition in MHD patients. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - November 25, 2014 Category: Urology & Nephrology Authors: Emily J. Tomayko, Brandon M. Kistler, Peter J. Fitschen, Kenneth R. Wilund Tags: Original Research Source Type: research

Metabolic Acidosis Components in Advanced Chronic Kidney Disease: Association With Serum Albumin and Parathyroid Hormone
To investigate the associations between the 2 main components of metabolic acidosis (unmeasured anions [UA] and hyperchloremia) with serum albumin and intact parathormone (iPTH) in patients with advanced chronic kidney disease. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - November 21, 2014 Category: Urology & Nephrology Authors: Daniele Pinto Vasconcelos, Rafaela Elizabeth Bayas de Queiroz, Tandara Maria Ponte Costa, Monique Queiroz Rocha Guerreiro, Maria Alessandra Oliveira Leitão, Larissa Chagas Corrêa, Alexandre Braga Libório Tags: Clinical Brief Source Type: research

The Importance of Vitamin K Monitoring With Warfarin (Coumadin) Use in Chronic Kidney Disease Patients
Warfarin (Coumadin) is most commonly prescribed for individuals with increased risk of blood clots associated with coronary heart disease. Many patients who have chronic kidney disease (CKD) may also be prescribed warfarin (Coumadin) related to the coronary heart disease risk factors. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - November 13, 2014 Category: Urology & Nephrology Authors: Haewook Han Tags: Patient Education Source Type: research

Plasma Ascorbic Acid Concentrations in Prevalent Patients With End-Stage Renal Disease on Hemodialysis
To determine the prevalence of vitamin C (ascorbic acid [AA]) deficiency in patients with end-stage renal disease, the effect of supplemental AA on plasma AA concentrations, and the extrinsic and intrinsic factors that affect plasma AA concentrations in this patient population. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - November 6, 2014 Category: Urology & Nephrology Authors: William D. Sirover, Yuguan Liu, Amanda Logan, Krystal Hunter, Robert L. Benz, Deepali Prasad, Jose Avila, Thaliga Venkatchalam, Lawrence S. Weisberg, Garry J. Handelman Tags: Original Research Source Type: research

Effect of a Symbiotic Gel ( + + Inulin) on Presence and Severity of Gastrointestinal Symptoms in Hemodialysis Patients
The study aimed to assess the effect of a symbiotic gel on presence and severity of gastrointestinal symptoms (GIS) in hemodialysis patients. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - November 6, 2014 Category: Urology & Nephrology Authors: Daniela Viramontes-Hörner, Fabiola Márquez-Sandoval, Fabiola Martín-del-Campo, Barbara Vizmanos-Lamotte, Ana Sandoval-Rodríguez, Juan Armendáriz-Borunda, Héctor García-Bejarano, Karina Renoirte-López, Guillermo García-García Tags: Original Research Source Type: research

Fiber Supplementation Lowers Plasma -Cresol in Chronic Kidney Disease Patients
To determine the effects of supplemental fiber on plasma p-cresol, stool frequency, and quality of life (QoL) in chronic kidney disease (CKD) patients. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - November 4, 2014 Category: Urology & Nephrology Authors: Younis A. Salmean, Mark S. Segal, Sergiu P. Palii, Wendy J. Dahl Tags: Research Brief Source Type: research

Subjective Global Assessment Remains an Important Nutrition Assessment Tool: Response to Marcelli, DiBenedetto, Ciotola, Grassmann, and Canaud
We thank Drs. Marcelli, DiBenedetto, Ciotola, Grassmann, and Canaud for their response1 to our article titled “Subjective Global Assessment Scores Have Poor Correlation with Serum Albumin in Obese Patients.”2 We agree with these authors and attempted to point out in our analysis that while albumin is not pure nutrition marker, it is highly prognostic of morbidity3 and is considered a key quality indicator by the Centers for Medicare and Medicaid Services,4 the main payer for dialysis in the United States. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - November 1, 2014 Category: Urology & Nephrology Authors: Rosa K. Hand, Alison L. Steiber Tags: Letter to the Editor Source Type: research

Is Routine Multivitamin Supplementation Necessary in US Chronic Adult Hemodialysis Patients? A Systematic Review
Because of concern that United States (US) chronic hemodialysis patients are at high risk for the development of vitamin deficiencies, the great majority of such patients are routinely supplemented with a multivitamin. This policy is supported by major US dialysis providers and nonprofit organizations. Yet routine multivitamin supplementation expands hemodialysis patients' already large pill burden, probably accounts for many millions of dollars in annual costs, and in light of previous reports may even carry with it the possibility of increased risk of adverse outcomes. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - October 29, 2014 Category: Urology & Nephrology Authors: Bryan M. Tucker, Sami Safadi, Allon N. Friedman Tags: Review Article Source Type: research

The Importance of Exercise for Chronic Kidney Disease Patients
Due to fatigue and muscle weakness, patients with chronic kidney disease (CKD) have low levels of physical activity.1 The decline in physical capacity in this patient cohort is noteworthy as it is associated with deconditioning and muscle wasting, declining kidney function, and an increased risk of comorbidities such as cardiovascular disease.2 Thus, a downward spiral between disease, disuse, and deconditioning exists leading to a reduced quality of life, increased hospitalization rates, and mortality. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - October 26, 2014 Category: Urology & Nephrology Authors: Danielle L. Kirkman, Shannon Lennon-Edwards, David G. Edwards Tags: Patient Education Source Type: research

The National Kidney Foundation Council on Renal Nutrition Addresses the Food and Drug Administration
On July 24, 2014, the Food and Drug Administration (FDA) held an open forum to review proposed changes to the Nutrition Facts Label and to allow for public comment on these changes. Lisa Gutekunst, MSEd, RD, CSR, CDN, Chair of the National Kidney Foundation Council on Renal Nutrition, lobbied the FDA to add phosphorus to the Nutrition Facts Label. This is her address to the FDA. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - October 26, 2014 Category: Urology & Nephrology Authors: Lisa Gutekunst Tags: Special Report Source Type: research

Addressing the FDA
On July 24, 2014, I had the opportunity to address the Food and Drug Administration (FDA) about adding phosphorus to the nutrition facts label. My statement is included in this edition of the Journal. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - October 26, 2014 Category: Urology & Nephrology Authors: Lisa Gutekunst Tags: Message From the Chairperson Source Type: research

November Meeting Announcements
(Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - October 26, 2014 Category: Urology & Nephrology Source Type: research

To Eat or Not to Eat—International Experiences With Eating During Hemodialysis Treatment
Providing food or nutrition supplements during hemodialysis (HD) may be associated with improved nutritional status and reduced mortality; however, despite these potential benefits, eating practices vary across countries, regions, and clinics. Understanding present clinic practices and clinician experiences with eating during HD may help outline best practices in this controversial area. Therefore, the objective of this study was to examine clinical practices and experiences related to eating during HD treatment. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - October 26, 2014 Category: Urology & Nephrology Authors: Brandon Kistler, Deborah Benner, Mary Burgess, Maria Stasios, Kamyar Kalantar-Zadeh, Kenneth R. Wilund Tags: ISRNM Proceedings Source Type: research

Probiotic Use in Chronic Kidney Disease Patients
Probiotic use in chronic kidney disease (CKD) patients continues to be an area of interest among renal health care professionals. It is becoming more widely accepted that people with CKD have altered gut flora.1-3 This is an area of interest because altered gut flora impacts the patient in a myriad of ways. In the forefront is gastrointestinal (GI) health and uremic toxins. Restoring balance to intestinal flora favorably impacts the CKD patient as it would any individual and improves any GI issues such as constipation or diarrhea as well as promotes healthy digestion and improved immunity. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - October 26, 2014 Category: Urology & Nephrology Authors: Lindsey Zirker Tags: Product Update Source Type: research

Chronic Kidney Disease, Frailty, and Unsuccessful Aging: A Review
The global prevalence of chronic kidney disease (CKD) is rising, particularly among the elderly population. Defining aging as successful or unsuccessful has become clinically relevant in the last 15 years, with an increased recognition of the frail phenotype. Frailty has been shown to be associated with CKD and poorer outcomes, such as death or dialysis. It is likely that the mechanisms of disease in CKD such as altered protein metabolism, inflammation, oxidative stress, and anemia accelerate normal aging and lead to worsening frailty in elderly patients with CKD. (Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - October 26, 2014 Category: Urology & Nephrology Authors: Simon R. Walker, Martin Wagner, Navdeep Tangri Tags: ISRNM Proceedings Source Type: research

Masthead
(Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - October 26, 2014 Category: Urology & Nephrology Source Type: research

Editorial Board
(Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - October 26, 2014 Category: Urology & Nephrology Source Type: research

Table of Contents
(Source: Journal of Renal Nutrition)
Source: Journal of Renal Nutrition - October 26, 2014 Category: Urology & Nephrology Source Type: research

Words of Caution Regarding Research Design When Using the Nutrition Care Process Model
The Nutrition Care Process (NCP), first introduced in 2003, provides a well-defined framework and a standardized terminology to guide Registered Dietitian Nutritionists (RDNs) in planning nutrition care.1 It has become the central component of standards of practice for the profession of nutrition and dietetics, as presented in Standards of Practice for Nutrition Care and Standards of Professional Performance for Registered Dietitians.2 The most recent update of the Standards of Practice for Nutrition Care and Standards of Professional Performance for Nephrology Nutrition, published jointly by the National Kidney Foundation...
Source: Journal of Renal Nutrition - October 25, 2014 Category: Urology & Nephrology Authors: Maureen P. McCarthy Tags: Editorial Source Type: research

Rethinking the Restriction on Nutrition During Hemodialysis Treatment
The annual mortality rate for patients undergoing maintenance hemodialysis (MHD) treatment in the United States is 20%, a rate higher than most other countries in the world. Poor nutrition status in MHD patients contributes to this adverse outcome as well as poor quality of life. Providing oral nutrition to MHD patients, especially during hemodialysis (HD) treatment has many potential benefits including improvements in nutrition status and attenuating HD-related muscle wasting. However, this practice is generally restricted in the United States presumably because of concerns that include worsening hemodynamic instability, ...
Source: Journal of Renal Nutrition - October 18, 2014 Category: Urology & Nephrology Authors: Brandon M. Kistler, Peter J. Fitschen, T. Alp Ikizler, Kenneth R. Wilund Tags: Review Article Source Type: research