scholarly journals Dietary calcium intake does not meet the nutritional requirements of children with chronic kidney disease and on dialysis

2020 ◽  
Vol 35 (10) ◽  
pp. 1915-1923
Author(s):  
Louise McAlister ◽  
Selmy Silva ◽  
Vanessa Shaw ◽  
Rukshana Shroff
Keyword(s):  
Kidney Disease ◽  
Nutrient Intake ◽  
Bone Mineralization ◽  
Dietary Calcium Intake ◽  
Nutritional Requirements ◽  
National Kidney Foundation ◽  
Dairy Foods ◽  
Disease Outcomes ◽  
Upper Limit ◽  
The Uk

Abstract Background Adequate calcium (Ca) intake is required for bone mineralization in children. We assessed Ca intake from diet and medications in children with CKD stages 4–5 and on dialysis (CKD4–5D) and age-matched controls, comparing with the UK Reference Nutrient Intake (RNI) and international recommendations. Methods Three-day prospective diet diaries were recorded in 23 children with CKD4–5, 23 with CKD5D, and 27 controls. Doses of phosphate (P) binders and Ca supplements were recorded. Results Median dietary Ca intake in CKD4–5D was 480 (interquartile range (IQR) 300–621) vs 724 (IQR 575–852) mg/day in controls (p = 0.00002), providing 81% vs 108% RNI (p = 0.002). Seventy-six percent of patients received < 100% RNI. In CKD4–5D, 40% dietary Ca was provided from dairy foods vs 56% in controls. Eighty percent of CKD4–5D children were prescribed Ca-based P-binders, 15% Ca supplements, and 9% both medications, increasing median daily Ca intake to 1145 (IQR 665–1649) mg/day; 177% RNI. Considering the total daily Ca intake from diet and medications, 15% received < 100% RNI, 44% 100–200% RNI, and 41% > 200% RNI. Three children (6%) exceeded the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) upper limit of 2500 mg/day. None with a total Ca intake < RNI was hypocalcemic, and only one having > 2 × RNI was hypercalcemic. Conclusions Seventy-six percent of children with CKD4–5D had a dietary Ca intake < 100% RNI. Restriction of dairy foods as part of a P-controlled diet limits Ca intake. Additional Ca from medications is required to meet the KDOQI guideline of 100–200% normal recommended Ca intake.

scholarly journals Peranan Sistem Penilaian CAVeA2T2 dalam Memprediksi Maturasi Fistula Radiosefalika

2020 ◽  
Vol 48 (1) ◽  
pp. 15-37
Author(s):  
Ratna Astri Andhini ◽  
Teguh Marfen Djajakusumah ◽  
Putie Hapsari ◽  
Rama Nusjirwan
Keyword(s):  
Kidney Disease ◽  
National Kidney Foundation ◽  
Chi Square ◽  
Consecutive Sampling ◽  
Disease Outcomes ◽  
Rule Of Six

Latar Belakang. Berdasarkan panduan National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (NKF/KDOQI), fistula radiosefalika merupakan pilihan utama akses vaskular pada pasien yang menjalani hemodialisis. Fistula dikatakan matur apabila sesuai dengan rule of six (laju aliran >600mL/menit, diameter ≥6mm dan berjarak sekitar ≤6mm dari permukaan kulit). Sistem penilaian CAVeA2T2 (akses vena sentral ipsilateral, usia >73 tahun, vena <2,2mm, riwayat angioplasty pada tungkai bawah, dan tidak ditemukannya thrill intraoperatif) memiliki potensi dalam menilai maturasi fistula radiosefalika. Metode. Desain analitis menggunakan metode kohort prospektif dengan consecutive sampling untuk menilai perananan sistem penilaian CAVeA2T2 dalam memprediksi maturasi fistula radiosefalika. Populasi terjangkau adalah pasien gagal ginjal terminal (GGT) yang datang ke poliklinik Bedah Vaskular RSUP Dr. Hasan Sadikin Bandung dan RSKG Ny.R.A.Habibie yang akan menjalani operasi fistula radiosefalika. Uji statistik menggunakan uji univariat untuk dekskripsi data. Sampel dikelompokkan berdasarkan skor CAVeA2T2 (skor <2 dan ≥2) dan status maturasi fistula (matur/non matur) kemudian dianalisis melalui perbandingan antar kelompok melalui model bivariat. Selanjutnya analisis untuk menguji hipotesis melalui analisis Chi-Square Fisher dengan batas kemaknaan 0,05.  Hasil. Didapatkan 24 pasien (perbandingan laki-laki dan perempuan adalah 1:1) yang dilakukan analisis dengan rentang usia 21-76 tahun, rerata tekanan sistolik 149,2 (±28,4) mmHg. Didapatkan sitem penilaian CAVeA2T2 memiliki peranan dalam memprediksi maturasi fistula radiosefalika dengan probabilitas kesalahan statistik sebesar p<0,01 dan koefisien kontingensi sebesar C=0,674. Derajat peranan sistem penilaian CAVeA2T2 terhadap maturasi fistula radiosefalika tergolong sangat kuat berdasarkan klasifikasi Guilford. Kesimpulan. Sistem penilaian CAVeA2T2 memiliki peranan dalam memprediksi maturasi fistula radiosefalika. (ISSN 2723-7494 J Bedah Indonesia. 2020;48:15-37)

scholarly journals Cardiorespiratory fitness assessment using risk-stratified exercise testing and dose–response relationships with disease outcomes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tomas I. Gonzales ◽  
Kate Westgate ◽  
Tessa Strain ◽  
Stefanie Hollidge ◽  
Justin Jeon ◽  
...  
Keyword(s):  
Cardiorespiratory Fitness ◽  
Maximal Oxygen Consumption ◽  
Estimation Method ◽  
The Novel ◽  
Exercise Tests ◽  
Metabolic Equivalent ◽  
Fitness Assessment ◽  
Disease Outcomes ◽  
All Cause Mortality ◽  
The Uk

AbstractCardiorespiratory fitness (CRF) is associated with mortality and cardiovascular disease, but assessing CRF in the population is challenging. Here we develop and validate a novel framework to estimate CRF (as maximal oxygen consumption, VO2max) from heart rate response to low-risk personalised exercise tests. We apply the method to examine associations between CRF and health outcomes in the UK Biobank study, one of the world’s largest and most inclusive studies of CRF, showing that risk of all-cause mortality is 8% lower (95%CI 5–11%, 2670 deaths among 79,981 participants) and cardiovascular mortality is 9% lower (95%CI 4–14%, 854 deaths) per 1-metabolic equivalent difference in CRF. Associations obtained with the novel validated CRF estimation method are stronger than those obtained using previous methodology, suggesting previous methods may have underestimated the importance of fitness for human health.

scholarly journals A phosphate and calcium-enriched diet promotes progression of 5/6-nephrectomy-induced chronic kidney disease in C57BL/6 mice

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
J. Radloff ◽  
N. Latic ◽  
U. Pfeiffenberger ◽  
C. Schüler ◽  
S. Tangermann ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Calcium Phosphate ◽  
Kidney Disease ◽  
Renal Fibrosis ◽  
Time Course ◽  
Bone Mineralization ◽  
Fibroblast Growth Factor 23 ◽  
Functional Decline ◽  
Left Ventricular ◽  
Normal Diet

AbstractC57BL/6 mice are known to be rather resistant to the induction of experimental chronic kidney disease (CKD) by 5/6-nephrectomy (5/6-Nx). Here, we sought to characterize the development of CKD and its cardiac and skeletal sequelae during the first three months after 5/6-Nx in C57BL/6 mice fed a calcium- and phosphate enriched diet (CPD) with a balanced calcium/phosphate ratio. 5/6-NX mice on CPD showed increased renal fibrosis and a more pronounced decrease in glomerular filtration rate when compared to 5/6-Nx mice on normal diet (ND). Interestingly, despite comparable levels of serum calcium, phosphate, and parathyroid hormone (PTH), circulating intact fibroblast growth factor-23 (FGF23) was 5 times higher in 5/6-Nx mice on CPD, relative to 5/6-Nx mice on ND. A time course experiment revealed that 5/6-Nx mice on CPD developed progressive renal functional decline, renal fibrosis, cortical bone loss, impaired bone mineralization as well as hypertension, but not left ventricular hypertrophy. Collectively, our data show that the resistance of C57BL/6 mice to 5/6-Nx can be partially overcome by feeding the CPD, and that the CPD induces a profound, PTH-independent increase in FGF23 in 5/6-Nx mice, making it an interesting tool to assess the pathophysiological significance of FGF23 in CKD.

scholarly journals Outcome trends in people with heart failure, type 2 diabetes mellitus and chronic kidney disease in the UK over twenty years

2021 ◽  
Vol 32 ◽  
pp. 100739
Author(s):  
Claire A Lawson ◽  
Samuel Seidu ◽  
Francesco Zaccardi ◽  
Gerry McCann ◽  
Umesh T Kadam ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
Kidney Disease ◽  
Failure Type ◽  
The Uk
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