scholarly journals Evaluating the Impact of Goal Setting on Improving Diet Quality in Chronic Kidney Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Chi H. Chan ◽  
Marguerite Conley ◽  
Marina M. Reeves ◽  
Katrina L. Campbell ◽  
Jaimon T. Kelly
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Behavior Change ◽  
Goal Setting ◽  
Diet Quality ◽  
Healthy Eating Index ◽  
Text Messages ◽  
Fiber Intake ◽  
Patient Centered ◽  
The Impact

Background: Improving diet quality in chronic kidney disease (CKD) is challenging due to a myriad of competing recommendations. Patient-centered goal setting can facilitate dietary behavior change; however, its role in improving diet quality in CKD has not been investigated.Aim: The aim of the study is to evaluate the effects of goal setting on improving diet quality in stages 3–4 CKD.Methods: Forty-one participants completed a 6-month dietitian-led telehealth (combined coaching calls and text messages) intervention as part of a larger RCT. Participants set one to two diet-related SMART goals and received weekly goal tracking text messages. Dietary intake was assessed using the Australian Eating Survey at baseline, 3, and 6 months, with diet quality determined using the Alternate Healthy Eating Index (AHEI).Results: Significant improvements in AHEI (+6.9 points; 95% CI 1.2–12.7), vegetable (+1.1 serves; 95% CI 0.0–2.3) and fiber intake (+4.2 g; 95% CI 0.2–8.2) were observed at 3 months in participants setting a fruit and/or vegetable goal, compared with those who did not. However, no significant or meaningful changes were observed at 6 months. No other goal setting strategy appeared in effect on diet intake behavior or clinical outcomes in this group of CKD participants.Conclusions: Patient-centered goal setting, particularly in relation to fruit and vegetable intake, as part of a telehealth coaching program, significantly improved diet quality (AHEI), vegetable and fiber intake over 3 months. More support may be required to achieve longer-term behavior change in stages 3–4 CKD patients.

Diet Quality of Chronic Kidney Disease Patients and the Impact of Nutritional Counseling

2018 ◽  
Vol 28 (6) ◽  
pp. 403-410 ◽  
Author(s):  
Andréia Silva Fernandes ◽  
Christiane Ishikawa Ramos ◽  
Fabiana Baggio Nerbass ◽  
Lilian Cuppari
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diet Quality ◽  
Nutritional Counseling ◽  
The Impact

FC 082DIET QUALITY, PROTEIN-BOUND URAEMIC TOXINS AND GASTROINTESTINAL MICROBIOME IN CHRONIC KIDNEY DISEASE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Catherine McFarlane ◽  
Rathika Krishnasamy ◽  
Tony Stanton ◽  
Emma Savill ◽  
Matthew Snelson ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Dietary Intake ◽  
Diet Quality ◽  
Metagenomic Sequencing ◽  
Gastrointestinal Microbiota ◽  
Microbial Composition ◽  
Gastrointestinal Microbiome ◽  
Fibre Intake ◽  
The Impact

Abstract Background and Aims Individuals with chronic kidney disease (CKD) have significantly increased risk of cardiovascular mortality which is only partially explained by Framingham risk factors. There is a growing body of evidence linking the gut-derived uraemic toxins indoxyl sulphate (IS) and p-cresyl sulphate (PCS) with accelerated kidney disease progression and cardiovascular burden in CKD. Whilst the effect of specific nutrients on uraemic toxin generation has been explored, few studies have characterised the impact of diet quality on the gastrointestinal microbiome in the CKD population. This study aims to explore the associations between dietary quality, protein-bound uraemic toxins and gastrointestinal microbiome in adults with CKD. Method This was a baseline cross-sectional study of adults with stage 3 to 4 CKD who were enrolled in a randomised controlled trial of prebiotic and probiotic supplementation. Habitual dietary intake was measured using a 7-day diet history method by a specialist Dietitian. Diet quality was assessed using food group analysis; protein intake, fibre intake, dietary protein:fibre ratio and adherence to plant-based diet index (PDI) (overall PDI, healthy PDI, unhealthy PDI). Serum uraemic toxins (free and total; IS and PCS) were determined by ultra-performance liquid chromatography. Metagenomic sequencing was used to determine gastrointestinal microbiota richness, diversity, composition and functional capacity. Results There were 68 CKD patients [66% male, median age 70 (IQR 58-75) years] with a mean estimated glomerular filtration rate of 34 ± 11 mL/min/1.73m2. Greater adherence to a hPDI was associated with lower levels of free PCS [-0.021 µmol/L (95% CI -0.042 to -0.001)], while a higher intake of dietary fibre intake was associated with lower levels of free IS [-0.022 µmol/L (95% CI -0.043 to -0.001)]. Compositionally, the gastrointestinal microbiota of this cohort was dominated by members of the phyla Firmicutes and Bacteroidetes. Supervised analysis at the species level demonstrated that 21% of variance in gastrointestinal microbial composition could be attributed to protein:fibre ratio (F=1.27, p=0.04). Further, a higher protein:fibre ratio was associated with an increased relative abundance of unclassified members of order Oscillospirales. Subdoligranulum formicile was correlated with dietary intake of vegetables and wholegrains while an unclassified Prevotella species was correlated with food items considered discretionary including sweet drinks, sweet desserts, animal fats and potatoes. Conclusion The study suggests that habitual diets that are higher in fibre and plant-based foods may positively influence uraemic toxin levels and gut microbiota diversity and composition in adults with CKD. These findings provide rationale for well-designed dietary intervention studies targeting the production of uraemic toxins and exploring the impact on gut microbiome in the CKD population.

scholarly journals The Psychosocial and Somatic Effects of Relocation from Remote Canadian First Nation Communities to Urban Centres on Indigenous Peoples with Chronic Kidney Disease (CKD)

2021 ◽  
Vol 18 (7) ◽  
pp. 3838
Author(s):  
Denise Genereux ◽  
Lida Fan ◽  
Keith Brownlee
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Indigenous Peoples ◽  
Health Care Professionals ◽  
Medical Condition ◽  
Geographical Location ◽  
Well Being ◽  
First Nation ◽  
Urban Centre ◽  
The Impact

Chronic kidney disease, also referred to as end-stage renal disease (ESRD), is a prevalent and chronic condition for which treatment is necessary as a means of survival once affected individuals reach the fifth and final stage of the disease. Dialysis is a form of maintenance treatment that aids with kidney functioning once a normal kidney is damaged. There are two main types of dialysis: hemodialysis (HD) and peritoneal dialysis (PD). Each form of treatment is discussed between the patient and nephrologist and is largely dependent upon the following factors: medical condition, ability to administer treatment, supports, geographical location, access to necessary equipment/supplies, personal wishes, etc. For Indigenous Peoples who reside on remote Canadian First Nation communities, relocation is often recommended due to geographical location and limited access to both health care professionals and necessary equipment/supplies (i.e., quality of water, access to electricity/plumbing, etc). Consequently, the objective of this paper is to determine the psychosocial and somatic effects for Indigenous Peoples with ESRD if they have to relocate from remote First Nation communities to an urban centre. A review of the literature suggests that relocation to urban centres has negative implications that are worth noting: cultural isolation, alienation from family and friends, somatic issues, psychosocial issues, loss of independence and role adjustment. As a result of relocation, it is evident that the impact is profound in terms of an individuals’ mental, emotional, physical and spiritual well-being. Ensuring that adequate social support and education are available to patients and families would aid in alleviating stressors associated with managing chronic kidney disease.

scholarly journals Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy

2021 ◽  
Vol 18 (8) ◽  
pp. 4370
Author(s):  
A Kim ◽  
Hayeon Lee ◽  
Eun-Jeong Shin ◽  
Eun-Jung Cho ◽  
Yoon-Sook Cho ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Medication Management ◽  
Medication Use ◽  
Potentially Inappropriate Medications ◽  
Management Service ◽  
Ckd Stage ◽  
The Impact

Inappropriate polypharmacy is likely in older adults with chronic kidney disease (CKD) owing to the considerable burden of comorbidities. We aimed to describe the impact of pharmacist-led geriatric medication management service (MMS) on the quality of medication use. This retrospective descriptive study included 95 patients who received geriatric MMS in an ambulatory care clinic in a single tertiary-care teaching hospital from May 2019 to December 2019. The average age of the patients was 74.9 ± 7.3 years; 40% of them had CKD Stage 4 or 5. Medication use quality was assessed in 87 patients. After providing MMS, the total number of medications and potentially inappropriate medications (PIMs) decreased from 13.5 ± 4.3 to 10.9 ± 3.8 and 1.6 ± 1.4 to 1.0 ± 1.2 (both p < 0.001), respectively. Furthermore, the number of patients who received three or more central nervous system-active drugs and strong anticholinergic drugs decreased. Among the 354 drug-related problems identified, “missing patient documentation” was the most common, followed by “adverse effect” and “drug not indicated.” The most frequent intervention was “therapy stopped”. In conclusion, polypharmacy and PIMs were prevalent in older adults with CKD; pharmacist-led geriatric MMS improved the quality of medication use in this population.

scholarly journals High dietary fiber intake is associated with decreased inflammation and all-cause mortality in patients with chronic kidney disease

2012 ◽  
Vol 81 (3) ◽  
pp. 300-306 ◽  
Author(s):  
Vidya M. Raj Krishnamurthy ◽  
Guo Wei ◽  
Bradley C. Baird ◽  
Maureen Murtaugh ◽  
Michel B. Chonchol ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Dietary Fiber ◽  
Fiber Intake ◽  
Dietary Fiber Intake ◽  
All Cause Mortality

scholarly journals New Pathogenic Concepts and Therapeutic Approaches to Oxidative Stress in Chronic Kidney Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-21 ◽  
Author(s):  
José Pedraza-Chaverri ◽  
Laura G. Sánchez-Lozada ◽  
Horacio Osorio-Alonso ◽  
Edilia Tapia ◽  
Alexandra Scholze
Keyword(s):  
Oxidative Stress ◽  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Cardiovascular Complications ◽  
Vitamin D Metabolism ◽  
Therapy Options ◽  
Mitochondrial Alterations ◽  
Inflammatory Processes ◽  
The Impact

In chronic kidney disease inflammatory processes and stimulation of immune cells result in overproduction of free radicals. In combination with a reduced antioxidant capacity this causes oxidative stress. This review focuses on current pathogenic concepts of oxidative stress for the decline of kidney function and development of cardiovascular complications. We discuss the impact of mitochondrial alterations and dysfunction, a pathogenic role for hyperuricemia, and disturbances of vitamin D metabolism and signal transduction. Recent antioxidant therapy options including the use of vitamin D and pharmacologic therapies for hyperuricemia are discussed. Finally, we review some new therapy options in diabetic nephropathy including antidiabetic agents (noninsulin dependent), plant antioxidants, and food components as alternative antioxidant therapies.

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