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Evenepoel P, Jørgensen HS, Bover J, Davenport A, Bacchetta J, Haarhaus M, Hansen D, Gracia-Iguacel C, Ketteler M, McAlister L, White E, Mazzaferro S, Vervloet M, Shroff R. Recommended calcium intake in adults and children with chronic kidney disease-a European consensus statement. Nephrol Dial Transplant 2024; 39:341-366. [PMID: 37697718 DOI: 10.1093/ndt/gfad185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Indexed: 09/13/2023] Open
Abstract
Mineral and bone disorders (MBD) are common in patients with chronic kidney disease (CKD), contributing to significant morbidity and mortality. For several decades, the first-line approach to controlling hyperparathyroidism in CKD was by exogenous calcium loading. Since the turn of the millennium, however, a growing awareness of vascular calcification risk has led to a paradigm shift in management and a move away from calcium-based phosphate binders. As a consequence, contemporary CKD patients may be at risk of a negative calcium balance, which, in turn, may compromise bone health, contributing to renal bone disease and increased fracture risk. A calcium intake below a certain threshold may be as problematic as a high intake, worsening the MBD syndrome of CKD, but is not addressed in current clinical practice guidelines. The CKD-MBD and European Renal Nutrition working groups of the European Renal Association (ERA), together with the CKD-MBD and Dialysis working groups of the European Society for Pediatric Nephrology (ESPN), developed key evidence points and clinical practice points on calcium management in children and adults with CKD across stages of disease. These were reviewed by a Delphi panel consisting of ERA and ESPN working groups members. The main clinical practice points include a suggested total calcium intake from diet and medications of 800-1000 mg/day and not exceeding 1500 mg/day to maintain a neutral calcium balance in adults with CKD. In children with CKD, total calcium intake should be kept within the age-appropriate normal range. These statements provide information and may assist in decision-making, but in the absence of high-level evidence must be carefully considered and adapted to individual patient needs.
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Affiliation(s)
- Pieter Evenepoel
- Department of Microbiology, Immunology and Transplantation, Nephrology and Renal Transplantation Research Group, KU Leuven, Leuven, Belgium
- Department of Medicine, Division of Nephrology, University Hospitals Leuven, Leuven, Belgium
| | - Hanne Skou Jørgensen
- Department of Microbiology, Immunology and Transplantation, Nephrology and Renal Transplantation Research Group, KU Leuven, Leuven, Belgium
- Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Nephrology, Aalborg University Hospital, Aalborg, Denmark
| | - Jordi Bover
- Department of Nephrology, University Hospital Germans Trias i Pujol, Barcelona, Catalonia, Spain
- REMAR-IGTP Group, Germans Trias i Pujol Research Institute, Can Ruti Campus, Barcelona, Catalonia, Spain
| | - Andrew Davenport
- Department of Renal Medicine, Royal Free Hospital, University College London, London, UK
| | - Justine Bacchetta
- Pediatric Nephrology Rheumatology and Dermatology Unit, Reference Center for Rare Renal Diseases, ORKID and ERK-Net networks, Lyon University Hospital, Bron, France
- Lyon Est Medical School, INSERM1033 Research Unit, Claude Bernard Lyon 1 University, Lyon, France
| | - Mathias Haarhaus
- Division of Renal Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Diaverum Sweden, Malmö, Sweden
| | - Ditte Hansen
- Department of Nephrology, Copenhagen University Hospital-Herlev, Copenhagen
- Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - Carolina Gracia-Iguacel
- Department of Renal Medicine, IIS-Fundación Jiménez Díaz UAM University Hospital, Madrid, Spain
| | - Markus Ketteler
- Department of General Internal Medicine and Nephrology, Robert-Bosch Hospital, Stuttgart, Germany
| | - Louise McAlister
- Dietetic Team, UCL Great Ormond Street Hospital for Children and University College London, London, UK
| | - Emily White
- Dietetic Team, Royal Free Hospital, University College London, London, UK
| | - Sandro Mazzaferro
- Department of Translation and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Marc Vervloet
- Amsterdam Cardiovascular Sciences, Amsterdam UMC, The Netherlands
- Department of Nephrology, Amsterdam UMC, The Netherlands
| | - Rukshana Shroff
- Renal Unit, UCL Great Ormond Street Hospital for Children, London, UK
- Institute of Child Health, University College London, London, UK
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Chen N, Ma LL, Zhang Y, Chu X, Dong J, Yan YX. Association of long-term triglyceride-glucose index patterns with the incidence of chronic kidney disease among non-diabetic population: evidence from a functional community cohort. Cardiovasc Diabetol 2024; 23:7. [PMID: 38172903 PMCID: PMC10765660 DOI: 10.1186/s12933-023-02098-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The triglyceride-glucose (TyG) index is a reliable surrogate marker of insulin resistance and previous studies have confirmed the association of TyG index with incident chronic kidney disease (CKD). However, the impact of longitudinal patterns of TyG index on CKD risk among non-diabetic population is still unknown. Therefore, this study aimed to investigate the association of longitudinal patterns of TyG index with incident CKD among non-diabetic population. METHODS A total of 5484 non-diabetic participants who underwent one health examination per year from 2015 to 2017 were included in this prospective study. TyG index variability and cumulative TyG index were calculated to assess the longitudinal patterns of TyG index. Cox proportional hazard models were performed to estimate the association of TyG index variability or cumulative TyG index with incident CKD. RESULTS During a median of 3.82 years follow-up, 879 participants developed CKD. Compared with participants in the lowest quartile, the hazard ratio (HR) and 95% confidence interval (CI) of incident CKD were 1.772 (95% CI: 1.453, 2.162) for the highest TyG index variability quartile and 2.091 (95% CI: 1.646, 2.655) for the highest cumulative TyG index quartile in the fully adjusted models. The best discrimination and reclassification improvement were observed after adding baseline TyG, TyG index variability and cumulative TyG index to the clinical risk model for CKD. CONCLUSIONS Both TyG index variability and cumulative TyG index can independently predict incident CKD among non-diabetic population. Monitoring longitudinal patterns of TyG index may assist with prediction and prevention of incident CKD.
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Affiliation(s)
- Ning Chen
- Department of Epidemiology and Biostatistics, Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Lin-Lin Ma
- Department of Epidemiology and Biostatistics, Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Yu Zhang
- Department of Epidemiology and Biostatistics, Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Xi Chu
- Health Management Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jing Dong
- Health Management Center, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu-Xiang Yan
- Department of Epidemiology and Biostatistics, Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China.
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmenWai, Fengtai District, Beijing, 100069, China.
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Yi J, Song G, Lin Z, Peng Y, Wu J. Validity and Reproducibility of Food Group-Based Food Frequency Questionnaires in Assessing Sugar-Sweetened Beverage Consumption Habits among Chinese Middle-School Students. Nutrients 2023; 15:3928. [PMID: 37764712 PMCID: PMC10537416 DOI: 10.3390/nu15183928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Assessing the intake of sugar-sweetened beverages (SSBs) is crucial for reducing obesity; however, a simple but relatively accurate method for determining added sugar consumption among school adolescents is lacking. The aim of this study was to evaluate the reproducibility and validity of a food group-based food frequency questionnaire (FG-FFQ) for SSBs in assessing SSB consumption and added sugar among middle-school students. A total of 242 school students completed the FG-FFQs twice and four discontinuous 24-h dietary records (24HDR) over a three-month period. A weighted average approach was used to obtain the average sugar content in the sugary drink food group (FG). Correlation coefficient, weighted kappa statistic, misclassification analysis, and Bland-Altman plot were used to evaluate the validity and reproducibility of the FG-FFQ. Linear regression was utilized to obtain the calibration formulas. The average content of added sugar in sugary drink FG was 8.1 g/100 mL. SSB consumption frequency, consumption amount, and added sugar had correlation coefficients of 0.81, 0.87, and 0.87, respectively, in the validity analysis (p < 0.05). The majority of scatter plots were covered by 95% confidence intervals in the Bland-Altman bias analysis. The intra-class correlation coefficient of SSB consumption frequency and Spearman correlation coefficient of SSB consumption amount and added sugar were 0.74, 0.81, and 0.90, respectively, in the reproducibility analysis (p < 0.05). Results produced by the FG-FFQ calibration formula were more comparable to 24HDR. The FG-FFQ for SSB consumption showed acceptable validity and reproducibility, making it a viable instrument for epidemiological studies on sugary drinks in adolescents.
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Affiliation(s)
- Junyao Yi
- School of Public Health, Nanjing Medical University, Nanjing 211166, China; (J.Y.); (G.S.)
| | - Guoye Song
- School of Public Health, Nanjing Medical University, Nanjing 211166, China; (J.Y.); (G.S.)
| | - Zhenghao Lin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Z.L.); (Y.P.)
| | - Yuting Peng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Z.L.); (Y.P.)
| | - Jieshu Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; (Z.L.); (Y.P.)
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Sullivan VK, Rebholz CM. Nutritional Epidemiology and Dietary Assessment for Patients With Kidney Disease: A Primer. Am J Kidney Dis 2023; 81:717-727. [PMID: 36610612 PMCID: PMC10200755 DOI: 10.1053/j.ajkd.2022.11.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/19/2022] [Indexed: 01/06/2023]
Abstract
Nutritional epidemiology seeks to understand nutritional determinants of disease in human populations using experimental and observational study designs. Though randomized controlled trials provide the strongest evidence of causality, the expense and difficulty of sustaining adherence to dietary interventions are substantial barriers to investigating dietary determinants of kidney disease. Therefore, nutritional epidemiology commonly employs observational study designs, particularly prospective cohort studies, to investigate long-term associations between dietary exposures and kidney disease. Due to the covarying nature and synergistic effects of dietary components, holistic characterizations of dietary exposures that simultaneously consider patterns of foods and nutrients regularly consumed are generally more relevant to disease etiology than single nutrients or foods. Dietary intakes have traditionally been self-reported and are subject to bias. Statistical methods including energy adjustment and regression calibration can reduce random and systematic measurement errors associated with self-reported diet. Novel approaches that assess diet more objectively are gaining popularity but have not yet fully replaced self-report and require refinement and validation in populations with chronic kidney disease. More accurate and frequent diet assessment in existing and future studies will yield evidence to better personalize dietary recommendations for the prevention and treatment of kidney disease.
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Affiliation(s)
- Valerie K Sullivan
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland
| | - Casey M Rebholz
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland; Division of Nephrology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
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Beer J, Lambert K, Lim W, Bettridge E, Woodward F, Boudville N. Validation of a Phosphorus Food Frequency Questionnaire in Patients with Kidney Failure Undertaking Dialysis. Nutrients 2023; 15:nu15071711. [PMID: 37049551 PMCID: PMC10096831 DOI: 10.3390/nu15071711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/29/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Nutritional guidelines recommended limiting dietary phosphorus as part of phosphorus management in patients with kidney failure. Currently, there is no validated phosphorus food frequency questionnaire (P-FFQ) to easily capture this nutrient intake. An FFQ of this type would facilitate efficient screening of dietary sources of phosphorus and assist in developing a patient-centered treatment plan. The objectives of this study were to develop and validate a P-FFQ by comparing it with the 24 hr multi-pass recall. Fifty participants (66% male, age 70 ± 13.3 years) with kidney failure undertaking dialysis were recruited from hospital nephrology outpatient departments. All participants completed the P-FFQ and 24 hr multi-pass recalls with assistance from a renal dietitian and then analysed using nutrient analysis software. Bland–Altman analyses were used to determine the agreement between P-FFQ and mean phosphorus intake from three 24 hr multi-pass recalls. Mean phosphorous intake was 1262 ± 400 mg as determined by the 24 hr multi pass recalls and 1220 ± 348 mg as determined by the P-FFQ. There was a moderate correlation between the P-FFQ and 24 hr multi pass recall (r = 0.62, p = 0.37) with a mean difference of 42 mg (95% limits of agreement: 685 mg; −601 mg, p = 0.373) between the two methods. The precision of the P-FFQ was 3.33%, indicating suitability as an alternative to the 24 hr multi pass recall technique. These findings indicate that the P-FFQ is a valid, accurate, and precise tool for assessing sources of dietary phosphorus in people with kidney failure undertaking dialysis and could be used as a tool to help identify potentially problematic areas of dietary intake in those who may have a high serum phosphate.
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Affiliation(s)
- Joanne Beer
- Nutrition and Dietetics Department, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
| | - Kelly Lambert
- School of Medical, Indigenous and Health Science, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Wai Lim
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
| | - Ellen Bettridge
- Nutrition and Dietetics Department, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
| | - Fiona Woodward
- Nutrition and Dietetics Department, St John of God, Bunbury, WA 6223, Australia
| | - Neil Boudville
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
- Medical School, University of Western Australia, Nedlands, WA 6009, Australia
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Li S, Guo W, Ren Z, Tan L, Fan L, Zhu M, Wei H, Zhang W. The simplified iodine-specific food frequency questionnaire can evaluate iodine intake in Chinese adults. Nutr Res 2023; 109:47-57. [PMID: 36586289 DOI: 10.1016/j.nutres.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 11/29/2022] [Accepted: 12/04/2022] [Indexed: 12/14/2022]
Abstract
We hypothesized that an effective iodine-specific food frequency questionnaire (I-FFQ) simplification method could expand the application of the I-FFQ in evaluating long-term iodine intake. An adult I-FFQ was developed and was simplified by deleting food items with iodine contribution rates ≤0.1%, combining food items with similar species and iodine contribution rates, and calculating the iodine content of combined food by a weighted calculation method. A 3-day (3-d) diet diary tested the validity of the I-FFQ. We evaluated the relationship between iodine intake estimated using the I-FFQ and the urinary iodine to creatinine ratio, thyroid volume (Tvol), and thyroid function. The Kappa value was 0.62 for the original I-FFQ and the 3-d diet diary (P < .001), 0.78 for the short-version I-FFQ and the 3-d diet diary (P < .001), and 0.76 for the original I-FFQ and the short-version I-FFQ (P < .001). The mean difference before and after simplification was 27.1 µg/d. The Tvol was different between the I-FFQ groups and showed an upward trend (P for trend = .01). Tvol was higher in the 284 <I-FFQ <347 µg/d (β = 0.55; 95% CI, 0.06-1.03; P = .03) and I-FFQ >347 µg/d (β = 0.72; 95% CI, 0.16-1.28; P = .01) groups after simplification. The I-FFQ is an effective method for evaluating iodine nutritional status in adults. After streamlining, the food items were reduced from 58 to 15, which shortened the investigation time while retaining evaluation efficiency; it is also easier to get the cooperation of the subjects and improve the availability of I-FFQ.
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Affiliation(s)
- Shaohan Li
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Wenxing Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Zhiyuan Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Long Tan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Lili Fan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Mei Zhu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Hongyan Wei
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, 300070, China; Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, 300052, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China; Tianjin Key Laboratory of Hormones and Development (Ministry of Health), Tianjin, 300384, China.
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Huang MC, Hung SC, Tai TH, Lin TY, Chang CI, Hsu CC. Using a Short Food Frequency Questionnaire to Evaluate Macronutrients, Fiber, Phosphorus, Potassium, and Calcium in Adults with Stages 3-5 Chronic Kidney Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11998. [PMID: 36231298 PMCID: PMC9565822 DOI: 10.3390/ijerph191911998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
The progression of chronic kidney disease (CKD) can be directly or indirectly accelerated by a poor diet and the diet's influence on risk factors for this disease. There have been no food frequency questionnaires (FFQs) developed for the assessment of diet in patients with CKD in Taiwan. This study analyzed the validity of a short FFQ (SFFQ) with 42 items for estimating patient intake of macronutrients, fiber, phosphorus, potassium, and calcium against 3-day dietary records (3-day DRs) in Taiwanese patients with stages 3-5 CKD. In an interview, 107 participants with the help of a dietician filled out an SFFQ and reviewed a 3-day DR the patients had filled out prior to the interview. Partial Pearson correlation coefficients between SFFQ and 3-day DR were 0.722, 0.619, 0.593, 0.572, 0.450, 0.611 and 0.410 for protein, fat, carbohydrate, fiber, phosphorus, potassium, and calcium, respectively, after adjusting for energy intake. Cross-classification analysis revealed 63.5-83.2% similarity in cross-tool estimated intakes of macronutrients, fiber, phosphorus, potassium, and calcium in the same quartiles or adjacent ones. Bland-Altman plots revealed good agreement between the two tools along different intake levels. In conclusion, the newly developed SFFQ had moderate relative validity in estimating the usual intake of key nutrients related to nutrition management of patients with late-stage CKD, suggesting it can be used to assess dietary intakes in a population with CKD, especially in those residing in an Asian region.
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Affiliation(s)
- Meng-Chuan Huang
- Department of Nutrition and Dietetics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Szu-Chun Hung
- Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, School of Medicine, Tzu Chi University, Hualien 97002, Taiwan
| | - Tsen-Hua Tai
- Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, School of Medicine, Tzu Chi University, Hualien 97002, Taiwan
| | - Ting-Yun Lin
- Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, School of Medicine, Tzu Chi University, Hualien 97002, Taiwan
| | - Chiao-I Chang
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County 35053, Taiwan
- Department of Health Services Administration, China Medical University, Taichung 40402, Taiwan
- Department of Family Medicine, Min-Sheng General Hospital, Taoyuan 33044, Taiwan
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8
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Wagner S, Merkling T, Metzger M, Koppe L, Laville M, Boutron-Ruault MC, Frimat L, Combe C, Massy ZA, Stengel B, Fouque D. Probiotic Intake and Inflammation in Patients With Chronic Kidney Disease: An Analysis of the CKD-REIN Cohort. Front Nutr 2022; 9:772596. [PMID: 35433774 PMCID: PMC9005823 DOI: 10.3389/fnut.2022.772596] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 03/07/2022] [Indexed: 12/13/2022] Open
Abstract
Background and Aims Little is known about the effects of probiotics on inflammation in the context of chronic kidney disease (CKD). We investigated the association between probiotic intake and inflammation in patients with moderate-to-advanced CKD. Methods We performed a cross-sectional study of 888 patients with stage 3–5 CKD and data on serum C-reactive protein (CRP) levels and a concomitant food frequency questionnaire. We estimated the odds ratios (ORs) [95% confidence interval (CI)] for various CRP thresholds (>3, >4, >5, >6, and >7 mg/L) associated with three intake categories (no yoghurt, ordinary yoghurt, and probiotics from yoghurts or dietary supplements) and two frequency categories (daily or less than daily). Results The 888 study participants (median age: 70; men: 65%) had a median estimated glomerular filtration rate of 28.6 mL/min/1.73 m2 and a median [interquartile range] CRP level of 3.0 [1.6, 7.0] mg/L. Fifty-seven percent consumed ordinary yoghurt and 30% consumed probiotic yoghurt. The median intake frequency for yoghurt and probiotics was 7 per week. Relative to participants not consuming yoghurt, the ORs [95% CI] for CRP > 6 or >7 mg/L were significantly lower for participants consuming ordinary yoghurt (0.58 [0.37, 0.93] and 0.57 [0.35, 0.91], respectively) and for participants consuming probiotics (0.54 [0.33, 0.9] and 0.48 [0.28, 0.81], respectively), independently of age, sex, body mass index, CKD stage, cardiovascular disease, and fibre, protein and total energy intakes. The ORs were not significantly lower for CRP thresholds >3, >4, and >5 mg/L and were not significantly greater in daily consumers than in occasional consumers. Conclusion We observed independent associations between the consumption of yoghurt or probiotics and lower levels of inflammation in patients with CKD. There was no evidence of a dose-effect relationship. Clinical Trial Registration [https://www.clinicaltrials.gov/ct2/show/NCT03381950], identifier [NCT03381950].
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Affiliation(s)
- Sandra Wagner
- Université de Lorraine, INSERM CIC 1433, Nancy CHRU, Inserm U1116, Nancy, France
- FCRIN INI-CRCT, Nancy, France
- *Correspondence: Sandra Wagner,
| | - Thomas Merkling
- Université de Lorraine, INSERM CIC 1433, Nancy CHRU, Inserm U1116, Nancy, France
| | - Marie Metzger
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Univ Paris-Saclay, UVSQ, INSERM, Equipe Epidémiologie Clinique, Villejuif, France
| | - Laetitia Koppe
- Département de Néphrologie, Hopital Lyon Sud – HCL, Pierre-Bénite, France
- Université de Lyon, CarMeN Laboratory, INSA-Lyon, INSERM U1060, INRA, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Maurice Laville
- Université de Lyon, CarMeN Laboratory, INSA-Lyon, INSERM U1060, INRA, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Marie-Christine Boutron-Ruault
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Université Paris-Saclay, UVSQ, INSERM, Gustave Roussy, Equipe Exposome-Hérédité, Villejuif, France
| | - Luc Frimat
- EA4360 APEMAC, Université de Lorraine, Université Paris Descartes, Nancy, France
- Département de Néphrologie, CHU de Nancy, Vandoeuvre-lès-Nancy, France
| | - Christian Combe
- Service de Néphrologie-Transplantation-Dialyse-Aphérèse, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
- INSERM, U1026, Université Bordeaux Segalen, Bordeaux, France
| | - Ziad A. Massy
- FCRIN INI-CRCT, Nancy, France
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Univ Paris-Saclay, UVSQ, INSERM, Equipe Epidémiologie Clinique, Villejuif, France
- Service de Néphrologie, Hôpital Ambroise Paré, APHP, Paris, France
| | - Bénédicte Stengel
- FCRIN INI-CRCT, Nancy, France
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Univ Paris-Saclay, UVSQ, INSERM, Equipe Epidémiologie Clinique, Villejuif, France
| | - Denis Fouque
- Département de Néphrologie, Hopital Lyon Sud – HCL, Pierre-Bénite, France
- Université de Lyon, CarMeN Laboratory, INSA-Lyon, INSERM U1060, INRA, Université Claude Bernard Lyon 1, Villeurbanne, France
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Rossato SL, Mosele F, Moreira LB, Rodrigues MP, Lima RF, Fuchs FD, Fuchs SC. Development, Validation, and Reproducibility of Food Group-Based Frequency Questionnaires for Clinical Use in Brazil: A Pre-Hypertension and Hypertension Diet Assessment. Nutrients 2021; 13:nu13113881. [PMID: 34836136 PMCID: PMC8622104 DOI: 10.3390/nu13113881] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/27/2021] [Accepted: 10/06/2021] [Indexed: 12/02/2022] Open
Abstract
The Blood pressure control diet is well described; however, it has not been implemented in clinical care, possibly due to the impracticability of the diet assessment in these contexts. In order to facilitate the dietary assessment, we developed and assessed the validity and reproducibility of two food group-based food frequency questionnaires (FG-FFQs), with a one-week (7-day FG-FFQ) and a one-month (30-day FG-FFQ) period of coverage for patients with pre-hypertension or hypertension. In 2010, 155 men and women, 30–70 years old, were invited to participate in a prospective study in two outpatient clinics in Porto Alegre, southern Brazil. The participants responded to two 30-day, two 7-day FG-FFQ, four 24-h dietary recalls, and underwent demographic, anthropometric, and blood pressure assessments. The validity and reproducibility were assessed using partial correlation coefficients adjusted for sex and age, and the internal validity was tested using the intra-class correlation coefficient. The participants were aged 61 (±10) years and 60% were women. The validity correlation coefficient was higher than r = 0.80 in the 30-day FG-FFQ for whole bread (r = 0.81) and the 7-day FG-FFQ for diet/light/zero soda and industrialized juices (r = 0.84) in comparison to the 24-h dietary recalls. The global internal validity was α = 0.59, but it increased to α = 0.76 when 19 redundant food groups were excluded. The reproducibility was higher than r = 0.80 for pasta, potatoes and manioc, bakery goods, sugar and cocoa, and beans for both versions. The 30-day had a slightly higher validity, both had good internal validity, and the 7-day FG-FFQ had a higher reproducibility.
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Affiliation(s)
- Sinara L. Rossato
- Postgraduate Program of Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, RS, Brazil; (F.M.); (L.B.M.); (F.D.F.); (S.C.F.)
- Institute of Geography, Campus Santa Mônica, Universidade Federal de Uberlândia, Uberlândia 38408-100, MG, Brazil
- Department of Nutrition, Harvard T.H. Chann School of Public Health, Harvard University, Boston, MA 02115, USA
- Correspondence: ; Tel.: +55-14-99116-1551
| | - Francisca Mosele
- Postgraduate Program of Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, RS, Brazil; (F.M.); (L.B.M.); (F.D.F.); (S.C.F.)
- PREVER National Institute of Science and Technology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil;
- Nutrition Thinking® Co., Tecnopuc, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre 90619-900, RS, Brazil
| | - Leila B. Moreira
- Postgraduate Program of Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, RS, Brazil; (F.M.); (L.B.M.); (F.D.F.); (S.C.F.)
- PREVER National Institute of Science and Technology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil;
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 91509-900, RS, Brazil;
| | - Marcela Perdomo Rodrigues
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 91509-900, RS, Brazil;
| | - Ruchelli França Lima
- PREVER National Institute of Science and Technology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil;
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 91509-900, RS, Brazil;
| | - Flávio D. Fuchs
- Postgraduate Program of Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, RS, Brazil; (F.M.); (L.B.M.); (F.D.F.); (S.C.F.)
- PREVER National Institute of Science and Technology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil;
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 91509-900, RS, Brazil;
| | - Sandra C. Fuchs
- Postgraduate Program of Epidemiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, RS, Brazil; (F.M.); (L.B.M.); (F.D.F.); (S.C.F.)
- PREVER National Institute of Science and Technology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, RS, Brazil;
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre 91509-900, RS, Brazil;
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Bin Zarah A, Feraudo MC, Andrade JM. Development and Relative Validity of the Chronic Kidney Disease Short Food Frequency Questionnaire (CKD SFFQ) to Determine Diet Quality and Dietary Habits among Adults with Chronic Kidney Disease. Nutrients 2021; 13:3610. [PMID: 34684611 PMCID: PMC8538370 DOI: 10.3390/nu13103610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/08/2021] [Accepted: 10/13/2021] [Indexed: 12/21/2022] Open
Abstract
Limited instruments are available to determine diet quality among US adults with chronic kidney disease (CKD). The purpose of this study was two-fold: (1) to develop a food frequency questionnaire, CKD SFFQ, for adults with CKD and (2) to validate the CKD SFFQ against two 24-h recalls in determining diet quality (DQ). A 57-item CKD SFFQ was developed through a content validation method. Adults with CKD (n = 46) completed the CKD SFFQ and 2-24-h recalls. Statistical analyses included descriptive statistics, frequencies, t-tests, Pearson correlations, and Bland-Altman plots. All data were analyzed using JMP SAS v15 with statistical significance detected at p < 0.05. Results showed no differences for the overall DQ (p = 0.11) and the nine whole-food components (p = 0.07 to p = 0.44) when comparing the CKD SFFQ to the 2-24-h recalls. Pearson correlation coefficients ranged from -0.39 (refined grains) to 0.60 (greens and beans). Bland-Altman plots showed overall good agreement and there was a systematic trend towards higher estimates with the CKD SFFQ, particularly for overall DQ, total proteins, and dairy. The majority of participants rarely or never consumed grains, fruits, vegetables, seafood, and plant proteins. The CKD SFFQ was demonstrated to be an acceptable method to determine DQ for adults with CKD.
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Affiliation(s)
- Aljazi Bin Zarah
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611, USA; (A.B.Z.); (M.C.F.)
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| | - Mary Carissa Feraudo
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611, USA; (A.B.Z.); (M.C.F.)
| | - Jeanette Mary Andrade
- Food Science and Human Nutrition Department, University of Florida, Gainesville, FL 32611, USA; (A.B.Z.); (M.C.F.)
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11
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Mason DL, Godugu K, Nnani D, Mousa SA. Effects of sevelamer carbonate versus calcium acetate on vascular calcification, inflammation, and endothelial dysfunction in chronic kidney disease. Clin Transl Sci 2021; 15:353-360. [PMID: 34599865 PMCID: PMC8841464 DOI: 10.1111/cts.13151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/28/2021] [Accepted: 08/03/2021] [Indexed: 01/12/2023] Open
Abstract
Hyperphosphatemia is present in most patients with end‐stage renal disease (ESRD) and has been associated with increased cardiovascular mortality. Phosphate binders (calcium‐based and calcium free) are the mainstay pharmacologic treatment to lower phosphorus levels in patients with ESRD. We evaluated biochemical markers of vascular calcification, inflammation, and endothelial dysfunction in patients with chronic kidney disease (CKD) treated with sevelamer carbonate (SC) versus calcium acetate (CA). Fifty patients with CKD (stages 3 and 4) were enrolled and assigned to treatment with SC and CA for 12 weeks. At the end of the study the biomarkers of vascular calcification, inflammation, and endothelial dysfunction were analyzed. A significant increase in HDL‐cholesterol was observed with SC but not with CA in patients with CKD. Treatment with SC reduced serum phosphate, calcium phosphate, and FGF‐23 levels and there was no change with CA treatment. The inflammatory markers IL‐8, IFN‐γ, and TNFα decreased with response to both treatments. The levels of IL‐6 significantly increased with CA treatment and no change was observed in the SC treatment group. SC showed favorable effects on anti‐inflammatory and vascular calcification biomarkers compared to CA treatment in patients with CKD stages 3 and 4 with normal phosphorous values.
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Affiliation(s)
- Darius L Mason
- Methodist Le Bonheur Healthcare, Memphis, Tennessee, USA.,Department of Clinical Pharmacy & Translational Science, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Kavitha Godugu
- The Pharmaceutical Research Institute, Albany College of Pharmacy and Health Sciences, Rensselaer, New York, USA
| | - Daryl Nnani
- Department of Pharmacy, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, Bronx, New York, USA
| | - Shaker A Mousa
- The Pharmaceutical Research Institute, Albany College of Pharmacy and Health Sciences, Rensselaer, New York, USA
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12
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Rao SN, Chandra A, Tiwari P, Mishra P. Development and Validation of a Novel Food-frequency Questionnaire for Hemodialysis Patients in Lucknow, India. Indian J Nephrol 2021; 31:276-282. [PMID: 34376943 PMCID: PMC8330646 DOI: 10.4103/ijn.ijn_134_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 10/17/2019] [Accepted: 11/17/2019] [Indexed: 11/09/2022] Open
Abstract
Introduction: Food-frequency questionnaire (FFQ) is a preferred tool for longitudinal dietary assessment and has been recently validated in patients on hemodialysis in other countries. As dietary habits vary vastly across regions, this study was planned to develop and validate a novel dialysis FFQ in northern India. Materials and Methods: Dietary recall data from patients on hemodialysis available from the previous year were used for identifying food items for inclusion in the FFQ. A nutrient database was created to estimate energy, protein, calcium, phosphorus, and potassium content of the foods included in the food list. The FFQ was validated against a 2-day dietary recall method (one predialysis, one on the dialysis day) in patients on maintenance hemodialysis in a tertiary care hospital in Lucknow, northern India. Results: Dietary recall data from 78 patients on hemodialysis were used for the generation of the FFQ. A total of 84 patients completed the validation study. All the nutrients measured by the FFQ correlated significantly with the means of the 2-day dietary record (r values 0.31–0.76) both in crude- and energy-adjusted intakes. De-attenuation further improved the correlation (0.35–0.80). Bland-Altman plots showed higher estimates by FFQ than by dietary recall. Cross-classification analysis showed correct classification in the exact or adjacent quintile (average 60%) by both methods and 2% gross misclassification. Weighted kappa showed fair agreement for energy intake and slight agreement for others. Conclusion: This novel semiquantitative FFQ is a valid tool for measuring energy and nutrient intakes in hemodialysis patients.
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Affiliation(s)
- S Namrata Rao
- Department of Nephrology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Abhilash Chandra
- Department of Nephrology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Poonam Tiwari
- Department of Dietetics, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Prabhaker Mishra
- Department of Biostatistics and Health Informatics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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13
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Validation of a six-item dietary calcium screening tool among HIV patients in China. Public Health Nutr 2021; 24:4786-4795. [PMID: 33820577 DOI: 10.1017/s1368980021001427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Individuals with HIV are at increased risk for osteoporosis. A healthy diet with adequate Ca is recommended to promote bone health. However, lengthy nutritional assessments pose barriers to routine screenings in clinical practice. This study aimed to examine the validity and reproducibility of a six-item dietary Ca screening tool among Chinese individuals with HIV. DESIGN We conducted a two time-point study in an outpatient setting. Volunteers self-administered the six-item tool upon enrolment and again at 1-month follow-up. At baseline, participants also completed a validated FFQ and surveys regarding demographic and clinical risk factors. SETTING Beijing, China; Shenzhen, Guangdong, China. PARTICIPANTS Upon enrolment, 127 individuals with HIV participated in the study, of whom 83 completed the follow-up screening. RESULTS Mean age of participants was 35·2 (sd 9·3) years, average BMI was 22·8 (sd 3·8) kg/m2 and 89 % were men. Among the participants, 54·7 % reported Ca intake less than 800 mg/d. The six-item tool demonstrated fair-to-moderate relative validity with a correlation of 0·39 and 75·7 % of subjects classified in same/adjacent quartiles as the reference, and moderate-to-good reproducibility with a correlation of 0·60 and 83·1 % of subjects classified in same/adjacent quartiles. Finally, receiver operating characteristic analyses yielded a sensitivity of 87·0 % and a specificity of 39·4 % with optimised cut-off level. CONCLUSIONS The six-item tool presented adequate validity and reproducibility to identify individuals with low Ca intake among the target population, providing a convenient instrument for categorising Ca intake in clinical practice, prompting referrals for further assessment, and raising awareness of dietary Ca in bone disease prevention.
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14
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Fladie IA, Adewumi TM, Vo NH, Tritz DJ, Vassar MB. An Evaluation of Nephrology Literature for Transparency and Reproducibility Indicators: Cross-Sectional Review. Kidney Int Rep 2020; 5:173-181. [PMID: 32043031 PMCID: PMC7000850 DOI: 10.1016/j.ekir.2019.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 11/04/2019] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Reproducibility is critical to diagnostic accuracy and treatment implementation. Concurrent with clinical reproducibility, research reproducibility establishes whether the use of identical study materials and methodologies in replication efforts permits researchers to arrive at similar results and conclusions. In this study, we address this gap by evaluating nephrology literature for common indicators of transparent and reproducible research. METHODS We searched the National Library of Medicine catalog to identify 36 MEDLINE-indexed, English-language nephrology journals. We randomly sampled 300 publications published between January 1, 2014, and December 31, 2018. RESULTS Our search yielded 28,835 publications, of which we randomly sampled 300 publications. Of the 300 publications, 152 (50.7%) were publicly available, whereas 143 (47.7%) were restricted through paywall and 5 (1.7%) were inaccessible. Of the remaining 295 publications, 123 were excluded because they lack empirical data necessary for reproducibility. Of the 172 publications with empirical data, 43 (25%) reported data availability statements and 4 (2.3%) analysis scripts. Of the 71 publications analyzed for preregistration and protocol availability, 0 (0.0%) provided links to a protocol and 8 (11.3%) were preregistered. CONCLUSION Our study found that reproducible and transparent research practices are infrequently used by the nephrology research community. Greater efforts should be made by both funders and journals. In doing so, an open science culture may eventually become the norm rather than the exception.
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Affiliation(s)
- Ian A. Fladie
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Tomi M. Adewumi
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Nam H. Vo
- Kansas City University of Medicine and Biosciences, Joplin, Missouri, USA
| | - Daniel J. Tritz
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Matt B. Vassar
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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15
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Prevalence and Correlates of Sarcopenia among Elderly CKD Outpatients on Tertiary Care. Nutrients 2018; 10:nu10121951. [PMID: 30544657 PMCID: PMC6315502 DOI: 10.3390/nu10121951] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 11/27/2018] [Accepted: 12/04/2018] [Indexed: 02/08/2023] Open
Abstract
Background: Sarcopenia is a widespread concern in chronic kidney disease (CKD) as well in elderly patients and is one of the main reasons why low-protein diets for this population are controversial. The aim of this study was to assess the prevalence and correlates of sarcopenia among elderly male patients affected by CKD followed up in an outpatient nephrology clinic, where moderate protein restriction (0.6–0.8 g/Kg/day) is routinely recommended to patients in CKD stage 3b-5 not on dialysis. Methods: This observational study included 80 clinically-stable male out-patients aged >60, affected by stage 3b-4 CKD. Forty patients aged ≥75 (older seniors) were compared to the other forty patients aged 60–74 (younger seniors). All patients underwent a comprehensive nutritional and functional assessment. Results: Older seniors showed lower serum albumin, hand-grip strength, body mass index (BMI), skeletal muscle mass, and resting energy expenditure. Protein intake was significantly lower in older seniors whereas energy intake was similar. Average daily physical activity was lower in the older seniors than in the younger ones. Sarcopenia was more prevalent in older than in younger seniors. Among older seniors, sarcopenic and non-sarcopenic ones differed in age and performance on the Six-Minute Walk test, whereas the estimated glomerular filtration rate (eGFR), biochemistry, dietary protein, and energy intakes were similar. Conclusions: Older senior CKD male patients have lower muscle mass, muscle strength, and physical capacity and activity levels, with a higher prevalence of sarcopenia than younger patients. This occurs at the same residual renal function and metabolic profile and protein intake. Energy intake was at the target in both subgroups. In this CKD cohort, sarcopenia was associated with age and physical capacity, but not with eGFR or dietary intakes.
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Affret A, El Fatouhi D, Dow C, Correia E, Boutron-Ruault MC, Fagherazzi G. Relative Validity and Reproducibility of a New 44-Item Diet and Food Frequency Questionnaire Among Adults: Online Assessment. J Med Internet Res 2018; 20:e227. [PMID: 29980502 PMCID: PMC6053608 DOI: 10.2196/jmir.9113] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 02/01/2018] [Accepted: 02/18/2018] [Indexed: 12/29/2022] Open
Abstract
Background Dietary questionnaires currently available which can assess the habitual diet are timely, costly, or not adapted well to the modern diet; thus, there is a need for a shorter food frequency e-Questionnaire (FFeQ) adapted to Western diets, in order to properly estimate energy and macronutrient intakes or rank individuals according to food and nutrient intakes. Objective The aim of this study was to evaluate the relative validity and reproducibility of a 30-minute and 44-item FFeQ in a sample of adults obtained from the general population. Methods A sample of French adults was recruited through social media and an advertising campaign. A total of 223 volunteers completed the FFeQ twice at one-year intervals and were included in the reproducibility study. During that interval, 92 participants completed three-to-six 24-hour recalls and were included in the validity study. Nutrient and dietary intakes were computed for all validity and reproducibility participants. The level of agreement between the two methods was evaluated for nutrient and food group intakes using classification into quintiles of daily intake, correlation coefficients and Bland-Altman plots. Results For relative validity, correlation coefficients ranged from 0.09 to 0.88 (unadjusted correlation coefficients, median: 0.48) and 0.02 to 0.68 (deattenuated and energy adjusted correlation coefficients, median: 0.50) for food group and nutrient intakes, respectively. The median proportion of subjects classified into the same or adjacent quintile was 73% and 66% for food and nutrient intakes, respectively. Bland-Altman plots showed good agreement across the range of intakes. Regarding reproducibility, intraclass correlation coefficients ranged from 0.33 to 0.72 (median: 0.60) and 0.55 to 0.73 (median: 0.64), for food and nutrient intakes, respectively. Conclusions The FFeQ showed acceptable validity and reproducibility in a sample of adults based on their food and nutrient intakes. The FFeQ is a promising and low-cost tool that can be used in large-scale online epidemiological studies or clinical routines and could be integrated into evidence-based smartphone apps for assessing diet components.
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Affiliation(s)
- Aurélie Affret
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Douae El Fatouhi
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Courtney Dow
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Emmanuelle Correia
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Marie-Christine Boutron-Ruault
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Guy Fagherazzi
- Inserm U1018, Center for Research in Epidemiology and Population Health, Villejuif, France.,Université Paris-Sud, Orsay, France.,Université de Versailles-Saint-Quentin-en-Yvelines, Versailles, France
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Crews DC. Potential applications of a new short food frequency questionnaire for CKD patients. BMC Nephrol 2017; 18:338. [PMID: 29179684 PMCID: PMC5704403 DOI: 10.1186/s12882-017-0765-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 11/20/2017] [Indexed: 11/23/2022] Open
Abstract
Diet is among the most modifiable risk factors for chronic kidney disease (CKD) progression. Studies of beneficial dietary patterns for persons with CKD have largely utilized dietary assessment measures developed in individuals without CKD. In BMC Nephrology, Affret et al. report on their study of the reproducibility of a newly developed short 49-item food frequency questionnaire (SFFQ) adapted to patients with CKD. Here, we discuss potential applications of this SFFQ, towards better understanding of which dietary patterns portend the most favorable outcomes in CKD.
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Affiliation(s)
- Deidra C Crews
- Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, 301 Mason F. Lord Drive, Suite 2500, Baltimore, MD, 21224, USA. .,Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA. .,Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, MD, USA. .,Johns Hopkins Center for Health Equity, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
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