Nutritional Status of Children with ESRD Varies with Renal Replacement Therapy Modality

Among pediatric patients with end-stage kidney disease (ESRD), the frequency of protein-energy malnutrition ranges from 20% to 80%, resulting in loss of lean mass, depletion of fat mass, and deceleration of growth, affecting height. Multiple factors are involved in these alterations, including hormonal imbalance, low nutrient intake, decreased residual renal function, use of renal replacement therapies (RRT), i.e., hemodialysis and ... Read More »

Obesity and Outcomes in ESRD Patients Receiving Peritoneal Dialysis

In developed countries, since the mid-1980s the prevalence of obesity among patients with end-stage renal disease (ESRD) has increased. The increase parallels that in the general population; however, the trends in the ESRD population in the United States have been more dramatic. The difference in the trends may be explained by the increased risk for chronic kidney disease in patients ... Read More »

Mortality and Cardiovascular Risk after AKI Requiring Dialysis

Among patients with end-stage renal disease (ESRD) requiring renal replacement therapy (RRT), there is a high burden of cardiovascular disease and early death; the risk is particularly high in the first year following initiation of dialysis therapy. Cardiovascular disease is a contributing factor in >50% of all deaths with known causes among patients with ESRD. Results of recent studies suggest ... Read More »

Low Protein Intake Associated with Higher Mortality Risk

Glomerular filtration rate (GFR) is a key index of kidney function. Protein intake is a major dietary modulator of GFR and standard practice calls for low protein intake to slow the progression of chronic kidney disease (CKD). Results of studies on low protein intake in kidney disease have been inconsistent regarding decline in kidney function and/or mortality over time. Massimo ... Read More »

Jackson Heart Study Post Hoc Analysis: Protein Intake and Long-Term Decline in Kidney Function

The estimated prevalence of chronic kidney disease (CKD) in the United States is 14% to 16% of the adult population. Patients with CKD commonly progress to end-stage renal disease (ESRD), requiring dialysis therapy or transplantation; CKD is associated with substantial morbidity and mortality. Diabetes and hypertension are major contributors to kidney disease; other modifiable risk factors, including diet, may be ... Read More »

Jackson Heart Study: Dietary Acid Load and Risk of CKD Progression

Results of recent studies have shown that progression of chronic kidney disease (CKD), defined by estimated glomerular filtration rate (eGFR), can be affected by acid-base status. Research, including animal studies, observational epidemiology, and small clinical trials, has examined the impact of chronic metabolic acidosis on eGFR decline in individuals with moderately impaired kidney function. Diets high in sulfur-rich protein and ... Read More »

Eculizumab Treatment More Effective in Patients with Rapidly Progressive C3 Glomerulopathy

Membranoproliferative glomerulonephritis (MPGN) has traditionally been classified into three subtypes: type I and type III, characterized by immunoglobulins and complement deposits, and type II (dense deposit disease [DDD]), defined as the presence of dense deposits in the basement membrane on electron microscopy study. A new classification has been proposed to consider the wide variety of pathologic patterns of MPGN on ... Read More »

Weight Loss in Children and Adolescents with CKD Occurs with Decrease in eGFR

Children with chronic kidney disease (CKD), including end-stage renal disease (ESRD), are at risk for weight loss. Results of prior cross-sectional studies in adults have suggested that weight loss begins to occur at an estimated glomerular filtration rate (eGFR) of 40 mL/min/1.73 m2. However, there are few available data for longitudinal assessments of the timing or degree of weight loss ... Read More »

Center-Level Characteristics and Variations in Peritoneal Dialysis Outcomes

One of the most common reasons for discontinuation of peritoneal dialysis therapy is peritonitis. A significant proportion of patients receiving peritoneal dialysis who develop peritonitis experience serious adverse outcomes, including hospitalization, relapsed or recurrent peritonitis, removal of the peritoneal dialysis catheter, permanent transfer to hemodialysis therapy, and/or death. Studies have documented marked variation in peritonitis rates and technique survival across ... Read More »

Developing and Validating New Models to Estimate Lean Body Mass in Patients with CKD

Protein-energy wasting (PEW), a condition associated with adverse outcomes due to cardiac comorbidity and inflammation, is a common complication in patients with CKD. Patients undergoing dialysis experience PEW most often, but PEW is also seen in non–dialysis-dependent CKD patients. As renal function declines, protein catabolism can be gradually aggravated via various complex mechanisms and may become apparent in nutritional indices ... Read More »