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July Meeting Announcements

October 7-10, 2023, Academy of Nutrition and Dietetics, Food and Nutrition Conference and Expo (FNCE) 2023, Colorado Convention Center, Denver, CO. www.eatright.org/FNCE or call 800-877-1600 ext. 4862. October 14-16, 2023, American Nephrology Nurses Association (ANNA) Fall Meeting, Hilton Chicago, Chicago, IL. www.annanurse.org/events/2023-nephrology-nursing-practice-management-leadership-conference or call 888-600-2662. November 2-5, 2023, American Society of Nephrology (ASN) Kidney Week 2023, Pennsylvania Convention Center, Philadelphia, PA. www.asn-online.org/education or call 866-849-8868. April 13-16, 2024, International Society of Nephrology (ISN) World Congress of Nephrology 2024, Buenos Aires, Argentina. Visit www.theisn.org/wcn. April 14-17, 2024, American Nephrology Nurses Association (ANNA) 2024 Natl Symp Caribe Royale All Suite Hotel Convention Cent Orlando, FL. www.ananurse.org/events/2024-national-symposium or call 888-600-2662 May 14-18, 2024, National Kidney Foundation (NKF) Spring Clinical Meeting, Long Beach, CA. Visit www.kidney.org. or call 800-622-9010. May 23-26, 2024, 61st European Renal Association-European Dialysis and Transplantation Association (ERA-EDTA) Congress, Stockholmsmassan, Stockholm, Sweden, [email protected]. August 28-31, 2024, International Society on Renal Nutrition and Metabolism, 21st Congress of the International Society of Renal Nutrition and Metabolism, Hyderabad, India. www.icrnm2024.com. September 26-29, 2024, International Society for Peritoneal Dialysis, 40th Anniversary Congress, Dubai, UAE. www.ispd.org/dubai2024.

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Nutritional Status is Associated With Preserved Kidney Function in Patients With Autosomal Dominant Polycystic Kidney Disease

Malnutrition is a common complication in autosomal dominant polycystic kidney disease (ADPKD). We examined whether nutritional status is associated with the preservation of kidney function, using a cohort of typical ADPKD. We enrolled ambulatory ADPKD patients in 9 tertiary medical centers in Korea from May 2019 to December 2021. We excluded patients who were aged less than 18years, who had known end-stage kidney disease at the time of enrollment, who had a diagnosis of atypical ADPKD, and who were Tolvaptan users. The primary outcome was an estimated glomerular filtration rate (eGFR) decline >3mL/min/1.73m2, based on nutritional status assessed by subjective global assessment (SGA). We also evaluated an eGFR decline >1mL/min/1.73m2, an increase in urine protein-creatinine ratio (UPCR)>0, and an increase in UPCR >0.3 as secondary outcomes, based on SGA after the 1-year follow-up. A logistic regression (LR) model was used to calculate the odds ratio (OR) for the primary outcome. Because there were differences in several baseline variables, such as Mayo classification, serum hemoglobin, serum creatinine, and UPCR between SGA groups, we matched propensity scores. In total, 805 patients were prospectively enrolled. Among them, 236 patients who had 1-year follow-up data and typical imaging findings were analyzed to evaluate the effect of nutritional status on kidney function. SGA was used to assess the nutritional status. The mean age was 45.0±13.3years, and 49.6% of the patients were female. The mean eGFR was 81.9mL/min/1.73m2. Among the 236 patients, 91 (38.6%) experienced a 1-year eGFR decline >3mL/min/1.73m2. When a multivariable LR was applied, SGA 3-6 was identified as a significant factor related to a 1-year eGFR decline >3mL/min/1.73m2 (adjusted OR=1.22 [1.04-1.43]; P=.017). Despite matching propensity scores, the 1-year eGFR decline >3mL/min/1.73m2 was still higher in the SGA 3-6 group regardless of proteinuria. Good nutritional status is associated with better-preserved kidney function in non-obese typical ADPKD patients who do not take Tolvaptan.

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High Protein Whole Food Snack and Albumin Outcomes in Patients With Dialysis-Dependent Chronic Kidney Disease

Protein-energy wasting is common among patients on hemodialysis (HD). This study sought to define effects that a novel, post-HD, high-calorie, high-protein whole food snack had on patients' serum albumin (serum alb), serum phosphorus and equilibrated normalized protein catabolic rate (enPCR). A 12-month (6months intervention, 6months pre/post data collection), single-center, unblinded study was conducted. Participants (n=67) consumed, ad libitum, a whole food snack post-HD for 6 treatments each month. Upon analysis, regression models identified relationships between serum alb and whole food snack consumption across follow up. Predefined effect size anticipated was + 0.2g/dL. Patients were stratified by high (≥4g/dL) or low (<4g/dL) mean serum alb during a 3-month baseline period. Paired t-tests compared mean per patient difference in serum alb, enPCR and serum phosphorus from baseline to each month of follow up, stratified by high (≥640 g) or low (<640 g) consumption of the whole food snack (a priori caloric estimation). Linear regression models showed positive associations between higher serum alb and enPCR with higher whole food snack consumption across follow up (all P<.05). Assessments from baseline to each follow-up month show some increases in serum alb, yet t test comparisons were not significant. No significant changes were seen in serum phosphorus levels during follow-up. Albeit the catabolic effects of HD are well-known, effective nutritional interventions are scarce. Results showed that providing a whole food snack post-HD to individuals with serum alb <4.0g/dL may be beneficial but further studies are recommended.

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Differences in the Food Consumption Between Kidney Stone Formers and Nonformers in the Swiss Kidney Stone Cohort

Diet has a major influence on the formation and management of kidney stones. However, kidney stone formers' diet is difficult to capture in a large population. Our objective was to describe the dietary intake of kidney stone formers in Switzerland and to compare it to non-stone formers. We used data from the Swiss Kidney Stone Cohort (n=261), a multicentric cohort of recurrent or incident kidney stone formers with additional risk factors, and a control group of CT-scan proven non-stone formers (n=197). Dieticians conducted two consecutive 24-h dietary recalls, using structured interviews and validated software (GloboDiet). We took the mean consumption per participant of the two 24-h dietary recalls to describe the dietary intake and used two-part models to compare the two groups. The dietary intake was overall similar between stone and non-stone formers. However, we identified that kidney stone formers had a higher probability of consuming cakes and biscuits (odds ratio, OR[95% CI] =1.56[1.03; 2.37]) and soft drinks (OR=1.66[1.08; 2.55]). Kidney stone formers had a lower probability of consuming nuts and seeds (OR =0.53[0.35; 0.82]), fresh cheese (OR=0.54[0.30; 0.96]), teas (OR=0.50[0.3; 0.84]), and alcoholic beverages (OR=0.35[0.23; 0.54]), especially wine (OR=0.42[0.27; 0.65]). Furthermore, among consumers, stone formers reported smaller quantities of vegetables (β coeff[95% CI]= - 0.23[- 0.41; - 0.06]), coffee (β coeff= - 0.21[- 0.37; - 0.05]), teas (β coeff= - 0.52[- 0.92; - 0.11]) and alcoholic beverages (β coeff= - 0.34[- 0.63; - 0.06]). Stone formers reported lower intakes of vegetables, tea, coffee, and alcoholic beverages, more specifically wine, but reported drinking more frequently soft drinks than non-stone formers. For the other food groups, stone formers and non-formers reported similar dietary intakes. Further research is needed to better understand the links between diet and kidney stone formation and develop dietary recommendations adapted to the local settings and cultural habits.

Open Access
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Activity and Profile of the Users of a Novel Mobile Application Supporting Proper Diet Among Maintenance Hemodialysis Patients

Diet plays a key role in the management of chronic kidney disease. The aim of our study was to evaluate the usage of a self-developed mobile application supporting proper dietary choices among maintenance hemodialysis (HD) patients. The primary functions of the application are to provide databases of products and recipes. Data on user activity recorded using Internet solutions were collected for 12months from April 2021. The application was promoted both via the Internet and directly to patients. Additionally, a questionnaire was employed to evaluate the usage of the software. The application was downloaded by 841 smartphone users, 44.4% of whom were from 2 regions of Poland with the largest populations of HD patients. Residents of cities with a population above 250,000 accounted for 86.0% of users. Sixty HD patients (32 males, 28 females; age 56.2±14.8years) filled the questionnaire. All features of the application scored a median of 4.0 points or higher on a 5-point Likert scale; however, 63.3% of respondents indicated the need to improve particular functions of the application. There was a significant difference in dialysis vintage between respondents who used the application for less than 1month and others (1.0 vs. 3.3years; P=.02). The positive perception of its influence on diet adherence was significantly higher among younger (<50years) compared to older users (5.0 vs. 4.0; P=.03) and among women compared to men (5.0 vs. 4.0; P=.01). HD patients showed interest in dietary mobile applications, and Internet channels were effective in promoting the software. Place of residency, age, gender, and dialysis vintage are factors that influence patient satisfaction with and the time of using the mobile application.

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