Case Study: The Weighty Issue of Treatment Options for Obese Dialysis Patients.

Obesity is a complex chronic disease and common comorbidity in kidney failure and is the leading causes of death and disability in this population. Guidelines do not specifically address the preferred weight management option(s) for obesity while on dialysis. Large body size is a limiting factor for consideration of a kidney transplantation.

Medical Nutrition Therapy Provided by Dietitians is Effective and Saves Healthcare Costs in the Management of Adults with Dyslipidemia.

Purpose Of Review: Referral to nutrition care providers in the USA such as registered dietitian nutritionists (RDNs) for medical nutrition therapy (MNT) remains low. We summarize research on the effectiveness of MNT provided by dietitians versus usual care in the management of adults with dyslipidemia. Improvements in lipids/lipoproteins were examined.

Effectiveness of medical nutrition therapy in the management of adult dyslipidemia: A systematic review and meta-analysis.

Cardiovascular disease (CVD) is a leading cause of mortality in the United States. Many primary risk factors, such as dyslipidemia and blood pressure, are modifiable with diet and lifestyle interventions. Therefore, the objective of this systematic review and meta-analysis was to evaluate the effectiveness of medical nutrition therapy (MNT) interventions provided by registered dietitian nutritionists (RDN) or international equivalents, compared to usual care or no MNT, on lipid profile and blood pressure (secondary outcome) in adults with dyslipidemia.

Association of Urine Findings with Metabolic Syndrome Traits in a Population of Patients with Nephrolithiasis.

Background: The odds of nephrolithiasis increase with more metabolic syndrome (MetS) traits. We evaluated associations of metabolic and dietary factors from urine studies and stone composition with MetS traits in a large cohort of stone-forming patients.

Methods: Patients >18 years old who were evaluated for stones with 24-hour urine collections between July 2009 and December 2018 had their records reviewed retrospectively.

Do the high-protein recommendations for athletes set some on a path to kidney injury and dialysis?

Athletes and fitness enthusiasts are often encouraged to follow high-protein diets to optimize muscle protein synthesis, modify body composition, and enhance performance, yet the safety of these higher protein intakes has been debated. Many people with kidney dysfunction are unaware of their condition, and the potential harm of excess protein intake on the kidneys may not be adequately reported in the sports nutrition literature. Studies suggesting that high-protein intake may be associated with incident kidney disease have led the nephrology community to make conservative recommendations.

Hemodialysis using a low bicarbonate dialysis bath: Implications for acid-base homeostasis.

The low bath bicarbonate concentration ([ ]) used by a nephrology group in Japan (25.5 mEq/L), coupled with a bath [acetate] of 8 mEq/L, provided an opportunity to study the acid-base events occurring during hemodialysis when flux is from the patient to the bath. We used an analytic tool that allows calculation of delivery during hemodialysis and the physiological response to it in 17 Japanese outpatients with an average pre-dialysis blood [ ] of 25 mEq/L.

Clinical and cost benefits of medical nutrition therapy by registered dietitian nutritionists for management of dyslipidemia: A systematic review and meta-analysis.

Background: Faced with increasing health care costs, it is incumbent to discern whether managing dyslipidemia with medical nutrition therapy (MNT) by a registered dietitian nutritionist (RDN) is clinically and cost effective.

Objective: To systematically examine evidence on the clinical effectiveness and cost benefit of MNT by an RDN for the treatment of dyslipidemia.

Methods: English and full-text research articles published between January 2003 and October 2014 were identified using PubMed, MEDLINE, and the Worldcat.

Medical Nutrition Therapy for Chronic Kidney Disease Improves Biomarkers and Slows Time to Dialysis.

Objective: To investigate whether medical nutrition therapy (MNT) provided by a registered dietitian experienced in chronic kidney disease (CKD) slows the progression of disease and improves nutrition-related biomarkers.

Design: Retrospective cohort study.

Subjects: The cohort included 265 participants from a regional nephrology center in a rural state; 147 of who received MNT were compared to a group that did not receive MNT and had started dialysis over a 10-year period.