Project description:ObjectiveTo systematically identify and describe self-management interventions for adult patients with chronic kidney disease (CKD).SettingCommunity-based.ParticipantsAdults with CKD stages 1-5 (not requiring kidney replacement therapy).InterventionsSelf-management strategies for adults with CKD.Primary and secondary outcome measuresUsing a scoping review, electronic databases and grey literature were searched in October 2016 to identify self-management interventions for adults with CKD stages 1-5 (not requiring kidney replacement therapy). Randomised controlled trials (RCTs), non-RCTs, qualitative and mixed method studies were included and study selection and data extraction were independently performed by two reviewers. Outcomes included behaviours, cognitions, physiological measures, symptoms, health status and healthcare.ResultsFifty studies (19 RCTs, 7 quasi-experimental, 5 observational, 13 pre-post intervention, 1 mixed method and 5 qualitative) reporting 45 interventions were included. The most common intervention topic was diet/nutrition and interventions were regularly delivered face to face. Interventions were administered by a variety of providers, with nursing professionals the most common health professional group. Cognitions (ie, changes in general CKD knowledge, perceived self-management and motivation) were the most frequently reported outcome domain that showed improvement. Less than 1% of the interventions were co-developed with patients and 20% were based on a theory or framework.ConclusionsThere was a wide range of self-management interventions with considerable variability in outcomes for adults with CKD. Major gaps in the literature include lack of patient engagement in the design of the interventions, with the majority of interventions not applying a behavioural change theory to inform their development. This work highlights the need to involve patients to co-developed and evaluate a self-management intervention based on sound theories and clinical evidence.
Project description:Background & Aims:Although dietary patterns have been linked to chronic diseases such as cardiovascular disease, sparse data are available for a relationship between dietary patterns and incident chronic kidney disease (CKD) in West Asian populations. The aim of this study was to evaluate the association of population-based dietary pattern with the risk of incident CKD after 6.1?years of follow-up. Methods:At baseline, habitual dietary intakes of 1630 participants of the Tehran Lipid and Glucose Study (TLGS) who were free of CKD was assessed by a valid and reliable food-frequency questionnaire. The following three major dietary patterns were identified using a principal components analysis: Lacto-vegetarian dietary pattern, traditional Iranian dietary pattern, and high fat, high sugar dietary pattern. Estimated glomerular filtration rate (eGFR) was calculated, using the Modification of Diet in Renal Disease (MDRD) Study equation and CKD was defined as eGFR <?60?mL/min/1.73m2. Odds ratio (OR) using multivariable logistic regression was calculated for the association of incident CKD with the extracted dietary patterns. Results:After adjusting for age, sex, smoking, total energy intake, physical activity, body mass index, diabetes, and hypertension the OR for participants in the highest compared with those in the lowest tertile of the lacto-vegetarian dietary pattern was 0.57 (95% confidence interval [CI]: 0.41 to 0.80, P-trend?=?0.002). In contrast, the high fat, high sugar dietary pattern was positively associated with the incidence of CKD (OR for the third tertile compared with first tertile: 1.46; 95% CI: 1.03-2.09; P-trend?=?0.036). Traditional Iranian dietary pattern was not associated with incident CKD. Conclusion:The high fat, high sugar dietary pattern was associated with significantly increased (46%) odds of incident CKD, whereas a lacto-vegetarian dietary pattern may be protective against the occurrence of CKD by 43%.
Project description:BackgroundDietary net endogenous acid production (NEAP), which represents total dietary load of nonvolatile acid, may affect kidney function. Estimated NEAP (eNEAP) is calculated indirectly by the ratio of protein and potassium intake. A few studies are available assessing the association between eNEAP and chronic kidney disease (CKD), and its relation to dietary protein and potassium intake in the elderly.MethodsA total 1,369 community-dwelling elderly Koreans in the Kangbuk Samsung Cohort Study (KSCS) were evaluated using a food frequency questionnaire (FFQ) and comprehensive health examination. We evaluated the association between eNEAP and the CKD. We also examined their relation to protein and potassium intake.ResultseNEAP was correlated with potassium intake (r = -0.410, P < 0.001), but was not correlated with protein intake (r = -0.004, P = 0.879). In a full multivariate adjustment for sociodemographic factors, dietary factors, and comorbidities, the participants with higher eNEAP quartiles (Q2, Q3, Q4) had higher odds of CKD compared to the lowest eNEAP quartile (Q1); OR (95% CI) were 1.47 (0.78-2.72), 1.66 (0.85-3.23), and 2.30 (1.16-4.60) respectively (P for trend = 0.019). The odds of CKD decreased for participants with higher potassium intake quartiles (Q2, Q3, Q4) compared to the lowest potassium intake quartile (Q1); OR (95% CI) were 0.52 (0.28-0.95), 0.50 (0.26-0.96), and 0.50 (0.21-0.99) respectively (P for trend = 0.050). Protein intake was not associated with CKD. The association between eNEAP and CKD was similar in subgroup analysis.ConclusionDietary acid load was associated with CKD. Among the nutrients related to dietary acid load, potassium intake was negatively associated with CKD, but protein intake was not associated with CKD in elderly adults.
Project description:This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effectiveness of any intervention in preventing or reducing kidney complications or CKD in people with SCD (including red blood cell transfusions, hydroxyurea and ACEI (either alone or in combination with each other)).
Project description:Background and aimsCognitive impairment (CI) is a prevalent condition in patients with chronic kidney disease (CKD), who face an elevated risk of developing cognitive decline. The fundamental mechanism underlying CI is linked to chronic inflammation, which can be gauged by the Dietary Inflammatory Index (DII). The DII is categorized into anti-inflammatory diets with lower scores and pro-inflammatory diets with higher scores. Specifically, pro-inflammatory diets may contribute to chronic inflammation. However, the correlation between the inflammatory potential of diet and cognitive function in patients with CKD has not been explored. This study aims to investigate the connection between the inflammatory potential of diet and cognitive function in individuals with or without chronic kidney disease.MethodsData from the 2011-2012 and 2013-2014 National Health and Nutrition Examination Survey (NHANES) were utilized. Participants under the age of 60 or lacking DII, CI, CKD, and other essential data were excluded. DII was computed based on a 24-h dietary recall interview for each participant. Cognitive performance was evaluated using three cognitive tests: the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) test, the Animal Fluency Test (AFT), and the Digital Symbol Substitution Test (DSST). Logistic regression analysis and subgroup analysis were conducted to assess the independent relationship between DII score and CI in the CKD and non-CKD populations.ResultsThe study included a total of 2069 subjects, with CI prevalence ranging from 21.4 to 23.5%. Multiple regression models showed that after adjusting for all covariates of the three cognitive function tests, higher DII scores were significantly associated with increased risk of CI (CERAD OR = 1.18, 95% CI: 1.1 ~ 1.26, AFT OR = 1.15, 95% CI: 1.08 ~ 1.23, DSST OR = 1.19, 95% CI: 1.11 ~ 1.28). Subgroup analysis indicated that the effect of DII score on CI remained consistent in all subgroups (p > 0.05).ConclusionHigher DII scores were associated with an increased risk of cognitive impairment in people with or without CKD, suggesting that consuming a pro-inflammatory diet may contribute to the impairment of the cognitive function.
Project description:BackgroundDiet property grounded on inflammatory potential, evaluated by the dietary inflammatory index (DII), has been proven to be connected with mortality, while studies of adults with chronic kidney disease (CKD) are scarce.ObjectiveThe purpose of this research was to evaluate the interrelationships between DII and all-cause mortality among adults with CKD.MethodsIn the National Health and Nutrition Examination Survey (NHANES) 2001-2006, we identified and evaluated data of 4,554 adults with CKD. DII scores were calculated from 24 h of dietary consumption at baseline. Vital status was followed through 31 December 2015. The association of all-cause mortality with DII score was assessed using the Kaplan-Meier curve and the Cox regression analysis.ResultsAfter an average follow-up of 132.103 months, a total of 1,246 (27.36%) deaths were recorded. The death rates in the DII tertile categories were 24.04, 26.81, and 31.23%, respectively. The Kaplan-Meier curve showed increased death risks for the high DII tertile as compared with the low DII tertile. After we adjusted for a broad range of possible confounders, the estimation between extreme tertiles of DII scores presented a positive and significant association with all-cause mortality [hazard ratio (HR): 1.21, 95% CI: 1.05-1.39].ConclusionOur results confirm the hypothesis that proinflammatory diets contribute to the increased all-cause mortality in adults with CKD.
Project description: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.