Smoking increases the risk of ESRF in men with inflammatory and non-inflammatory renal disease.

Viscous polysaccharides reduce intestinal absorption of glucose and diminish postprandial hyperglycemia. However, it is unknown whether viscous fiber also inhibits absorption of nutrients under conditions of enteric feeding. Therefore, we measured the absorption rates of nutrients in miniature pigs by perfusing a 150-cm length of jejunum with 8.37 kJ/min of the three following enteral diets: an isoosmotic oligomeric diet (1670 kJ/L), a hyperosmotic oligomeric diet and an isoosmotic polymeric diet (both 3350 kJ/L). The diets were supplemented with guar gum from 0 to 4.4 g/L. With the three guar-free diets, the mean absorption rate of energy was 5.2 +/- 0.32 kJ/min, corresponding to 62% of the energy infused. Absorption rates of carbohydrate, protein, fat and energy linearly declined as concentrations of guar or the logarithm of chyme viscosity increased. Due to modulations in viscosity, the inhibitory effects of guar were significantly different among the three diets. With the isoosmotic and hyperosmotic oligomeric and the polymeric diets, the addition of 1 g guar/L diminished the absorption of energy by 9.7, 6. 6 and 3.7%, respectively. The strong inhibitory effect on nutrient absorption with the isoosmotic oligomeric diet was caused by an increase in chyme viscosity due to water absorption. With the hyperosmotic oligomeric and the polymeric diets, the chyme viscosity and thus inhibitory effects on absorption were diminished by water secretion and the concomitant infusion of pancreatic enzymes. Results indicate that the addition of small amounts of guar gum to enteral diets of high energy density exerts only small effects on absorption of nutrients.

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Enteric feeding is often associated with diarrhea. To avoid this side effect, isoosmotic and fiber-supplemented enteral diets are recommended. The aims of this study were to determine whether supplementing enteral diets with soy fiber influences nutrient absorption and whether in enteric feeding absorption of nutrients and water fluxes differ between hyperosmotic oligomeric and isoosmotic polymeric diets. In mini pigs intestinal absorption and water fluxes were measured by perfusing a 150-cm length of jejunum. Six noncommercial iso- and hyperosmotic oligomeric and polymeric diets and six commercial polymeric diets, either fiber-free or supplemented with soy fiber, were used. Pancreatic enzymes were infused concomitantly with the polymeric diets. The absorption of nutrients and energy did not differ between oligomeric and polymeric diets. Oligomeric diets of high energy density produced a pronounced secretion of water. Despite lower initial osmolality, polymeric diets produced a similar secretion of water due to rapid pancreatic hydrolysis. Supplementing diets with largely insoluble soy fiber increased viscosity only between 4.6 and 14.5 mPa x sec. Soy fiber did not influence absorption of nutrients and energy and had also no effects on luminal transit and flow rate. The lack of effects was not due to dilution of chyme by intestinal secretion of water because no differences existed between isoosmotic and hyperosmotic oligomeric diets. In conclusion, supplementing enteral diets with soy fiber does not impair the absorption of nutrients. Enteric feeding with isoosmotic polymeric diets provides no advantage compared with hyperosmotic oligomeric diets with respect to absorption of nutrients and secretion of water.

Partial meniscectomy patients have a greater likelihood for the development of early osteoarthritis (OA). To prevent the onset of early OA, patient-specific treatment algorithms need to be created that predict patient risk to early OA after meniscectomy. The aim of this work was to identify patient-specific risk factors in partial meniscectomy patients that could potentially lead to early OA.Partial meniscectomy patients operated between 01/2017 and 12/2019 were evaluated in the study (n=317). Exclusion criteria were other pathologies or surgeries for the evaluated knee and meniscus (n = 114). Following informed consent, an online questionnaire containing demographics and the “Knee Injury and Osteoarthritis Outcome Score” (KOOS) questionnaire was sent to the patient. Based on the KOOS pain score, patients were classified into “low” (> 75) and “high” (< 75) risk patients, indicating risk to symptomatic OA. The “high risk” patients also underwent a follow-up including an MRI scan to understand whether they have developed early OA.From 203 participants, 96 patients responded to the questionnaire (116 did not respond) with 61 patients considered “low-risk” and 35 “high-risk” patients. Groups that showed a significant increased risk for OA were patients aged > 40 years, females, overweight (BMI >25 kg/m2 ≤ 30 kg/m2), and smokers (*p < 0.05). The “high-risk”-follow-up revealed a progression of early osteoarthritic cartilage changes in seven patients, with the remaining nineteen patients showing no changes in cartilage status or pain since time of operation. Additionally, eighteen patients in the high-risk group showed a varus or valgus axis deviation.Patient-specific factors for worse postoperative outcomes after partial meniscectomy and indicators for an “early OA” development were identified, providing the basis for a patient-specific treatment approach. Further analysis in a multicentre study and computational analysis of MRI scans is ongoing to develop a patient-specific treatment algorithm for meniscectomy patients.