Effects of dietary intake and nutritional status on cerebral oxygenation in patients with chronic kidney disease not undergoing dialysis: A cross-sectional study

Abstract

BackgroundDietary management is highly important for the maintenance of renal function in patients with chronic kidney disease (CKD). Cerebral oxygen saturation (rSO2) was reportedly associated with the estimated glomerular filtration rate (eGFR) and cognitive function. However, data concerning the association between cerebral rSO2 and dietary intake of CKD patients is limited.MethodsThis was a single-center observational study. We recruited 67 CKD patients not undergoing dialysis. Cerebral rSO2 was monitored using the INVOS 5100c oxygen saturation monitor. Energy intake was evaluated by dietitians based on 3-day meal records. Daily protein and salt intakes were calculated from 24-h urine collection.ResultsMultivariable regression analysis showed that cerebral rSO2 was independently associated with energy intake (standardized coefficient: 0.370) and serum albumin concentration (standardized coefficient: 0.236) in Model 1 using parameters with p < 0.10 in simple linear regression analysis (body mass index, Hb level, serum albumin concentration, salt and energy intake) and confounding factors (eGFR, serum sodium concentration, protein intake), and the energy/salt index (standardized coefficient: 0.343) and Hb level (standardized coefficient: 0.284) in Model 2 using energy/protein index as indicated by energy intake/protein intake and energy/salt index by energy intake/salt intake in place of salt, protein and energy intake.ConclusionsCerebral rSO2 is affected by energy intake, energy/salt index, serum albumin concentration and Hb level. Sufficient energy intake and adequate salt restriction is important to prevent deterioration of cerebral oxygenation, which might contribute to the maintenance of cognitive function in addition to the prevention of renal dysfunction in CKD patients.

Cerebral oxygenation and body mass index association with cognitive function in chronic kidney disease patients without dialysis: a longitudinal study

“…Cerebral rSO 2 values in CKD patients without dialysis therapy (approximately 55–60%) and those undergoing HD (approximately 40–50%) were reportedly lower than those in healthy controls (approximately 70%) 15 – 18 , 35 . Furthermore, these values were reportedly associated with eGFR, serum albumin concentration, serum sodium concentration, hemoglobin level, energy intake, and energy intake/salt intake in CKD patients without dialysis therapy 17 , 18 .…”

“…Cerebral rSO 2 values in CKD patients without dialysis therapy (approximately 55–60%) and those undergoing HD (approximately 40–50%) were reportedly lower than those in healthy controls (approximately 70%) 15 – 18 , 35 . Furthermore, these values were reportedly associated with eGFR, serum albumin concentration, serum sodium concentration, hemoglobin level, energy intake, and energy intake/salt intake in CKD patients without dialysis therapy 17 , 18 . In the evaluation of cognitive performance using the MMSE score in patients undergoing HD, cerebral rSO 2 values in patients with cognitive impairment (MMSE score ≤ 23) were reported to be significantly lower than those with normal cognition (MMSE score ≥ 24), and cerebral rSO 2 represented a positive and independent association with the MMSE score 36 .…”

“…Cerebral regional oxygen saturation (rSO 2 ), a real-time marker of cerebral oxygenation, has been evaluated using near-infrared spectroscopy (NIRS) in the clinical setting 11 – 14 . In particular, CKD patients without dialysis therapy presented with relatively low cerebral rSO 2 values when compared with normal controls 15 – 17 , and were reportedly affected by dietary intake and nutritional status, including energy and salt intake 18 . Furthermore, a cross-sectional study demonstrated that there were significant associations between cerebral rSO 2 and cognitive function 17 , in addition to the association between nutritional status and cognitive function 19 .…”

The importance of sialic acid, pH and ion concentration on the interaction of uromodulin and complement factor H

“…A bunch of clinical studies have shown that dietary sodium restriction has protective effect on the kidney of patients with CKD. [36][37][38] The mechanism of the effect may be associated with regulation of glomerular filtration and the reduction of local activation of renin-angiotensin-aldosterone system. Our study indicates that the decrease of urinary sodium excretion after restriction of dietary sodium might improve the binding ability of UMOD with cFH and inhibit complement activation.…”

Dietary Daily Sodium Intake Lower than 1500 mg Is Associated with Inadequately Low Intake of Calorie, Protein, Iron, Zinc and Vitamin B1 in Patients on Chronic Hemodialysis

“…We used a 3-day food diary to assess sodium intake, a method that may imply inherent errors of dietary assessment and can be the cause of under-and over-reporting. Nevertheless, there is large recent evidence that the 3-day diet diary is a simple, useful, and effective method to measure the intake of macro-and micro-nutrients in patients on chronic hemodialysis [43][44][45][46][47]. The strength is that we included patients of different towns of Italy and consequently the data can be considered representative of the Italian population of patients on chronic hemodialysis.…”