Energy-Dense Diets and Mineral Metabolism in the Context of Chronic Kidney Disease–Metabolic Bone Disease (CKD-MBD)

Rodriguez, Mariano; Aguilera–Tejero, Escolástico

doi:10.3390/nu10121840

Cited by 7 publications

(7 citation statements)

References 72 publications

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“…Some studies have suggested the existence of a relationship between obesity, energy-dense diets, and mineral metabolism in CKD [ 122 ]. According to them, energy-dense food generally tends to contain low levels of Ca and also to decrease its intestinal absorption as a result of the interaction between Ca and lipids in the intestinal lumen and subsequent formation of Ca soaps [ 123 , 124 ].…”

Section: Dietsmentioning

confidence: 99%

The Influence of Dietary Interventions on Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD)

et al. 2021

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Chronic kidney disease is a health problem whose prevalence is increasing worldwide. The kidney plays an important role in the metabolism of minerals and bone health and therefore, even at the early stages of CKD, disturbances in bone metabolism are observed. In the course of CKD, various bone turnover or mineralization disturbances can develop including adynamic hyperparathyroid, mixed renal bone disease, osteomalacia. The increased risk of fragility fractures is present at any age in these patients. Nutritional treatment of patients with advanced stages of CKD is aiming at prevention or correction of signs, symptoms of renal failure, avoidance of protein-energy wasting (PEW), delaying or prevention of the occurrence of mineral/bone disturbances, and delaying the start of dialysis. The results of studies suggest that progressive protein restriction is beneficial with the progression of renal insufficiency; however, other aspects of dietary management of CKD patients, including changes in sodium, phosphorus, and energy intake, as well as the source of protein and lipids (animal or plant origin) should also be considered carefully. Energy intake must cover patients’ energy requirement, in order to enable correct metabolic adaptation in the course of protein-restricted regimens and prevent negative nitrogen balance and protein-energy wasting.

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Section: Dietsmentioning

confidence: 99%

The Influence of Dietary Interventions on Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD)

et al. 2021

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“…High-calorie diet in CKD patients, despite causing weight gain, is associated with less urea generation. In addition, weight loss and malnutrition correlated with worsened outcomes in CKD patients [ 28 ]. However, high-fat diets can reduce calcium absorption and consequently elevate 1,25(OH) 2 D, PTH, and phosphate absorption in CKD patients [ 28 ] and experimental animals [ 29 ].…”

Section: Nonpharmacological Approachmentioning

confidence: 99%

Bone Quality in Chronic Kidney Disease Patients: Current Concepts and Future Directions – Part II

et al. 2021

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Background: Patients with chronic kidney disease (CKD) have an increased risk of osteoporotic fractures, which is due not only to low bone volume and mass but also poor microarchitecture and tissue quality. The pharmacological and nonpharmacological interventions detailed, herein, are potential approaches to improve bone health in CKD patients. Various medications build up bone mass but also affect bone tissue quality. Antiresorptive therapies strikingly reduce bone turnover; however, they can impair bone mineralization and negatively affect the ability to repair bone microdamage and cause an increase in bone brittleness. On the other hand, some osteoporosis therapies may cause a redistribution of bone structure that may improve bone strength without noticeable effect on BMD. This may explain why some drugs can affect fracture risk disproportionately to changes in BMD. Summary: An accurate detection of the underlying bone abnormalities in CKD patients, including bone quantity and quality abnormalities, helps in institution of appropriate management strategies. Here in this part II, we are focusing on advancements in bone therapeutics that are anticipated to improve bone health and decrease mortality in CKD patients. Key Messages: Therapeutic interventions to improve bone health can potentially advance life span. Emphasis should be given to the impact of various therapeutic interventions on bone quality.

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“…patients, promotes VC through several mechanisms, including increased serum CaxP product, and phenotypic transdifferentiation of vascular smooth muscle cells to osteochondrogenic cells [119]. Obesity and the caloric content of the diet influence uremic VC [78,120]. In experimental models of uraemia, obese Zucker rats have been shown to develop more severe VC than lean Zucker rats.…”

Section: Caloric Intake and Vcmentioning

confidence: 99%

“…Obesity and the caloric content of the diet influence uremic VC [ 78 , 120 ]. In experimental models of uraemia, obese Zucker rats have been shown to develop more severe VC than lean Zucker rats.…”

Section: Caloric Intake and Vcmentioning

confidence: 99%

Caloric Intake in Renal Patients: Repercussions on Mineral Metabolism

et al. 2020

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The aim of this paper is to review current knowledge about how calorie intake influences mineral metabolism focussing on four aspects of major interest for the renal patient: (a) phosphate (P) handling, (b) fibroblast growth factor 23 (FGF23) and calcitriol synthesis and secretion, (c) metabolic bone disease, and (d) vascular calcification (VC). Caloric intake has been shown to modulate P balance in experimental models: high caloric intake promotes P retention, while caloric restriction decreases plasma P concentrations. Synthesis and secretion of the phosphaturic hormone FGF23 is directly influenced by energy intake; a direct correlation between caloric intake and FGF23 plasma concentrations has been shown in animals and humans. Moreover, in vitro, energy availability has been demonstrated to regulate FGF23 synthesis through mechanisms in which the molecular target of rapamycin (mTOR) signalling pathway is involved. Plasma calcitriol concentrations are inversely proportional to caloric intake due to modulation by FGF23 of the enzymes implicated in vitamin D metabolism. The effect of caloric intake on bone is controversial. High caloric intake has been reported to increase bone mass, but the associated changes in adipokines and cytokines may as well be deleterious for bone. Low caloric intake tends to reduce bone mass but also may provide indirect (through modulation of inflammation and insulin regulation) beneficial effects on bone. Finally, while VC has been shown to be exacerbated by diets with high caloric content, the opposite has not been demonstrated with low calorie intake. In conclusion, although prospective studies in humans are needed, when planning caloric intake for a renal patient, it is important to take into consideration the associated changes in mineral metabolism.

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Energy-Dense Diets and Mineral Metabolism in the Context of Chronic Kidney Disease–Metabolic Bone Disease (CKD-MBD)

Cited by 7 publications

References 72 publications

The Influence of Dietary Interventions on Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD)

The Influence of Dietary Interventions on Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD)

Bone Quality in Chronic Kidney Disease Patients: Current Concepts and Future Directions – Part II

Caloric Intake in Renal Patients: Repercussions on Mineral Metabolism

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