Nutrition and chronic kidney disease

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Nutrition and chronic kidney disease Denis Fouque, Solenne Pelletier, Denise Mafra, Philippe Chauveau Kidney International Volume 80, Issue 4, Pages 348-357 (August 2011) DOI: 10.1038/ki.2011.118 Copyright © 2011 International Society of Nephrology Terms and Conditions

Figure 1 Mortality rate of hemodialysis patients based on protein intake. Protein intake (g/kg/day) and 30-month hazard ratio for mortality in a prospective cohort of French hemodialysis patients from June 2007 to December 2009 (n=3000, adjusted for age, gender, serum albumin, body mass index, cardiovascular history, and diabetes; from Fouque et al.,76 with the permission of the National Kidney Foundation). nPNA, normalized protein nitrogen appearance. Kidney International 2011 80, 348-357DOI: (10.1038/ki.2011.118) Copyright © 2011 International Society of Nephrology Terms and Conditions

Figure 2 The phosphate and protein intake paradigm. Mortality decreases when protein intake increases up to 1.4g/kg/day (lower panel), despite a slight increase in serum phosphate (upper panel; from Shinaberger et al.,82 with the authorization of the American Society of Nutrition). nPNA, normalized protein nitrogen appearance. Kidney International 2011 80, 348-357DOI: (10.1038/ki.2011.118) Copyright © 2011 International Society of Nephrology Terms and Conditions

Figure 3 Daily walking and total energy expenditure. The relationship between total daily energy expenditure (TEE) estimated by the SenseWear Armband and patient steps number (mean of 7-day recording, n=24, r=0.84, P=0.001). Healthy subjects with moderate activity usually walk more than 8000–10,000 steps per day. Kidney International 2011 80, 348-357DOI: (10.1038/ki.2011.118) Copyright © 2011 International Society of Nephrology Terms and Conditions

Figure 4 The double impact of inflammation on wasting. The role of inflammation in chronic kidney disease, responsible for increased catabolism and anorexia, both actions that may induce protein–energy wasting and loss of body proteins, which can be counteracted by nutrients. Kidney International 2011 80, 348-357DOI: (10.1038/ki.2011.118) Copyright © 2011 International Society of Nephrology Terms and Conditions