About this Research Topic
Kidneys play key roles in removing waste products of metabolism as well as regulating electrolyte concentration and body fluid volume. In the presence of kidney disease (KD), this function is compromised, leading to the accumulation of water, minerals, and waste products. Supervised dietary modification is a key recommendation in KD management, which reduces the risk for cardiovascular disease and deals with the clinical effects of the reduced glomerular filtration rate while maintaining the optimal nutritional status.
Protein-energy wasting (PEW) and sarcopenia are common in KD patients and are associated with adverse clinical outcomes. Unsupervised or non-existent dietary modifications, which in conjunction with the loss of appetite, often observed in this patient group, may lead to a spontaneous reduction in energy and nutrient intake. Moreover, the catabolic effects of kidney replacement therapy (KRT), metabolic and hormonal derangements, the presence of systemic inflammation and comorbid conditions, and also reduced physical activity contribute to a state of negative energy and protein balance. Unique aspects of KD, such as fluid overload and consequent body weight fluctuations, hinders a reliable assessment of nutritional status, and consequently, the management of these conditions.
Although contradictory, obesity is also frequently observed in patients with KD and is considered one of the associated-etiologic factors of chronic kidney disease (CKD). Obesity can aggravate metabolic disturbances already present in CKD, including insulin resistance, low-grade inflammation, low concentration of vitamin D just to name a few. Considering the increased muscle catabolism associated with CKD, the risk in developing sarcopenic obesity should not be ignored. Therefore, clinical management of obesity in patients with KD requires a detailed nutritional assessment, supervised dietary recommendations, and follow-up.
Finally, renal nutrition care extends beyond CKD. For example, nephrolithiasis, in which a careful dietary plan aiming at controlling the production of new kidney stones is very important. More recently, the hydration status of subjects has gained more attention, especially in populations living in hot climates, as spontaneous dehydration has been pointed as an important risk factor for KD.
With that said, the goal of this Research Topic is to provide a contemporary and thorough overview of this important clinical and scientific research area. We encourage Original Research, Reviews, Perspectives or Commentaries on the topic of nutritional aspects of kidney disease.
Important topics include (but are not limited to):
· Hemodialysis, peritoneal dialysis, kidney transplantation
· Low protein diet
· Malnutrition, sarcopenia, obesity, frailty in KD
· Gut health: microbiota, dysbiosis, constipation in KD
· Dietary patterns in KD
· Mineral disorders: K and P
· Special macronutrients needs (protein)
· Acute kidney disease
· Altered hydration status
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.