As we delve deep into countless medical journals to uncover the latest on Integrative Medicine’s approach to kidney health, we are always reminded of the value of your time. Our commitment remains steadfast in curating and succinctly summarizing these vital studies for you. Welcome to the December Research and News.
Happy Holidays!
Beta-Hydroxybutyrate Levels and Kidney Function in ADPKD
In a novel study published by Knol et al., researchers explored the relationship between beta-hydroxybutyrate ketone levels and kidney function in patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD).
The study, involving 670 patients from the DIPAK cohort, found that higher endogenous plasma beta-hydroxybutyrate concentrations might be associated with a slower decline in kidney function, as indicated by the estimated glomerular filtration rate (eGFR).
Why is this important?
This finding is significant as it suggests a potential metabolic intervention for ADPKD, a condition where cystic cells predominantly depend on glucose and have limited ability to use other energy sources like ketone bodies.
Interventions that elevate beta-hydroxybutyrate concentration could potentially slow down the rate of kidney function decline in ADPKD patients. These interventions may include a modified Ketogenic diet and intermittent fasting.
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Prevalence of Sleep Apnea in CKD and ESKD Patients: A Comprehensive Meta-Analysis
A systematic review and meta-analysis conducted by Pisano et al. have brought to light the prevalence of sleep apnea (SA) in patients with chronic kidney disease (CKD) and end-stage kidney disease (ESKD).
This extensive study, which synthesized data from 32 individual studies for CKD and 91 studies for ESKD, found that SA is highly prevalent in these populations, with rates of 57% in CKD and 49% in ESKD patients.
Notably, the prevalence assessed through instrumental sleep monitoring was found to be significantly higher than that estimated using sleep questionnaires.
Why is this important?
The high prevalence of sleep apnea in CKD and ESKD patients underscores a critical aspect of patient management that often might be overlooked.
This association points towards a need for more vigilant screening and diagnosis of SA in these populations, preferably using objective diagnostic tools like polysomnography or portable sleep monitors rather than relying solely on sleep questionnaires.
Identifying and treating SA in CKD and ESKD patients could improve overall health outcomes, considering the potential impact of untreated SA on cardiovascular health and quality of life.
CKD may lead to SA through a variety of mechanisms, including alterations in chemoreflex responsiveness, pharyngeal narrowing due to fluid overload, and accumulation of uremic toxins. It is also being increasingly recognized that OSA can also accelerate the loss of kidney function.
Phosphate Wasting as a Predictor of Disease Progression in ADPKD
A recent study by Xue et al. in the DIPAK cohort has unveiled significant findings regarding phosphate metabolism in Autosomal Dominant Polycystic Kidney Disease (ADPKD).
Analyzing 604 ADPKD patients, the study observed that a considerable proportion (59%) exhibited phosphate wasting. This condition was associated with various factors, including male sex, eGFR, levels of fibroblast growth factor-23 (FGF-23), parathyroid hormone (PTH), and Copeptin.
More crucially, phosphate wasting correlated with a more rapid decline in eGFR and increased the risk of adverse kidney outcomes.
Why is this important?
This research provides valuable insights into the importance of phosphate metabolism in ADPKD, a disease typically characterized by cyst formation and kidney enlargement.
The association of phosphate wasting with accelerated disease progression in ADPKD indicates that it could serve as a potential biomarker for disease prognosis.
In fact, phosphate wasting, according to this study, can be an early sign of tubular dysfunction in patients with ADPKD. It can also lead to inflammation and faster progression of kidney disease.
Iron Levels and Cardiovascular Risk in CKD
In a significant study published by Hasegawa et al., researchers investigated the association between serum iron markers and cardiovascular disease (CVD) risk in patients with pre-dialysis chronic kidney disease (CKD).
The study, which included 1,416 CKD patients, examined serum transferrin saturation and ferritin levels in relation to the risk of CVD events.
Notably, it found that patients with serum transferrin saturation below 20% faced a higher risk of CVD and congestive heart failure.
Furthermore, iron supplementation was shown to be more beneficial in reducing CVD risk among patients with lower transferrin saturations.
Why is this important?
This study sheds light on the crucial link between iron metabolism and cardiovascular health in CKD patients. The findings suggest that monitoring and maintaining adequate serum transferrin saturation levels could be a key strategy in reducing the risk of cardiovascular events, a major cause of morbidity and mortality in CKD.
The effectiveness of iron supplementation in lowering CVD risk, especially in those with lower transferrin saturation, highlights the need for personalized treatment approaches in managing CKD patients.
It is, therefore, important to correct iron levels in CKD patients even if they do not have anemia.
Review article of the month
Diet and Polycystic Kidney Disease
Polycystic Kidney Disease (PKD) is a hereditary condition characterized by the growth of cysts in the kidneys and other organs. This chronic and progressive disease has recently seen a growing interest in the potential of dietary modifications as a means to prevent or slow its progression.
While vasopressin-receptor agonists have been a novel pharmacological breakthrough, recent trials and clinical studies have also shed light on dietary-related therapeutic strategies.
This review compiles the current evidence on the impact of nutrients, foods, and dietary patterns on the growth and progression of PKD cysts.
It also discusses the existing evidence-based dietary care for PKD patients and outlines the potential for further development of evidence-based dietary interventions, highlighting their possible implications in managing and treating PKD.
You can download the full PDF here.
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