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Non-Traditional Aspects of Renal Diets: Focus on Fiber, Alkali and Vitamin K1 Intake.
Nutrients. 2017 Apr 29; 9(5)N

Abstract

Renal diets for advanced chronic kidney disease (CKD) are structured to achieve a lower protein, phosphate and sodium intake, while supplying adequate energy. The aim of this nutritional intervention is to prevent or correct signs, symptoms and complications of renal insufficiency, delaying the start of dialysis and preserving nutritional status. This paper focuses on three additional aspects of renal diets that can play an important role in the management of CKD patients: the vitamin K1 and fiber content, and the alkalizing potential. We examined the energy and nutrients composition of four types of renal diets according to their protein content: normal diet (ND, 0.8 g protein/kg body weight (bw)), low protein diet (LPD, 0.6 g protein/kg bw), vegan diet (VD, 0.7 g protein/kg bw), very low protein diet (VLPD, 0.3 g protein/kg bw). Fiber content is much higher in the VD and in the VLPD than in the ND or LPD. Vitamin K1 content seems to follow the same trend, but vitamin K2 content, which could not be investigated, might have a different pattern. The net endogenous acid production (NEAP) value decreases from the ND and LPD to the vegetarian diets, namely VD and VLPD; the same finding occurred for the potential renal acid load (PRAL). In conclusion, renal diets may provide additional benefits, and this is the case of vegetarian diets. Namely, VD and VLPD also provide high amounts of fibers and Vitamin K1, with a very low acid load. These features may have favorable effects on Vitamin K1 status, intestinal microbiota and acid-base balance. Hence, we can speculate as to the potential beneficial effects on vascular calcification and bone disease, on protein metabolism, on colonic environment and circulating levels of microbial-derived uremic toxins. In the case of vegetarian diets, attention must be paid to serum potassium levels.

Authors+Show Affiliations

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56126, Italy. adamasco.cupisti@med.unipi.it.Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56126, Italy. dalessandroclaudia@gmail.com.Department of Emergency and Organ Transplantation-Nephrology, Dialysis and Transplantation Unit, University of Bari Aldo Moro, Bari, 70124, Italy. loreto.gesualdo@uniba.it.Department of Emergency and Organ Transplantation-Nephrology, Dialysis and Transplantation Unit, University of Bari Aldo Moro, Bari, 70124, Italy. carmela.cosola@uniba.it.San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, University of Milano, Milano, 20153, Italy. maurizio.gallieni@unimi.it.Department of Clinical and Experimental Medicine, University of Pisa, Pisa, 56126, Italy. m.egidi@ao-pisa.toscana.it.National Research Council (CNR), Institute of Clinical Physiology (IFC), Pisa and Department of Medicine, University of Padua, Padua, 35122, Italy. dante.lucia@libero.it.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28468236

Citation

Cupisti, Adamasco, et al. "Non-Traditional Aspects of Renal Diets: Focus On Fiber, Alkali and Vitamin K1 Intake." Nutrients, vol. 9, no. 5, 2017.
Cupisti A, D'Alessandro C, Gesualdo L, et al. Non-Traditional Aspects of Renal Diets: Focus on Fiber, Alkali and Vitamin K1 Intake. Nutrients. 2017;9(5).
Cupisti, A., D'Alessandro, C., Gesualdo, L., Cosola, C., Gallieni, M., Egidi, M. F., & Fusaro, M. (2017). Non-Traditional Aspects of Renal Diets: Focus on Fiber, Alkali and Vitamin K1 Intake. Nutrients, 9(5). https://doi.org/10.3390/nu9050444
Cupisti A, et al. Non-Traditional Aspects of Renal Diets: Focus On Fiber, Alkali and Vitamin K1 Intake. Nutrients. 2017 Apr 29;9(5) PubMed PMID: 28468236.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-Traditional Aspects of Renal Diets: Focus on Fiber, Alkali and Vitamin K1 Intake. AU - Cupisti,Adamasco, AU - D'Alessandro,Claudia, AU - Gesualdo,Loreto, AU - Cosola,Carmela, AU - Gallieni,Maurizio, AU - Egidi,Maria Francesca, AU - Fusaro,Maria, Y1 - 2017/04/29/ PY - 2017/02/27/received PY - 2017/04/16/revised PY - 2017/04/20/accepted PY - 2017/5/5/entrez PY - 2017/5/5/pubmed PY - 2018/3/29/medline KW - CKD KW - PRAL KW - Renal diets KW - Vitamin K1 KW - fiber KW - gut microbiota KW - low protein diet, renal nutrition, metabolic acidosis KW - uremic toxins JF - Nutrients JO - Nutrients VL - 9 IS - 5 N2 - Renal diets for advanced chronic kidney disease (CKD) are structured to achieve a lower protein, phosphate and sodium intake, while supplying adequate energy. The aim of this nutritional intervention is to prevent or correct signs, symptoms and complications of renal insufficiency, delaying the start of dialysis and preserving nutritional status. This paper focuses on three additional aspects of renal diets that can play an important role in the management of CKD patients: the vitamin K1 and fiber content, and the alkalizing potential. We examined the energy and nutrients composition of four types of renal diets according to their protein content: normal diet (ND, 0.8 g protein/kg body weight (bw)), low protein diet (LPD, 0.6 g protein/kg bw), vegan diet (VD, 0.7 g protein/kg bw), very low protein diet (VLPD, 0.3 g protein/kg bw). Fiber content is much higher in the VD and in the VLPD than in the ND or LPD. Vitamin K1 content seems to follow the same trend, but vitamin K2 content, which could not be investigated, might have a different pattern. The net endogenous acid production (NEAP) value decreases from the ND and LPD to the vegetarian diets, namely VD and VLPD; the same finding occurred for the potential renal acid load (PRAL). In conclusion, renal diets may provide additional benefits, and this is the case of vegetarian diets. Namely, VD and VLPD also provide high amounts of fibers and Vitamin K1, with a very low acid load. These features may have favorable effects on Vitamin K1 status, intestinal microbiota and acid-base balance. Hence, we can speculate as to the potential beneficial effects on vascular calcification and bone disease, on protein metabolism, on colonic environment and circulating levels of microbial-derived uremic toxins. In the case of vegetarian diets, attention must be paid to serum potassium levels. SN - 2072-6643 UR - https://www.unboundmedicine.com/medline/citation/28468236/Non_Traditional_Aspects_of_Renal_Diets:_Focus_on_Fiber_Alkali_and_Vitamin_K1_Intake_ L2 - https://www.mdpi.com/resolver?pii=nu9050444 DB - PRIME DP - Unbound Medicine ER -