Browsing by Author "Johansson, Lina"

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Mediterranean diet as the diet of choice for patients with chronic kidney disease
(2018) Sezer, Siren; Chauveau, Philippe; Aparicio, Michel; Bellizzi, Vincenzo; Campbell, Katrina; Hong, Xu; Johansson, Lina; Kolko, Anne; Molina, Pablo; Wanner, Christoph; Ter Wee, Pieter M.; Teta, Daniel; Fouque, Denis; Carreo, Juan; 29106612
Traditional dietary management of chronic kidney disease (CKD) focuses on the quantity within the diet of energy and protein, and the restriction of single micronutrients, with little mention of dietary quality. Dietary patterns that are more plant-based, lower in meat (including processed meat), sodium and refined sugar, and have a higher content of grains and fibres are now included in multiple clinical guidelines for chronic disease prevention. The Mediterranean diet (MD) has been associated with reduced cardiovascular disease incidence in both observational and interventional studies. A wealth of evidence links MD with other beneficial effects on chronic diseases such as diabetes, obesity or cognitive health. This review examines each constituent of the classical MD and evaluates their suitability for the management of patients with CKD. We also evaluate the potential hyperkalaemia risk of increasing fruit and vegetable intake. Overall, a decrease in net endogenous acid production and increase in fibre may lead to a better control of metabolic acidosis. This, together with other putative favourable effects of MD on endothelial function, inflammation, lipid profile and blood pressure, provide mechanistic pathways to explain the observed reduced renal function decline and improved survival in CKD patients adhering to an MD.
PRIORITIES OF NUTRITIONAL ISSUES IN NON-DIALYSIS CKD ACCORDING TO STAKEHOLDERS
(2019) Bellizzi, Vincenzo; Carrero, Juan Jesus; Calella, Patrizia; Chauveau, Philippe; Johansson, Lina; Molina, Pablo; Sezer, Siren; Teta, Daniel; Fouque, Denis
Retarding chronic kidney disease (CKD) progression: a practical nutritional approach for non-dialysis CKD
(2016) Sezer, Siren; Bellizzi, Vincenzo; Carrero, Jan Jesus; Chauveau, Philippe; Cozzolino, Mario; Cupisti, Adamasco; D'Alessandro, Claudia; De Nicola, Luca; Fiaccadori, Enrico; Johansson, Lina; Minutolo, Roberto; Molina, Pablo; Ter Wee, Pieter; Teta, Daniel; Wanner, Christoph; Calella, Patrizia; Fouque, Denis
This is a case report on a patient with non-dialysis chronic kidney disease (CKD) in whom several nutritional issues are briefly discussed from a practical point of view. The article is accompanied by an editorial published in this Journal in relation to the 2nd International Conference of the European Renal Nutrition working group at ERA-EDTA-" Retarding CKD progression: readily available through comprehensive nutritional management?"and focuses on several practical topics associated with the nutritional approach for the conservative treatment of non-dialysis CKD. The article is divided into 3 sections-basic nutritional assessment, nutritional targets, and nutritional follow-up in non-dialysis CKD-linked to 3 consecutive steps of the clinical follow-up of the patient and the related nutritional concerns and intervention. First visit: Baseline nutritional assessment and basic nutritional considerations in non-dialysis chronic kidney disease (CKD) What nutritional assessment/monitoring for protein-energy wasting (PEW) should be employed? Is a body mass index (BMI) of 21 kg/m2 adequate? What phosphate target should be pursued? What are the nutritional habits in patients with incident CKD? What protein needs and amount of dietary protein should be pursued? Does the quality of protein matter? What amount of dietary salt should be employed? How should this be obtained? How should normal serum phosphate be achieved? What diet should be recommended? Is a vegetarian diet an option? Second visit: Major nutritional targets in non-dialysis CKD Consequences of unintentional weight loss What is the role of the renal dietitian in helping the patient adhere to a renal diet? Intermediate visits: Nutritional follow-up in non-dialysis CKD What treatment for calcium/parathyroid hormone (PTH) will affect CKD progression? Final visits: Would a dietary recall/intensive dietary education improve adherence with the diet? Would a very-low-protein diet (VLPD)/ketodiet be indicated for this patient?
The Role of Phosphate in Kidney Disease
(2017) Vervloet, Marc C.; Sezer, Siren; Massy, Ziad A.; Johansson, Lina; Cozzolino, Mario; Fouque, Denis; 27867189
The importance of phosphate homeostasis in chronic kidney disease (CKD) has been recognized for decades, but novel insights-which are frequently relevant to everyday clinical practice-continue to emerge. Epidemiological data consistently indicate an association between hyperphosphataemia and poor clinical outcomes. Moreover, compelling evidence suggests direct toxicity of increased phosphate concentrations. Importantly, serum phosphate concentration has a circadian rhythm that must be considered when interpreting patient phosphate levels. Detailed understanding of dietary sources of phosphate, including food additives, can enable phosphate restriction without risking protein malnutrition. Dietary counselling provides an often underestimated opportunity to target the increasing exposure to dietary phosphate of both the general population and patients with CKD. In patients with secondary hyperparathyroidism, bone can be an important source of serum phosphate, and adequate appreciation of this fact should impact treatment. Dietary and pharmotherapeutic interventions are efficacious strategies to lower phosphate intake and serum concentration. However, strong evidence that targeting serum phosphate improves patient outcomes is currently lacking. Future studies are, therefore, required to investigate the effects of modern dietary and pharmacological interventions on clinically meaningful end points.