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. 2019 Oct 10;14(10):e0223605.
doi: 10.1371/journal.pone.0223605. eCollection 2019.

Effects of dietary intake and nutritional status on cerebral oxygenation in patients with chronic kidney disease not undergoing dialysis: A cross-sectional study

Susumu Ookawara  1   2 , Yoshio Kaku  1 , Kiyonori Ito  1 , Kanako Kizukuri  2 , Aiko Namikawa  2 , Shinobu Nakahara  2 , Yuko Horiuchi  2 , Nagisa Inose  2 , Mayako Miyahara  2 , Michiko Shiina  2 , Saori Minato  1 , Mitsutoshi Shindo  1 , Haruhisa Miyazawa  1 , Keiji Hirai  1 , Taro Hoshino  1 , Miho Murakoshi  2 , Kaoru Tabei  3 , Yoshiyuki Morishita  1
Affiliations

Effects of dietary intake and nutritional status on cerebral oxygenation in patients with chronic kidney disease not undergoing dialysis: A cross-sectional study

Susumu Ookawara et al. PLoS One. .

Abstract

Background: Dietary management is highly important for the maintenance of renal function in patients with chronic kidney disease (CKD). Cerebral oxygen saturation (rSO2) was reportedly associated with the estimated glomerular filtration rate (eGFR) and cognitive function. However, data concerning the association between cerebral rSO2 and dietary intake of CKD patients is limited.

Methods: This was a single-center observational study. We recruited 67 CKD patients not undergoing dialysis. Cerebral rSO2 was monitored using the INVOS 5100c oxygen saturation monitor. Energy intake was evaluated by dietitians based on 3-day meal records. Daily protein and salt intakes were calculated from 24-h urine collection.

Results: Multivariable regression analysis showed that cerebral rSO2 was independently associated with energy intake (standardized coefficient: 0.370) and serum albumin concentration (standardized coefficient: 0.236) in Model 1 using parameters with p < 0.10 in simple linear regression analysis (body mass index, Hb level, serum albumin concentration, salt and energy intake) and confounding factors (eGFR, serum sodium concentration, protein intake), and the energy/salt index (standardized coefficient: 0.343) and Hb level (standardized coefficient: 0.284) in Model 2 using energy/protein index as indicated by energy intake/protein intake and energy/salt index by energy intake/salt intake in place of salt, protein and energy intake.

Conclusions: Cerebral rSO2 is affected by energy intake, energy/salt index, serum albumin concentration and Hb level. Sufficient energy intake and adequate salt restriction is important to prevent deterioration of cerebral oxygenation, which might contribute to the maintenance of cognitive function in addition to the prevention of renal dysfunction in CKD patients.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Patient flow chart.
Fig 2
Fig 2. Correlation between cerebral oxygen saturation and energy intake in advanced chronic kidney disease patients.
Equation of trend line (representing cerebral oxygen saturation) = 0.614 × energy intake + 39.1; r = 0.388, p = 0.001. Abbreviations: BW, body weight; rSO2, regional saturation of oxygen.
See this image and copyright information in PMC

References

    1. Japanese Society of Nephrology, eds. Clinical Practice Guidebook for Diagnosis and Treatment of Chronic Kidney Disease 2012. Tokyo, Japan: Tokyo-Igakusya; 2012. - PubMed
    1. Kopple JD. National kidney foundation K/DOQI clinical practice guidelines for nutrition in chronic renal failure. Am J Kidney Dis. 2001; 37(1 Suppl 2): S66–70. - PubMed
    1. Academy of Nutrition and Dietetics. Evidence-based nutrition practice guidelines. Chronic kidney disease (CKD). 2010. (https://www.andeal.org/template.cfm?template=guide_summary&key=2410&high...).
    1. Fouque D, Laville M, Boissel JP. Low protein diets for chronic kidney disease in non diabetic adults. Cochrane Database Syst Rev. 2009; CD001892 10.1002/14651858.CD001892.pub3 - DOI - PubMed
    1. Robertson L, Waugh N, Robertson A. Protein restriction for diabetic renal disease. Cochrane Database Syst Rev. 2007; CD002181 10.1002/14651858.CD002181.pub2 - DOI - PMC - PubMed

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