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1. Achievement of Low-Density Lipoprotein Cholesterol Targets in CKD

Author

Ziad A. Massy, Jean Ferrières, Eric Bruckert, Céline Lange, Sophie Liabeuf, Maja Velkovski-Rouyer, Bénédicte Stengel, Carole Ayav, Christian Combe, Denis Fouque, Luc Frimat, Yves-Edouard Herpe, Maurice Laville, Ziad Massy, Karine Legrand, Marie Metzger, Elodie Speyer, Bruno Moulin, Gaétan Lebrun, Éric Magnant, Gabriel Choukroun, Jean Philippe Bourdenx, Marie Essig, Raymond Azar, Mustafa Smati, Mohamed Jamali, Alexandre Klein, Michel Delahousse, Séverine Martin, Eric Thervet, Xavier Belenfant, Pablo Urena, Carlos Vela, Dominique Chauveau, Viktor Panescu, François Glowacki, Maxime Hoffmann, Maryvonne Hourmant, Dominique Besnier, Angelo Testa, Philippe Zaoui, Charles Chazot, Laurent Juillard, Stéphane Burtey, Adrien Keller, and Nassim Kamar

Subjects
Diseases of the genitourinary system. Urology, RC870-923
Abstract

Introduction: We describe the characteristics of patients with moderate/advanced chronic kidney disease (CKD) according to receipt of lipid-lowering therapy (LLT), and whether they achieved low-density lipoprotein cholesterol (LDL-C) targets for high- and very high-risk patients. Methods: CKD-REIN (NCT03381950), a prospective cohort study conducted in 40 nephrology clinics in France, enrolled 3033 patients with moderate (stage G3) or advanced (stage G4/G5) CKD (2013−2016) who had not been on chronic dialysis or undergone kidney transplantation. Data were collected from patients’ interviews and medical records. Patients were followed up at 1 year. Results: Among 2542 patients (mean [SD] age 67 [13] years, 34% women) with LDL-C measurements at baseline (mean [SD] LDL-C 2.7 [1.1] mmol/l; cholesterol 4.8 [1.3] mmol/l), 63% were on LLT; 24% were at high (CKD stage G3, no cardiovascular disease [CVD] or diabetes) and 74% at very high (CKD stage G3 with diabetes or CVD, or CKD stage G4/5) cardiovascular risk. Among high-risk patients, 45% of those on statin and/or ezetimibe achieved the LDL-C treatment target (

Published
2019
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2. Association of a Low-Protein Diet With Slower Progression of CKD

Author

Marie Metzger, Wen Lun Yuan, Jean-Philippe Haymann, Martin Flamant, Pascal Houillier, Eric Thervet, Jean-Jacques Boffa, François Vrtovsnik, Marc Froissart, Lise Bankir, Denis Fouque, and Bénédicte Stengel

Subjects
dietary protein intake, end-stage renal disease, glomerular filtration rate, mortality, urinary urea excretion, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Reducing protein intake is recommended for slowing chronic kidney disease (CKD) progression, but assessment of its true effectiveness is sparse. Methods: Using the Maroni formula, we assessed dietary protein intake (DPI) from 24-hour urinary urea excretion in 1594 patients (67% men and 33% women) with CKD, 784 of whom also had 7-day food records. Cause-specific hazard ratios (HRs) and 95% confidence intervals for the competing risks of DPI-associated end-stage renal disease (ESRD) or death were estimated in 1412 patients with baseline glomerular filtration rate ≥15 ml/min per 1.73 m2, measured by 51Cr-EDTA renal clearance (mGFR). Results: Overall, mean DPI estimated from urea excretion was 1.09 ± 0.30 g/kg of body weight per day (range = 0.34−2.76); 20% of patients had values > 1.3 g/kg per day, and 1.9% had values < 0.6 g/kg per day. Urea excretion and food records produced similar estimates of mean DPI. The lower the mGFR, the lower the mean DPI. Over a median follow-up of 5.6 years, there were 319 ESRD events and 189 pre-ESRD deaths. After adjusting for relevant covariates, each 0.1 g/kg daily higher baseline urea excretion−based DPI or food record−based DPI was associated with an HR for ESRD of 1.05 (95% confidence interval 1.01−1.10) or 1.09 (95% confidence interval 1.04−1.14), respectively. HRs were stronger in patients with baseline mGFR < 30 ml/min per 1.73 m2. There was no association with mortality. The mean age of the patients was 59 ± 15 years, and mean body mass index was 26.6 ± 5.2 kg/m2. Conclusion: In this prospective observational study, the lower the baseline DPI, the slower the progression toward ESRD. Most importantly, the absence of threshold for the relation between DPI and ESRD risk indicates that there is no optimal DPI in the range observed in this cohort.

Published
2018
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3. Preface

Author

Joel D. Kopple, Shaul G. Massry, Kamyar Kalantar-Zadeh, and Denis Fouque

Published
2022

5. List of contributors

Author

Marcin Adamczak, Maria Ida Amabile, Ibironke W. Apata, Mugurel Apetrii, Carla Maria Avesani, Udo Bahner, James L. Bailey, Anip Bansal, Christophe Barba, Ezequiel Bellorin-Font, Rachelle Bross, Amanda Brown-Tortorici, Michel Burnier, Jerrilynn Denise Burrowes, Juan Jesús Carrero, MacKenzie K. Cervantes, Steven Chadban, Vimal Chadha, Maria Chan, Winnie Chan, Charles Chazot, Janet M. Chiang, Michel Chonchol, Lydia Chwastiak, Adrian Covic, Lilian Cuppari, Neera K. Dahl, Biagio Di Iorio, Francesca Di Mario, Wilfred Druml, Ramanath Dukkipati, Gholamreza Fazeli, Enrico Fiaccadori, Fredric Finkelstein, Denis Fouque, Harold A. Franch, Allon N. Friedman, Pranav S. Garimella, Richard J. Glassock, David S. Goldfarb, Ailema González-Ortiz, Nimrit Goraya, Orlando M. Gutiérrez, Norio Hanafusa, August Heidland, Olof Heimbürger, Raimund Hirschberg, T. Alp Ikizler, Kirsten Johansen, Richard J. Johnson, Shivam Joshi, Kamyar Kalantar-Zadeh, Duk-Hee Kang, George A. Kaysen, Jun-Chul Kim, Brandon Kistler, Laetitia Koppe, Joel D. Kopple, Csaba P. Kovesdy, Holly J. Kramer, Kiyoshi Kurokawa, Bengt Lindholm, Kevin J. Martin, Steve Martino, Stefania Marzocco, Shaul G. Massry, Ziad A. Massy, William E. Mitch, Toshio Miyata, Alessio Molfino, Hamid Moradi, Takahiko Nakagawa, Yoko Narasaki, Nancy Puzziferri, Noel Quinn, Dominic S. Raj, Kalani L. Raphael, Renu Regunathan-Shenk, Connie M. Rhee, Eberhard Ritz, Alice Sabatino, Mark J. Sarnak, Julia Scialla, Lothar Seefried, John Sellinger, Anuja Shah, Neal B. Shah, Sudhir V. Shah, Manisha Singh, Leonardo Spatola, Robert C. Stanton, Alison L. Steiber, Peter Stenvinkel, David E. St-Jules, Thomas W. Storer, Keiichi Sumida, Elizabeth J. Sussman-Dabach, Sundararaman Swaminathan, John Sy, Ekamol Tantisattamo, Nosratola D. Vaziri, Alexandra Voinescu, Angela Yee-Moon Wang, Bradley A. Warady, Daniel E. Weiner, Donald E. Wesson, Andrzej Wiecek, Mark E. Williams, Bruce M. Wolfe, Biruh T. Workeneh, and Ying-Yong Zhao

Published
2022

7. Low Protein, Amino Acid and Ketoacid Diets to Slow the Progression of Chronic Kidney Disease and Improve Metabolic Control of Uremia

Author

Denis Fouque

Subjects
medicine.medical_specialty, Low protein, medicine.medical_treatment, Glomerulosclerosis, Renal function, Biology, medicine.disease, Uremia, Insulin resistance, Endocrinology, Internal medicine, medicine, Dyslipidemia, Dialysis, Kidney disease
Abstract

For many decades, nephrologists have advised kidney disease patients to control their protein intake in order to reduce accumulation of nitrogen waste products and limit uremic symptoms. More recently, renal pathophysiology findings have suggested that reducing protein intake protects against glomerular sclerosis, the consequence of hyperfiltration. Thus, two independent protective effects may occur in chronic kidney disease. Do these findings translate in human disease? There is now a bunch of evidence that many metabolic abnormalities will be improved in response to a reduction in protein intake, including insulin resistance, mineral and bone metabolism, proteinuria, dyslipidemia, inflammation, blood pressure and anemia. Effect of reducing protein intake on renal function has been more difficult to assess from clinical trials. However, a number of meta-analyses have provided a quite convincing conclusion that low protein diets reduce renal death, i.e., the number of deaths or dialysis starts in patients receiving low protein diets. Finally, the safety of and compliance to such diets will be discussed. It seems advisable to propose such dietary counseling for all chronic kidney disease patients, and follow-up in order to ensure the best nutritional status and minimal exposure to uremic toxins.

Published
2013

8. List of Contributors

Author

Marcin Adamczak, T. Alp Ikizler, James L. Bailey, Radhakrishna Baliga, Rinaldo Bellomo, J. Bikhchandani, George L. Blackburn, David A. Bushinsky, Vito M. Campese, Noel J. Cano, Juan Jesús Carrero, Steve Chadban, Vimal Chadha, Maria Chan, Alex Chang, Charles Chazot, Michal Chmielewski, Marta Christov, Horng-Ruey Chua, Lydia Chwastiak, Burl R. Don, Wilfred Druml, Ramanath Dukkipati, Bo Feldt-Rasmussen, Frederic Finkelstein, R.A. Forse, Denis Fouque, Harold A. Franch, Pranav S. Garimella, Marvin Grieff, Orlando M. Gutiérrez, Nabil Haddad, Lee A. Hebert, Olof Heimbürger, Raimund Hirschberg, Jessica Houston, Tamara Isakova, Sirin Jiwakanon, George A. Kaysen, Csaba P. Kovesdy, Holly Kramer, Kiyoshi Kurokawa, Daniel Landau, Yinan Li, Bengt Lindholm, Greta Magerowski, Kevin J. Martin, Cathi J. Martin, Steve Martino, Rajnish Mehrotra, Michal L. Melamed, William E. Mitch, Toshio Miyata, Alessio Molfino, Toshimitsu Niwa, Lara B. Pupim, Ralph Rabkin, Dominic Raj, Mohan Rajapurkar, Samia Raju, Eberhard Ritz, Mark J. Sarnak, Sudhir V. Shah, Rosemarie Shim, Robert Stanton, Alison l. Steiber, Peter Stenvinkel, Hillel Sternlicht, Thomas W. Storer, Sundararaman Swaminathan, Ravi Thadhani, Nosratola D. Vaziri, Manuel Velasquez, Alexandra Voinescu, Bradley A. Warady, Daniel E. Weiner, Andrzej Wiecek, Mark E. Williams, Maria Wing, Myles Wolf, B. Workeneh, and Min Zhang

Published
2013

9. Contributors

Author

Andrew Advani, Michael Allon, Amanda Hyre Anderson, Gerald B. Appel, Suheir Assady, Anthony Atala, Colin Baigent, Sevcan A. Bakkaloglu, Gina-Marie Barletta, Gavin J. Becker, Rinaldo Bellomo, Jeffrey S. Berns, Vivek Bhalla, Jürg Biber, Daniel G. Bichet, René J.M. Bindels, Melissa B. Bleicher, Jon D. Blumenfeld, Alain Bonnardeaux, Joseph V. Bonventre, William D. Boswell, Donald W. Bowden, Barry M. Brenner, Matthew D. Breyer, Richard M. Breyer, Dennis Brown, Carlo Brugnara, Timothy E. Bunchman, David A. Bushinsky, Stéphan Busque, Juan Jesús Carrero, Daniel Cattran, James C. Chan, Anil Chandraker, Ingrid J. Chang, Devasmita Choudhury, Fredric L. Coe, John F. Collins, H. Terence Cook, Ricardo Correa-Rotter, Shawn E. Cowper, Paolo Cravedi, Alfonso M. Cueto-Manzano, Vivette D. D’Agati, Mogomat Razeen Davids, Scott E. Delacroix, Bradley M. Denker, Thomas A. Depner, Thomas D. DuBose, Kai-Uwe Eckardt, Mohamed T. Eldehni, David H. Ellison, Michael Emmett, Ronald J. Falk, Harold I. Feldman, Robert A. Fenton, Andrew Z. Fenves, Kevin W. Finkel, Paola Fioretto, Damian G. Fogarty, John R. Foringer, Denis Fouque, Barry I. Freedman, Jørgen Frøkiaer, John W. Funder, David S. Game, Richard E. Gilbert, Jared J. Grantham, Mitchell L. Halperin, Matthew Hand, Donna S. Hanes, David C.H. Harris, Raymond C. Harris, Richard Haynes, Joost G.J. Hoenderop, Ewout J. Hoorn, Thomas H. Hostetter, Chi-yuan Hsu, Shih Hua-Lin, Hassan N. Ibrahim, Ajay K. Israni, Jossein Jadvar, J. Charles Jennette, Eric Jonasch, Kamel S. Kamel, S. Ananth Karumanchi, Bertram L. Kasiske, John A. Kellum, Carolyn J. Kelly, Ramesh Khanna, David K. Klassen, Christine J. Ko, Harbir Singh Kohli, Curtis K. Kost, L. Spencer Krane, Jordan Kreidberg, Tae-Hwan Kwon, Amit Lahoti, Martin J. Landray, John H. Laragh, Harold E. Layton, Moshe Levi, Bengt Lindholm, Frank Liu, Valerie A. Luyckx, David A. Maddox, Yoshiro Maezawa, Arthur J. Matas, Michael Mauer, Ivan D. Maya, Sharon E. Maynard, Alicia A. McDonough, Christopher W. McIntyre, Timothy W. Meyer, William E. Mitch, Orson W. Moe, Sharon M. Moe, Bruce A. Molitoris, Alvin H. Moss, David B. Mount, Karen A. Munger, Patrick H. Nachman, Saraladevi Naicker, Søren Nielsen, Eric G. Neilson, Lindsay E. Nicolle, Daniel B. Ornt, Manuel Palacín, Paul M. Palevsky, Suzanne L. Palmer, Hans-Henrik Parving, Jaakko Patrakka, David Pearce, Roberto Pecoits-Filho, Carmen A. Peralta, Norberto Perico, Neil R. Powe, Kearkiat Praditpornsilpa, Jeppe Prætorius, Susan E. Quaggin, L. Darryl Quarles, Jai Radhakrishnan, Rawi Ramadan, Piero Reggenenti, Heather N. Reich, Andrea Remuzzi, Giuseppe Remuzzi, Stephen S. Rich, Miguel C. Riella, Eberhard Ritz, Claudio Ronco, Norman D. Rosenblum, Peter Rossing, Dvora Rubinger, Robert K. Rude, Ernesto Sabath, Venkata Sabbisetti, Vinay Sakhuja, Alan D. Salama, Jeff M. Sands, Fernando Santos, Mohamed H. Sayegh, John D. Scandling, Franz Schaefer, Jon I. Scheinman, John C. Schwartz, Asif A. Sharfuddin, Susan Shaw, Visith Sitprija, Karl L. Skorecki, Itzchak N. Slotki, James P. Smith, Miroslaw J. Smogorzewski, Stuart M. Sprague, Peter Stenvinkel, John B. Stokes, Maarten W. Taal, Manjula Kurella Tamura, Jane C. Tan, Stephen C. Textor, Ravi Thadhani, Scott C. Thomson, Vincente E. Torres, Karl Tryggvason, Meryem Tuncel, Kriang Tungsanga, Joseph G. Verbalis, Jill W. Verlander, Shoyab Wadee, I. David Weiner, Matthew R. Weir, Steven D. Weisbord, David C. Wheeler, Christopher S. Wilcox, Christopher G. Wood, Stephen H. Wright, Jane Y. Yeun, Alan S.L. Yu, Kambiz Zandi-Nejad, and Mark L. Zeidel

Published
2012

10. Dietary Approaches to Kidney Diseases

Author

William E. Mitch and Denis Fouque

Subjects
Kidney, medicine.anatomical_structure, business.industry, Physiology, Medicine, business
Published
2011

11. CONTRIBUTORS

Author

Sergio R. Acchiardo, Rajiv Agarwal, Amira Al-Uzri, Connie Anderson, Vincent T. Armenti, Stephen R. Ash, Morrell Michael Avram, Antonio Bellasi, Mark R. Benfield, William M. Bennett, Jeffrey S. Berns, Anatole Besarab, Christopher R. Blagg, Geoffrey A. Block, Paola Boccardo, W. Kline Bolton, Mary L. Brandt, Eileen D. Brewer, Patrick D. Brophy, Warren S. Brown, Suphamai Bunnapradist, John M. Burkart, Vito M. Campese, Ralph J. Caruana, Darrell L. Cass, Vimal Chadha, Christopher T. Chan, Chaim Charytan, William R. Clark, Allan J. Collins, Carl H. Cramer, Terri L. Crawford-Bonadio, Declan de Freitas, José A. Diaz-Buxo, Lesley C. Dinwiddie, Eileen N. Ellis, Janet A. Englund, Fabrizio Fabrizi, Donald A. Feinfeld, Charles Jerome Foulks, Denis Fouque, Miriam Galbusera, Dayong Gao, F. John Gennari, Jeffrey Giullian, Stuart L. Goldstein, Esther A. Gonzalez, William G. Goodman, Frank A. Gotch, Leila Haghighat, Nikolas B. Harbord, Elizabeth Harvey, Nicholas Andrew Hoenich, Christer Holmberg, Clifford J. Holmes, Robert Hootkins, Daljit K. Hothi, Susan Hou, Alastair J. Hutchison, Zhongping Huang, Todd S. Ing, Curtis A. Johnson, Kamyar Kalantar-Zadeh, André A. Kaplan, Toros Kapoian, Elaine M. Kaptein, Pranay Kathuria, Jeffrey L. Kaufman, William F. Keane, Ramesh Khanna, Neenoo Khosla, Paul L. Kimmel, Carl M. Kjellstrand, Laura Kooienga, Peter Kotanko, Eugene C. Kovalik, Matthias Kraemer, Anthony Langone, Peter F. Lawrence, Jeffrey J. Letteri, Chi-Bon Leung, Adeera Levin, Nathan W. Levin, John Kenneth Leypoldt, Philip Kam-Tao Li, Robert McGregor Lindsay, Francisco Llach, Margaret MacDougall, Lionel U. Mailloux, Kevin J. Martin, Paul Martin, Ziad A. Massy, Philip A. McFarlane, Rajnish Mehrotra, Mark M. Mitsnefes, Neal Mittman, Michael J. Moritz, Laura L. Mulloy, Sean W. Murphy, Dana Negoi, Alicia M. Neu, Bijan Nikakhtar, Allen R. Nissenson, Pouneh Nouri, Jed G. Nuchtern, Matthew J. Oliver, Ali J. Olyaei, Madeleine V. Pahl, Patricia Painter, Biff F. Palmer, Patrick S. Parfrey, Ashley A. Perilloux, Phuong-Chi T. Pham, Phuong-Thu T. Pham, Andreas Pierratos, Joanne D. Pittard, Patrick H. Pun, Erik Qvist, Dominic S.C. Raj, Giuseppe Remuzzi, Claudio Rigatto, Michael V. Rocco, Rudolph A. Rodriguez, Claudio Ronco, Kai Rönnholm, Mitchell H. Rosner, John H. Sadler, Isidro B. Salusky, Ramin Sam, Cheryl P. Sanchez, Scott G. Satko, Franz Schaefer, Rebecca J. Schmidt, Cornelis H. Schröder, Gerald Schulman, Steve J. Schwab, Michael H. Schwenk, Warren B. Shapiro, Richard A. Sherman, Jodi M. Smith, Michael J.G. Somers, Evelyn Spanner, Bruce S. Spinowitz, John C. Stivelman, Cheuk-Chun Szeto, Alf M. Tannenberg, Karen B. Tipton, Avram Z. Traum, Arthur Tsai, Zbylut J. Twardowski, Antonios H. Tzamaloukas, Raymond Vanholder, Nosratola D. Vaziri, Maureen Wakeen, Bradley A. Warady, Richard A. Ward, Steven J. Wassner, Steven D. Weisbord, John J. White, Suzanne H. White, James F. Winchester, David W. Windus, Jay B. Wish, Anthony R. Zappacosta, and Stephen W. Zimmerman

Published
2008

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