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The recent research findings concerning syndromes of muscle wasting, malnutrition, and inflammation in individuals with chronic kidney disease (CKD) or acute kidney injury (AKI) have led to a need for new terminology. To address this need, the International Society of Renal Nutrition and Metabolism (ISRNM) convened an expert panel to review and develop(More)
BACKGROUND AND OBJECTIVES Levels of parathyroid hormone (PTH) and the phosphaturic hormone FGF23, a fibroblast growth factor (FGF) family member, increase early in chronic kidney disease (CKD) before the occurrence of hyperphosphatemia. This short-term 6-wk dose titration study evaluated the effect of two phosphate binders on PTH and FGF23 levels in(More)
BACKGROUND AND AIMS Calcium-containing phosphate binders have been shown to increase the progression of vascular calcification in hemodialysis patients. This is a prospective study that compares the effects of calcium acetate and sevelamer on coronary calcification (CAC) and bone histology. METHODS 101 hemodialysis patients were randomized for each(More)
BACKGROUND & AIMS Hypovitaminosis D [serum 25 vitamin D<30 ng/ml] is related to the development of metabolic bone disease and greater risk of chronic illnesses. However, it is frequently under-diagnosed, mainly in countries where UV radiation is abundant. We prospectively determined the prevalence and the predictors of serum 25 vitamin D (s25(OH)D) in a(More)
BACKGROUND Fibroblast growth factor 23 (FGF23) concentrations increase early in chronic kidney disease (CKD), and the influence of current CKD-mineral and bone disorder (MBD) therapies on serum FGF23 levels is still under investigation. METHODS In this post-hoc analysis of a randomized clinical trial, phosphate binders and calcitriol were washed out of 72(More)
BACKGROUND Coronary heart disease (CHD) is the leading cause of death among end-stage renal disease patients. There is evidence that coronary calcification is a marker of atherosclerotic vascular disease and is predictive of cardiovascular events, especially in patients on renal replacement therapy. It has recently been suggested that CHD begins in the(More)
OBJECTIVE To evaluate the impact of nutritional parameters at the time of initiation of hemodialysis (HD) on mortality. DESIGN Retrospective study. SETTING Dialysis Unit of the Federal University of Sao Paulo, Oswaldo Ramos Foundation. PATIENTS Three hundred forty-four incident HD patients (60.5% male, 26% diabetic) with the first nutritional(More)
BACKGROUND In the general population, waist circumference was noted to be a reliable predictor of visceral fat. In addition, increased waist circumference was strongly associated with risk factors for cardiovascular disease. In patients with chronic kidney disease (CKD), the association of waist circumference with visceral fat was never tested. STUDY(More)
OBJECTIVE To analyze the spontaneous food intake and the nutritional parameters of patients with different degrees of chronic renal insufficiency (CRI) at the onset of predialysis treatment. DESIGN Cross-sectional. SETTING Outpatient Clinic of the Nephrology Division of Federal University of São Paulo, Brazil. SUBJECTS The analysis involved 487 (187(More)
The food intake and the nutritional status of 100 chronic renal failure patients on maintenance hemodialysis in 10 facilities in the city of São Paulo were studied. The average food intake obtained through 3 days of dietary diaries showed a caloric intake of 26.6 +/- 10kcal/kg/day (mean +/- SD), 24% below the minimum daily caloric intake recommendation and(More)