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Background and Aims: The gold standard method for measuring resting energy expenditure (REE) is indirect calorimetry (IC) using an expensive device that requires specialized training. To overcome the limitations of IC, REE prediction formulas are used in patients with chronic kidney disease (CKD). However, it is still controversial which of these formulas has greater accuracy compared to IC. We aimed to determine the accuracies of REE measured by IC and estimated by formulas in patients with CKD. Methods: Fifty-three patients with stage 4–5 CKD underwent IC and five current REE prediction formulas. Accuracy was measured by Lin's correlation coefficient. Bland–Altman repeated measures analysis was used to assess the agreement of the formulas' results with those of IC. Precision was measured by the predicted IC ± 10% and 20%. Systematic bias was assessed by the Student's t-test, and linear regression was used to assess proportionality bias. Results: Patients had a mean estimated glomerular filtration rate (eGFR) of 12 ± 4 mL/min/1.73 m2, a mean age of 65 years, and 62% were male. The mean REE measured by IC was 1341 ± 37 Kcal/day, and the formula with the lowest mean bias (0.1509 [−653.5121; 398.9056]), best correlation (r = 0.789; p = 0.000), and best accuracy (85%) was the formula developed by Fernandes and Cols (REE (kcal/day) = 854 + (7.4 × body weight) + (179 × sex) − (3.3 × age) + (2.1 × eGFR) + 26 (if diabetes)). Conclusions: The Fernandes and Cols equation had good accuracy and was valuable for estimating energy requirements in the population studied. [ABSTRACT FROM AUTHOR]

The coronavirus disease-2019 (COVID-19) pandemic has had a profound impact on the world, causing loss of life, economic damage, and social disruption. Individuals with chronic kidney disease (CKD) are prone to complications and increased mortality related to COVID-19. Efforts have been made to increase understanding of the effects of COVID-19 in individuals with CKD. This paper aims to gather and discuss the state-of-the-art in the COVID-19 and CKD literature, involving the early history of COVID-19, the immunological aspects of CKD (such as abnormalities in neutrophilicand dendritic cells functions), the mechanisms of kidney injury by SARS-CoV-2 (for example, viral tropism to kidney tissue and direct cytotoxicity), the clinical course of the disease and consequences for CKD individuals (including kidney transplant recipients), and the emerging treatments (such as the use of Remdesivir, nirmatrelvir, and monoclonal neutralizing antibodies) and immunization for the CKD population. [ABSTRACT FROM AUTHOR]

Advanced glycation end products (AGEs) accumulation may be involved in the progression of CKD‐bone disorders. We sought to determine the relationship between AGEs measured in the blood, skin, and bone with histomorphometry parameters, bone protein, gene expression, and serum biomarkers of bone metabolism in patients with CKD stages 3 to 5D patients. Serum levels of AGEs were estimated by pentosidine, glycated hemoglobin (A1c), and N‐carboxymethyl lysine (CML). The accumulation of AGEs in the skin was estimated from skin autofluorescence (SAF). Bone AGEs accumulation and multiligand receptor for AGEs (RAGEs) expression were evaluated by immunohistochemistry; bone samples were used to evaluate protein and gene expression and histomorphometric analysis. Data are from 86 patients (age: 51 ± 13 years; 60 [70%] on dialysis). Median serum levels of pentosidine, CML, A1c, and SAF were 71.6 pmol/mL, 15.2 ng/mL, 5.4%, and 3.05 arbitrary units, respectively. AGEs covered 3.92% of trabecular bone and 5.42% of the cortical bone surface, whereas RAGEs were expressed in 0.7% and 0.83% of trabecular and cortical bone surfaces, respectively. AGEs accumulation in bone was inversely related to serum receptor activator of NF‐κB ligand/parathyroid hormone (PTH) ratio (R = −0.25; p = 0.03), and RAGE expression was negatively related to serum tartrate‐resistant acid phosphatase‐5b/PTH (R = −0.31; p = 0.01). Patients with higher AGEs accumulation presented decreased bone protein expression (sclerostin [1.96 (0.11–40.3) vs. 89.3 (2.88–401) ng/mg; p = 0.004]; Dickkopf‐related protein 1 [0.064 (0.03–0.46) vs. 1.36 (0.39–5.87) ng/mg; p = 0.0001]; FGF‐23 [1.07 (0.4–32.6) vs. 44.1 (6–162) ng/mg; p = 0.01]; and osteoprotegerin [0.16 (0.08–2.4) vs. 6.5 (1.1–23.7) ng/mg; p = 0.001]), upregulation of the p53 gene, and downregulation of Dickkopf‐1 gene expression. Patients with high serum A1c levels presented greater cortical porosity and Mlt and reduced osteoblast surface/bone surface, eroded surface/bone surface, osteoclast surface/bone surface, mineral apposition rate, and adjusted area. Cortical thickness was negatively correlated with serum A1c (R = −0.28; p = 0.02) and pentosidine levels (R = −0.27; p = 0.02). AGEs accumulation in the bone of CKD patients was related to decreased bone protein expression, gene expression changes, and increased skeletal resistance to PTH; A1c and pentosidine levels were related to decreased cortical thickness; and A1c levels were related to increased cortical porosity and Mlt. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research. [ABSTRACT FROM AUTHOR]

The role of native vitamin D in the bone tissue physiology is clear not only as an essential nutrient able to treat and prevent rickets but also as a regulator of calcium and phosphate homeostasis, as of bone metabolism. A wide spectrum of biological activities has been described, including effects on cardiovascular, central nervous, and immunological systems, in the cellular growth, as in the control of other hormonal systems. Epidemiological evidences have linked vitamin D deficiency with many other diseases as cancer, diabetes mellitus, arterial hypertension, autoimmune diseases, infections and mortality increase. Overall, this information boosted the use of vitamin D in different clinical settings, without strong scientific evidences, even in doubtful clinical situations. However, clinical trials are showing inconsistent results, putting into question the widespread use of vitamin D. This article presents a review about vitamin D and lists some key scientific evidence on the real benefits of supplementation in humans in various conditions. [ABSTRACT FROM AUTHOR]

Background Recent research has clarified the relationship between adipokines, metabolic syndrome (MS) and cardiovascular disease (CVD). The results of animal and clinical studies have revealed a positive relationship between leptin and vascular smooth muscle cell counts and calcification, arterial rigidity, carotid thickness and the incidence of CVD. However, despite leptin fulfilling the definition of a uremic toxin, its exact role in chronic kidney disease (CKD) has yet to be determined. Methods One hundred and forty-two CKD patients (stages 2–5D) participated in this study, and were followed for a minimum of 20 months at Amiens University Medical Center. Results Leptin was negatively correlated with the glomerular filtration rate (GFR), total adiponectin (TAdip) and high-molecular weight adiponectin and positively correlated with age, waist circumference, body mass index (BMI), aortic calcification score (ACS), C-reactive protein (CRP), triglycerides, insulin and parathormone (PTH). Leptin and insulin were significantly correlated with the MS score. The BMI, insulin, MS score and PTH were independent predictors of leptin levels (P = 0.002, 0.016, 0.028 and 0.017, respectively). Leptin, insulin and TAdip were independent predictors of the presence of MS (P = 0.05, 0.04 and 0.04). However, leptin levels were not significantly predictive of the clinical outcomes. Conclusions Our study was the first to demonstrate a significant, independent link between leptin and MS (but not clinical outcomes) and PTH in patients at different CKD stages. Future studies will have to assess the involvement of leptin in MS and clinical outcomes in CKD, and the potential modulation of leptin by PTH. [ABSTRACT FROM PUBLISHER]

Background: Cardiovascular disease is an important cause of death in patients on dialysis. Peripheral arterial disease (PAD) is a prognostic factor for cardiovascular disease. The ankle brachial index (ABI) is a noninvasive method used for the diagnosis of PAD. The difference between ABI pre- and post-dialysis had not yet been formally tested, and it was the main objective of this study. Methods: The ABI was assessed using an automated oscillometric device in incident patients on hemodialysis. All blood pressure readings were taken in triplicate pre- and post-dialysis in three consecutive dialysis sessions (times 1, 2, and 3). Results: One hundred and twenty-three patients (85 men) aged 53 ± 19 years were enrolled. We found no difference in ABI pre- and post-dialysis on the right or left side, and there was no difference in times 1, 2, and 3. In patients with a history of PAD, the ABI pre- versus post-dialysis were of borderline significance on the right side (p = 0.088). Conclusion: ABI measured pre- and post-dialysis presented low variability. The ABI in patients with a history of PAD should be evaluated with caution. The applicability of the current method in predicting mortality among patients on hemodialysis therefore needs further investigation. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]