Editorial: Nutrition and metabolism in kidney diseases

The impairment of kidney function, which occurs in chronic kidney disease (CKD) and acute kidney injury (AKI), promotes specific alterations in nutrient metabolism (1) and induces a pro-inflammatory state (2). These alterations affect the nutritional status of the patients and increase morbidity and mortality risk. Among the many factors that are associated with poor outcomes in this population, protein-energy wasting, malnutrition, and sarcopenia play a significant role. Nutritional management in individuals with impaired kidney function varies depending on the disease severity, nutritional status, cause of disease, comorbidities, medications, and treatment methods. Therefore, understanding the available methods for assessing nutritional status, establishing dietary requirements, and strategies for preventing or treating potential nutritional derangements is essential for optimal care of patients with kidney diseases. This Research Topic focuses on recent studies exploring nutrition and metabolism in CKD.</p

A Comparison of Dietary Intake Between Individuals Undergoing Maintenance Hemodialysis in the United Kingdom and China

Objective: Protein-energy wasting is highly prevalent in people with end-stage kidney disease receiving regular hemodialysis. Currently, it is unclear what the optimal nutritional recommendations are, which is further complicated by differences in dietary patterns between countries. The aim of the study was to understand and compare dietary intake between individuals receiving hemodialysis in Leicester, UK and Nantong, China. Methods: The study assessed 40 UK and 44 Chinese participants’ dietary intake over a period of 14 days using 24-hour diet recall interviews. Nutritional blood parameters were obtained from medical records. Food consumed by participants in the UK and China was analyzed using the Nutritics and Nutrition calculator to quantify nutritional intake. Results: Energy and protein intake were comparable between UK and Chinese participants, but with both below the recommended daily intake. Potassium intake was higher in UK participants compared to Chinese participants (2,115 [888] versus 1,159 [861] mg/d; P < .001), as was calcium (618 [257] versus 360 [312] mg/d; P < .001) and phosphate intake (927 [485] versus 697 [434] mg/d; P = .007). Vitamin C intake was lower in UK participants compared to their Chinese counterparts (39 [51] versus 64 [42] mg/d; P = .024). Data are reported here as median (interquartile range). Conclusion: Both UK and Chinese hemodialysis participants have insufficient protein and energy in their diet. New strategies are required to increase protein and energy intakes. All participants had inadequate daily intake of vitamins C and D; there may well be a role in the oral supplementation of these vitamins, and further studies are urgently needed