Energy-Dense Diets and Mineral Metabolism in the Context of Chronic Kidney Disease⁻Metabolic Bone Disease (CKD-MBD).
Study Goal
The researchers aimed to review the effects of energy-dense diets on mineral metabolism, particularly phosphorus, in the context of chronic kidney disease⁻metabolic bone disease (CKD-MBD).
Results Summary
The study found that energy-dense diets promote phosphorus retention and other detrimental changes in mineral metabolism, exacerbating CKD-MBD, but may help prevent weight loss in advanced CKD patients. High-fat diets in uremic animals worsened phosphorus-induced vascular calcification, which was mitigated by vitamin E supplementation.
Population
Patients with chronic kidney disease⁻metabolic bone disease (CKD-MBD) and uremic animals.
Effective Dosage
Not specified
Duration
Not specified
Interactions
Vitamin E supplementation ameliorated high phosphorus-induced vascular calcification.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
energy-dense diets | increase | obesity | - | - | promote | #1 |
energy-dense diets | increase | type II diabetes | - | - | promote | #2 |
energy-dense diets | decrease | weight loss | advanced CKD patients | - | may help to prevent | #3 |
energy-dense food | increase | phosphorus (P) retention | - | - | promotes changes in mineral metabolism | #4 |
energy-dense food | increase | concentrations of fibroblast growth factor 23 | - | - | promotes changes in mineral metabolism | #5 |
energy-dense food | decrease | levels of renal klotho | - | - | promotes changes in mineral metabolism | #6 |
energy-dense food | decrease | circulating concentrations of calcitriol | - | - | promotes changes in mineral metabolism | #7 |
high fat diet | increase | oxidative stress | uremic animals | - | induces | #8 |
high fat diet | increase | high P-induced vascular calcification | uremic animals | - | potentiates | #9 |
oral supplementation of vitamin E | decrease | these extraskeletal calcifications | uremic animals | - | can be ameliorated by | #10 |
The aim of this paper is to review current knowledge about the interactions of energy-dense diets and mineral metabolism in the context of chronic kidney disease⁻metabolic bone disease (CKD-MBD). Energy dense-diets promote obesity and type II diabetes, two well-known causes of CKD. Conversely, these diets may help to prevent weight loss, which is associated with increased mortality in advanced CKD patients. Recent evidence indicates that, in addition to its nephrotoxic potential, energy-dense food promotes changes in mineral metabolism that are clearly detrimental in the context of CKD-MBD, such as phosphorus (P) retention, increased concentrations of fibroblast growth factor 23, decreased levels of renal klotho, and reduction in circulating concentrations of calcitriol. Moreover, in uremic animals, a high fat diet induces oxidative stress that potentiates high P-induced vascular calcification, and these extraskeletal calcifications can be ameliorated by oral supplementation of vitamin E. In conclusion, although energy-dense foods may have a role in preventing undernutrition and weight loss in a small section of the CKD population, in general, they should be discouraged in patients with renal disease, due to their impact on P load and oxidative stress.