The prevalence of MCI among older adults with pre-dialysis CKD was as high as 62.5%. The association between MCI and reduced gait speed supports the possible interaction between physical and cognitive functions and the need for early screening.

<b><i>Introduction:</i></b> Patients with chronic kidney disease (CKD) exhibit a higher probability of having cognitive impairment or dementia than those without CKD. The beneficial effects of physical exercise on cognitive function are known in the general older population, but more research is required in older adults with CKD. <b><i>Methods:</i></b> Eighty-one outpatients (aged ≥65 years) with CKD stage G3–G4 were assessed for eligibility. Among them, 60 were randomized (single-center, unblinded, and stratified) and 53 received the allocated intervention (exercise <i>n</i> = 27, control <i>n</i> = 26). Patients in the exercise group undertook group-exercise training at our facility once weekly and independent exercises at home twice weekly or more, for 24 weeks. Patients in the control group received general care. General and specific cognitive functions (memory, attention, executive, and verbal) were measured, and differences in their scores at baseline and at the 24-week follow-up visit were assessed between the 2 groups. <b><i>Results:</i></b> Forty-four patients completed the follow-up at 24 weeks (exercise <i>n</i> = 23, control <i>n</i> = 21). Patients in the exercise group showed significantly greater changes in Wechsler Memory Scale-Revised Logical Memory delayed recall (exercise effect: 2.82, 95% CI: 0.46–5.19, <i>p</i> = 0.03), and immediate and delayed recall (exercise effect: 5.97, 95% CI: 1.13–10.81, <i>p</i> = 0.02) scores than those in the control group. <b><i>Conclusions:</i></b> The 24-week exercise intervention significantly improved the memory function in older adults with pre-dialysis CKD. This randomized controlled trial suggests that physical exercise is a useful nonpharmacological strategy for preventing cognitive decline in these patients.

Background Parathyroid hormone (PTH) acts on bone to indirectly increase the number and activity of osteoclasts. Thus, PTH has a stimulatory effect on bone resorption and upregulates bone turnover. However, the responsiveness of bone to PTH varies widely among patients receiving dialysis. In fact, relative to the serum PTH level, the level of serum tartrate-resistant acid phosphatase-5b (TRACP-5b), a bone resorption marker derived from osteoclasts, varies as well. This study aimed to examine factors related to bone responsiveness to PTH in patients undergoing chronic hemodialysis (HD). Methods This study included patients receiving chronic HD in Kawasaki Municipal Tama Hospital (Kanagawa, Japan) and Yonaha Medical Clinic (Okinawa, Japan) and excluded patients who received HD for less than 6 months, those who received a combination of HD and peritoneal dialysis, and those who had cancer bone metastases or myeloma. The TRACP-5b/intact PTH (iPTH) ratio was created as an index of bone responsiveness to PTH, categorized into tertiles (low, medium, and high), and a cross-sectional study was conducted. P < 0.05 indicated statistically significant differences. Results One hundred and six patients were analyzed. Age (P = 0.010), body mass index (BMI) (P = 0.003), use of calcium-sensing receptor (CaSR) agonists (P = 0.008), use of vitamin D receptor activators (VDRAs) (P = 0.012), plasma iPTH level (P < 0.001), serum 1,25(OH)2D level (P = 0.003), and serum TRACP-5b level (P < 0.001) were significantly different among the three categories. In the single linear regression analysis, age (P = 0.016), corrected serum calcium level (P = 0.007), and ln [1,25(OH)2D] (P = 0.044) showed a significant positive correlation with ln [TRACP-5b/iPTH], whereas BMI (P = 0.026), use of CaSR agonists (P = 0.001), use of VDRAs (P = 0.009), and serum phosphorus level (P = 0.018) showed a significant negative correlation. Upon conducting multiple linear regression analysis incorporating significant variables in the single linear regression analysis, a significant negative correlation was observed between the TRACP-5b/iPTH ratio and intravenous administration of a CaSR agonist (etelcalcetide) and/or a VDRA (calcitriol or maxacalcitol) in all the adjusted models. Conclusions Bone responsiveness to PTH is negatively correlated with the intravenous administration of a CaSR agonist and/or a VDRA in patients undergoing chronic HD.

The heat-induced gelling properties of mixtures of chicken ground meat and acid-precipitated soybean protein (APS-protein) preheated under various intensities were investigated, in order to elucidate the interaction between meat protein and soybean protein. The jelly strength, Young's modulus and water-holding capacity of mixtures of ground meat and non-preheated APS-protein showed only low values, while their values for the mixtures of ground meat and preheated APS-protein increased with increase of the preheating time. Although these values rapidly increased at the initial stage in preheating (0-4min), after 4min, the jelly strength increased only at a slow rate, while Young's modulus and water-holding capacity remained almost at a constant level. The amounts of preteins in the separated juices from mixed samples decreased with the increase of preheating time.The amounts of the sulfhydryl groups of APS-protein increased with the preheating time until 4min, but after that time, their values rapidly decreased.The physical properties of mixed samples were related to the sulfhydryl groups of APS-protein at the initial stage in preheating (0-4min), but after 4min, this relation was not observed.Jpn. J. Zootech. Sci., 56 (11): 897-904, 1985