Association between Overall Lifestyle Changes and the Incidence of Proteinuria: A Population-based, Cohort Study

Wakasugi, Minako; Kazama, Junichiro James; Narita, Ichiei; Iseki, Kunitoshi; Fujimoto, Shouichi; Moriyama, Toshiki; Yamagata, Kunihiro; Konta, Tsuneo; Tsuruya, Kazuhiko; Asahi, Koichi; Kondo, Masahide; Kurahashi, Issei; Ohashi, Yasuo; Kimura, Kenjiro; Watanabe, Tsuyoshi

doi:10.2169/internalmedicine.56.8006

Cited by 38 publications

(49 citation statements)

References 37 publications

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“…To paraphrase Aristotle: Nature does nothing without a purpose; virtue and excellences lie at the midpoint between two extremes (extreme deficiency and extreme excess). Promoting reasonable dietary moderation and avoidance of extremes, combined with physical activity and other elements of a healthy lifestyle [ 110 ], can bring harmony to the body’s biology and physiology, thus improving quality of life and minimizing risks for many modern era debilitating chronic diseases. This is of particular relevance to free-living omnivorous individuals with ready access to a virtually unlimited variety of foods.…”

Section: Discussionmentioning

confidence: 99%

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Dietary Influence on Body Fluid Acid-Base and Volume Balance: The Deleterious “Norm” Furthers and Cloaks Subclinical Pathophysiology

Qian

2018

Nutrients

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The popular modern diet, characterized by an excess of animal protein and salt but insufficient in fruits, vegetables and water, is a poor fit for human physiological and homeostatic regulatory systems. Sustained net acid and sodium retention, coupled with an insufficient intake of cardiovascular protective potassium-rich foods and hydration in the modern diet can give rise to debilitating chronic organ dysfunction and ultimately, mortality. This holds true, especially in our aging population who are already facing inevitable decline in organ functional reserve. Importantly, in most cases, despite the mismatch and adverse effects to multiple organ systems, plasma electrolyte and acid-base parameters can, on the surface, be maintained within a “normal” reference range, primarily by activating (often maximally activating) compensatory homeostatic mechanisms. These diet-induced effects can thus be clinically silent for decades. Embodied in the chronic corrective homeostatic processes, however, are real risks for multiorgan damage. According to the Dietary Guideline Advisory Committee (DGAC), half of American adults have one or more chronic diseases that are preventable with dietary modification. Here, homeostasis of body fluid acid-base, sodium, potassium and water is examined. Our current dietary habits and their required regulatory adaptation, maladaptation and relevant physiology and pathophysiology are discussed. A framework of dietary modifications to avoid a propensity for maladaptation and thus lowers the risks of common modern diseases (primary prevention) and minimizes the risk of chronic and age-related disease progression (secondary prevention) is emphasized. Although there are other variables at play, a key to restoring the all-important dietary potassium to sodium ratio is greater consumption of vegetables/fruits and adopting salt temperance. Dietary and nutritional optimization is an under-emphasized area of health care that has an enormous potential to temper the epidemics of prevalent chronic diseases in modern society and improve population health.

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Section: Discussionmentioning

confidence: 99%

“…Adherence to the guidelines should be advocated. A multi-pronged approach aiming to improve all elements of lifestyle will likely be effective [ 110 ].…”

Section: Prevention Of Acid-base and Electrolyte Maladaptive Respomentioning

confidence: 99%

Dietary Influence on Body Fluid Acid-Base and Volume Balance: The Deleterious “Norm” Furthers and Cloaks Subclinical Pathophysiology

Qian

2018

Nutrients

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“…Self-care behaviors are generally associated with improved health among individuals with chronic diseases. Physical activity has been associated with improved cardiovascular outcomes among patients with diabetes and CKD; smoking cessation, decreased alcohol consumption, and maintaining a healthy body mass index have been shown to significantly reduce incidence of proteinuria [ 3 – 5 ]. Participation in self-care behaviors may thus represent one way to mitigate adverse outcomes associated with CKD.…”

Section: Introductionmentioning

confidence: 99%

Association between health literacy and self-care behaviors among patients with chronic kidney disease

et al. 2018

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BackgroundWe explored the association between health literacy and self-care behaviors among low-income patients with chronic kidney disease (CKD).MethodsWe used baseline data from the Kidney Awareness Registry and Education trial (n = 137 patients with CKD) and multivariable logistic regressions to cross-sectionally examine the association between health literacy, defined by a validated questionnaire, and healthy behaviors.ResultsStudy participants had a mean age of 55 years, were racially diverse (6% White, 36% Hispanic, 43% Black, 15% Asian) and 26% had low health literacy. Over one-third (38%) had hypertension, 51% had diabetes, and 67% had CKD stage 3 or 4. Compared to individuals with adequate health literacy, those with low health literacy had non-statistically significant higher tobacco use (adjusted odds ratio [aOR] = 2.33; 95% CI 0.90–6.06) and lower consumption of sugary beverages (aOR = 0.50; 0.20-1.23) and statistically significant decreased fast food intake (aOR = 0.38; 0.16-0.93). Health literacy was not associated with differences in medication adherence (0.84; 0.38-1.89) or physical activity (aOR = 2.39; 0.54-10.53).ConclusionsHealth literacy was not uniformly associated with all self-care behaviors important for CKD management. A more nuanced understanding of the association of health literacy and self-care may be necessary to promote participation in behaviors known to slow CKD progression.

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“…A range of measures are necessary to prevent the progression and worsening of CKD. As arteriosclerosis-induced CKD caused by diabetes mellitus, hypertension, dyslipidemia, and obesity has continued to increase in the recent years, it is important to supervise the improvement in lifestyle factors in the early stages of the disease [2,10,11]. Investigation of lifestyle disease comorbidity and smoking status revealed increases in hypertension as the CKD stages worsen.…”

Section: Discussionmentioning

confidence: 99%

Medical and Dental Visits of Chronic Kidney Disease-Diagnosed Participants Analyzed From the Specific Health Checkups Results in Japan: TAMA MED Project-CKD

et al. 2020

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Background: Since 2012, Tama City has promoted the early detection of chronic kidney disease (CKD), through an initiative that measures serum creatinine as part of the specific health checkups. We examined preventive measures against CKD deterioration based on the outcomes of this initiative. Methods: The complications, medication status, body mass index, smoking status and other determining factors were surveyed among CKD-diagnosed participants over 3 years between 2013 and 2015. Moreover, factors aggravating CKD were investigated via a survey of medical and dental visits based on health insurance claim data over the same period. Results: There was an increased rate of comorbid hypertension with each increase in the CKD stage. Comorbidity rates of diabetes mellitus, dyslipidemia, obesity, and smoking increased until CKD stage G4, and then decreased from stage G5. A substantial number of participants with CKD stage G3b and above were not medicated despite comorbidities like hypertension, diabetes mellitus and dyslipidemia. While the rate of regular visits at medical institutions was seen to increase significantly in accordance with the worsening degree of CKD, there were also individuals who, despite having severe CKD, did not visit medical institutions specializing in internal medicine. The rate of dental visits decreased as the CKD stage increased, and further decreased as the diabetic control status worsened. Conclusions: CKD patients should become aware of the importance of the dental visit because only a limited number of patients with advanced CKD received dental care.

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Association between Overall Lifestyle Changes and the Incidence of Proteinuria: A Population-based, Cohort Study

Cited by 38 publications

References 37 publications

Dietary Influence on Body Fluid Acid-Base and Volume Balance: The Deleterious “Norm” Furthers and Cloaks Subclinical Pathophysiology

Dietary Influence on Body Fluid Acid-Base and Volume Balance: The Deleterious “Norm” Furthers and Cloaks Subclinical Pathophysiology

Association between health literacy and self-care behaviors among patients with chronic kidney disease

Medical and Dental Visits of Chronic Kidney Disease-Diagnosed Participants Analyzed From the Specific Health Checkups Results in Japan: TAMA MED Project-CKD

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