Dani Renouf, Dr. Michelle Wong and Dr. Kelly Picard present their talk, “Kidney Nutrition Research Update,” as part of BC Renal and UBC’s province-wide rounds.
0:03:08 - Introduction
Dani Renouf starts describing how team members at BC Renal have partnered to develop research and guidelines on nutrition in kidney disease. She then provides an overview of ways in which the gut microbiota is related to kidney disease. Kidney disease is associated with an imbalance in the gut bacteria, which can increase inflammation, uremic toxins, and impair the intestinal barrier. Diets higher in fiber tend to have more favourable gut microbiota, she notes..
0:11:30 - Gut microbiota and muscle-wasting research
Renouf then highlights an upcoming study her team is working on to understand the ways in which the gut microbiota influences protein-wasting (PEW) in people living kidney disease. Notably, patients with PEW have been found to have less diverse gut microbiota. The research team will assess levels of dietary fibre and protein intake on gut microbiota and fecal short chain fatty acid (SCFA) profiles of kidney patients, and assess how gut microbiota composition is associated with clinical outcomes. Among patients with protein-energy wasting, they will assess the impact of treatment with supplements.
0:23:00 - Potassium and phosphorous research
Dr. Picard then provides and overview of a separate study on potassium and phosphorous in chronic kidney disease (CKD), called SHOPP-CKD. In this study, the research team will look at grocery receipts and determine what percentage of foods contain additives of concern (i.e., potassium and phosphorous). Dr. Picard highlights data suggesting that not all potassium additives appear to be associated with increased potassium content. She points out that only 1% of phosphorous content is reported, further noting that Canadian food labels are not necessarily required to be accurate. SHOPP-CKD will be the first study of its kind to explore additive exposure for kidney patients, Dr. Picard says, noting they will use the results to help patients and clinicians better identify problematic foods.
0:39:40 - Debunking potassium myths
Next, Dr. Wong discusses several myths around potassium, including the myth that restricting potassium can help hyperkalemia. She points to evidence showing that associations between dietary and serum potassium are very weak. A second myth she highlights is to avoid fruits and vegetables, noting that the bioavailability of potassium content is different depending on the type of food (low for plant-based foods, followed by meat, and then highest for processed foods. Dr. Wong points to new handouts for potassium management in CKD:
Potassium Education Tools Health care providers: www.theisn.org/initiatives/to...
Patients: www.bcrenal.ca/resource-galler...
The third myth Dr. Wong highlights is that dietary potassium budget should be spent on animal protein, instead pointing to evidence that plant-based protein and diets are beneficial for kidney patients.
Lastly, Dr. Wong notes that her team will be evaluating the implementation of their potassium educational tools.
0:52:55 - Conclusions
Dr. Wong provides concluding remarks.
Potassium Education Tools
Health care providers: www.theisn.org/initiatives/to...
Patients: www.bcrenal.ca/resource-galler...
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