The Associations of Plant Protein Intake With All-Cause Mortality in CKD.

BACKGROUND: Plant protein intake is associated with lower production of uremic toxins and lower serum phosphorus levels. Therefore, at a given total protein intake, a higher proportion of dietary protein from plant sources might be associated with lower mortality in chronic kidney disease. STUDY DESIGN: Observational study. SETTINGS & PARTICIPANTS: 14,866 NHANES III participants 20 years or older without missing data for plant and animal protein intake and mortality. PREDICTORS: Plant protein to total protein ratio and total plant protein intake. Patients were stratified by estimated glomerular filtration rate (eGFR)<60 or ≥60mL/min/1.73m(2). OUTCOMES: All-cause mortality. MEASUREMENTS: Plant and total protein intakes were estimated from 24-hour dietary recalls. Mortality was ascertained by probabilistic linkage with National Death Index records through December 31, 2000. RESULTS: Mean values for plant protein intake and plant protein to total protein ratio were 24.6±13.2 (SD) g/d and 33.0% ± 14.0%, respectively. The prevalence of eGFRs<60mL/min/1.73m(2) was 4.9%. There were 2,163 deaths over an average follow-up of 8.4 years. Adjusted for demographics, smoking, alcohol use, comorbid conditions, body mass index, calorie and total protein intake, and physical inactivity, each 33% increase in plant protein to total protein ratio was not associated with mortality (HR, 0.88; 95% CI, 0.74-1.04) in the eGFR≥60mL/min/1.73m(2) subpopulation, but was associated with lower mortality risk (HR, 0.77; 95% CI, 0.61-0.96) in the eGFR<60mL/min/1.73m(2) subpopulation. In sensitivity analyses, results were similar in those with eGFR<60mL/min/1.73m(2) defined by serum cystatin C level. LIMITATIONS: Whether results are related to plant protein itself or to other factors associated with more plant-based diets is difficult to establish. CONCLUSIONS: A diet with a higher proportion of protein from plant sources is associated with lower mortality in those with eGFR<60mL/min/1.73m(2). Future studies are warranted to determine the causal role of plant protein intake in reducing mortality in those with eGFR<60mL/min/1.73m(2).

Low Physical Function in Maintenance Hemodialysis Patients Is Independent of Muscle Mass and Comorbidity.

OBJECTIVES: It is unknown whether muscle wasting accounts for impaired physical function in adults on maintenance hemodialysis (MHD). DESIGN: Observational study. SETTING: Outpatient dialysis units and a fall clinic. SUBJECTS: One hundred eight MHD and 122 elderly nonhemodialysis (non-HD) participants. EXPOSURE VARIABLE: Mid-thigh muscle area was measured by magnetic resonance imaging. MAIN OUTCOME MEASURE: Physical function was measured by distance walked in 6 minutes. RESULTS: Compared with non-HD elderly participants, MHD participants were younger (49.2 ± 15.8 vs. 75.3 ± 7.1 years; P < .001) and had higher mid-thigh muscle area (106.2 ± 26.8 vs. 96.1 ± 21.1 cm2; P = .002). However, the distance walked in 6 minutes was lower in MHD participants (322.9 ± 110.4 vs. 409.0 ± 128.3 m; P < .001). In multiple regression analysis adjusted for demographics, comorbid conditions, and mid-thigh muscle area, MHD patients walked significantly less distance (-117 m; 95% confidence interval: -177 to -56 m; P < .001) than the non-HD elderly. CONCLUSIONS: Even when compared with elderly non-HD participants, younger MHD participants have poorer physical function that was not explained by muscle mass or comorbid conditions. We speculate that the uremic milieu may impair muscle function independent of muscle mass. The mechanism of impaired muscle function in uremia needs to be established in future studies.

Sedentary Behavior in Individuals With Diabetic Chronic Kidney Disease and Maintenance Hemodialysis.

OBJECTIVE: The objective of this study was to examine whether more advanced kidney failure is associated with sedentary behavior and whether demographics, comorbidity, nutritional, and inflammatory markers explain this association. DESIGN: Observational study. SETTING: Outpatients recruited from outpatient clinics and dialysis units. SUBJECTS: One hundred sixty patients with chronic kidney disease (CKD) or receiving maintenance hemodialysis (MHD). METHODS: Standardized questionnaires including Baecke physical activity questionnaire, standardized anthropometry examination, and blood draw. MAIN OUTCOME MEASURE: Sedentary behavior (defined as answering "very often" for "during leisure time I watch television" or answering "never" for "during leisure time I walk") and being physically active (top 25th percentile of the total Baecke score). RESULTS: Nineteen percent of CKD and 50% of MHD patients were sedentary (P < .001) and 38.8% of CKD and 11.3% of MHD patients were physically active. In separate multivariable logistic regression models, compared with CKD patients, MHD patients were more sedentary (odds ratio 3.84; 95% confidence interval, 1.18-12.51) and less physically active (odds ratio 0.07; 95% confidence interval 0.01-0.40) independent of demographics, comorbidity, smoking, body size, serum high sensitivity C-reactive protein (hsCRP) and albumin. Congestive heart failure, peripheral vascular disease, and higher body mass index were independently associated with sedentary behavior, whereas younger age, lower body mass index, lower serum hsCRP, and higher serum albumin were associated with being physically active. CONCLUSIONS: Sedentary behavior is highly prevalent among diabetic CKD or MHD patients. The strong association of MHD status with sedentary behavior is not explained by demographics, smoking, comorbidity, nutritional, and inflammatory markers. Interventions targeting obesity might improve sedentary behavior and physical activity, whereas interventions targeting inflammation might improve physical activity in these populations.

Male and Female Tortricid Moth Response to Non-Pheromonal Semiochemicals.

In eastern North America, apple orchards are often attacked by several species of tortricid moths (Lepidoptera), including Cydia pomonella, Grapholita molesta, Argyrotaenia velutinana, and Pandemis limitata. Sex pheromones are routinely used to monitor male moth populations. Adding plant volatiles to monitoring traps could increase the capture of moths of both sexes and improve the effectiveness of mating disruption systems. This study sought to quantify the attraction of adults of four tortricid moth species to five olfactory treatments, namely (1) Pherocon® CM L2-P, (2) Pherocon Megalure CM 4K Dual® (=Megalure), (3) Megalure + benzaldehyde, (4) TRE 2266 (linalool oxide + (E)-4,8-dimethyl-1,3,7-nonatriene (DMNT)), and (5) TRE 2267 (linalool oxide + DMNT + benzaldehyde), in non-mating disrupted commercial apple orchards in Massachusetts. The commercial lure Megalure was attractive to both sexes of G. molesta and C. pomonella. The addition of benzaldehyde to TRE 2266 or to Megalure significantly increased the capture of male G. molesta during the mid and late season of 2021. Only when benzaldehyde was added to TRE 2266 did the latter lure attract P. limitata in 2020 and 2021. The greatest number of tortricid moths (all four species combined) was captured by TRE 2267. This finding highlights the opportunity to enhance the attractiveness of a commercial lure through the addition of benzaldehyde, an aromatic compound, to Megalure. The potential of these additional volatiles to detect moths in a mating-disrupted orchard and/or remove female moths as a component of a management system is discussed.

Total Serum Protein Estimation and Its Correlation with Clinical and Histopathological Grading using Masson's Trichrome Stain in Patients of Oral Submucous Fibrosis.

OBJECTIVES: Oral submucous fibrosis (OSMF) caused by dense deposition of collagen fibers which is a protein. There is a plethora of research to evaluate degree of collagen deposition using various simple histochemical techniques, but its correlation with total serum protein (TSP) level has not been explored so far. MATERIALS AND METHODS: This case-control study comprised total forty samples with thirty cases of OSMF and ten cases were selected as control group, divided into four groups as per Lai et al. classification. Histological grading was also done according to the Rooban et al.'s classification. Blood sample was collected to evaluate TSP estimation. Findings were tabulated, and comparisons were made between clinical, histological, and TSP estimation. Discrete statistical data were analyzed by Chi-square test, ANOVA, and t-test with a statistical analysis package (SPSS version software 6.0). RESULTS: No significant correlation was obtained between clinical staging and histopathological grading. Definite correlation was obtained in TSP and globulin levels of OSMF patients and their grades of fibrosis histopathologically. CONCLUSION: In the present study, it was observed that biochemical investigations involving assessment of TSP can be used as a diagnostic tool in OSMF, along with histopathological examination.