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Nutritional Management of Renal Disease
3rd Edition - December 17, 2012
Editors: Joel D. Kopple, Shaul G Massry, Kamyar Kalantar-Zadeh
Hardback ISBN:
9 7 8 - 0 - 1 2 - 3 9 1 9 3 4 - 2
eBook ISBN:
9 7 8 - 0 - 1 2 - 3 9 1 9 3 5 - 9
This translational text offers in-depth reviews of the metabolic and nutritional disorders that are prevalent in patients with renal disease. Chapter topics address the growing… Read more
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This translational text offers in-depth reviews of the metabolic and nutritional disorders that are prevalent in patients with renal disease. Chapter topics address the growing epidemic of obesity and metabolic syndrome. Each chapter integrates basic and clinical approaches, from cell biology and genetics to diagnosis, patient management and treatment. Chapters in sections 4-7 include new illustrative case reports, and all chapters emphasize key concepts with chapter-ending summaries. New features also include the latest National Kidney Foundation Clinical Practice Guidelines on Nutrition in Chronic Renal Failure, the most recent scientific discoveries and the latest techniques for assessing nutritional status in renal disease, and literature reviews on patients who receive continuous veno-venous hemofiltration with or without dialysis.
- Provides a common language for nephrologists, nutritionists, endocrinologists, and other interested physicians to discuss the underlying research and translation of best practices for the nutritional management and prevention of renal disease
- Saves clinicians and researchers time in quickly accessing the very latest details on nutritional practice as opposed to searching through thousands of journal articles
- Correct diagnosis (and therefore correct treatment) of renal, metabolic, and nutritional disorders depends on a strong understanding of the molecular basis for the disease – both nephrologists and nutritionists will benefit
- Nephrologists and nutritionists will gain insight into which treatments, medications, and diets to use based on the history, progression, and genetic make-up of a patient
- Case Reports will offer an added resource for fellows, nutritionists, and dieticians who need a refresher course
Practicing nephrologists, nephrology fellows, nutritionists, dieticians, and dialysis nurses; academic and clinical researchers in nephrology and nutrition; and physicians and researchers interested in renal nutrition and related renal diseases (renal cancer, diabetes, glomerulosclerosis, preeclampsia, lupus), such as endocrinologists, geriatricians, bariatric physicians, and diebetologists
Chapter 1. The Influence of Kidney Disease on Protein and Amino Acid Metabolism
Introduction
CKD Interrupts the Components of Protein Metabolism
Defining Muscle Wasting
Mechanisms of Muscle Wasting
The Ubiquitin-Proteasome System
Synergism of Proteolytic Pathways Causes Muscle Wasting in CKD
Proteolytic Activities Present in Muscles of Patients
Factors Triggering Muscle Wasting in CKD and Other Catabolic States
Myostatin and the Regulation of Muscle Protein Wasting
Myostatin in Muscle Increases in Catabolic Conditions
Beneficial Responses from Blocking Myostatin in Models of Muscle Catabolism
Blocking Myostatin can Suppress CKD-Induced Muscle Wasting
CKD Changes the Concentrations of Certain Amino Acids
Links Between Amino Acid and Protein Metabolism
Conclusion
References
Chapter 2. Carbohydrate Metabolism in Kidney Disease and Kidney Failure
Introduction
Insulin Resistance
Insulin Secretion
Insulin Clearance
Hypoglycemia
Carbohydrate Metabolism in Patients with Renal Replacement Therapy
Treatment of Diabetes Mellitus in Diabetics with CKD
Drug Management in Diabetics with CKD (Figure 2.1)
References
Chapter 3. Altered Lipid Metabolism and Serum Lipids in Kidney Disease and Kidney Failure
Introduction
Plasma Lipid and Lipoprotein Profile in CKD/ESRD Patients
The Nature and Mechanisms of CKD-Induced Lipid Abnormalities
The Nature and Mechanisms of Adverse Effects of Lipid Disorders in CKD
Treatment of CKD-Associated Dyslipidemia
Potential Adverse Effects of Statins
References
Chapter 4. Uremic Toxicity
Introduction
Uremic Symptoms and Signs
Toxic Effects of Uremic Plasma or Serum
Definition of a Uremic Toxin
Impact of Dialysis Treatment on Uremic Toxicity
Toxicity of Inorganic Substances in Uremia
Free Water-Soluble Low-Molecular-Weight Solutes
Protein-Bound Solutes
Middle Molecules
General Conclusions
Acknowledgement
References
Chapter 5. Inflammation in Chronic Kidney Disease
General Considerations
Multifactorial Causes of Inflammation in Chronic Kidney Disease
Inflammation as a Cause of Protein-Energy Wasting
Inflammation as a Catalyst of Other Risk Factors
Other Consequences of Inflammation
Monitoring Inflammation
Treatment of Inflammation in Chronic Kidney Disease
References
Chapter 6. Catalytic (Labile) Iron in Kidney Disease
Introduction
Definition of Catalytic (Labile) Iron and its Importance in Tissue Injury
Role of Catalytic Iron in Acute Kidney Injury
Gentamicin-Induced Mobilization of Iron From Renal Cortical Mitochondria
Evidence Suggesting a Role for Iron in Gentamicin-Induced Acute Renal Failure in Rats
Catalytic Iron in Chronic Kidney Disease (Table 6.3)
Catalytic Iron in Diabetic Nephropathy
Catalytic Iron in Chronic Kidney Disease
Concluding Comments
References
Chapter 7. Carbonyl Stress in Uremia
Introduction
Increased Age and other Protein Modifications
Carbonyl Stress
Clinical Consequences of Carbonyl Stress
Nutrition and Carbonyl Stress
References
Chapter 8. Effect of Acidemia and Alkalemia on Nutrition and Metabolism
Introduction
Acute Responses to Acidosis and Alkalosis
Comparing Effects of Acidemia to those of Starvation
Endocrine Responses to Acidemia
Calcium Metabolism
Protein Malnutrition
Metabolic Acidemia Stimulates the Ubiquitin/Proteasome Proteolytic Pathway
Clinical Implications of Acidemia for Protein Nutrition
References
Chapter 9. Prevention and Management of Cardiovascular Disease in Kidney Disease and Kidney Failure
Introduction
Cardiovascular Risk Factors
Management of CVD
Conclusion
References
Chapter 10. Assessment of Protein and Energy Nutritional Status
Introduction
Definition of Protein and Energy Wasting
Assessment of Protein Mass
Assessment of Protein and Energy Homeostasis
Summary and Recommendations
References
Chapter 11. Causes of Protein-Energy Wasting in Chronic Kidney Disease
Introduction
Causes of Pew in CKD
Pathophysiology of Pew in CKD
Endocrine and Hormonal Disorders
Effect of Volume Overload
Contribution of Co-Morbidities
Altered Protein Kinetics in CKD
Nutrient Loss During Dialysis
Inflammation: Agent Provocateur of Pew
Role of Metabolic Acidemia
Oxidative Stress: Other Key Pathways
Summary and Conclusion
References
Chapter 12. Protein-Energy Wasting as a Risk Factor of Morbidity and Mortality in Chronic Kidney Disease
Introduction
Pertinent Outcomes in Patients with CKD
Association of Measures of Nutrition with Outcomes
Nutrient Intake and Outcomes
Body Size, Body Composition and Outcomes
Laboratory Measures and Outcome
Nutritional Scoring Systems and Outcomes
Nutritional Interventions and Outcomes
Conclusions
References
Chapter 13. Effect of Nutritional Status and Changes in Protein Intake on Renal Function
Introduction
Role of Specific AA
Factors Mediating the Renal Response to Protein and Amino Acids
Humoral Mediators
Local Mediators
Intrinsic Renal Mechanisms
Effects of Nutritional Status or Protein Deprivation on Renal Function
Levels of Plasma Creatinine and Serum Urea Nitrogen in Patients with Protein-Energy Malnutrition
Concentration and Dilution of the Urine in Patients with Protein-Energy Malnutrition
Acid Excretion and Acid-Base Balance in Patients with Calorie-Protein Malnutrition
Effects of Chronic Protein-Energy Malnutrition on Renal Sodium Excretion
Effects of Maternal Nutrition on Renal Development
Protein Energy Wasting in Advanced Renal Disease
References
Chapter 14. Low Protein, Amino Acid and Ketoacid Diets to Slow the Progression of Chronic Kidney Disease and Improve Metabolic Control of Uremia
Introduction
Assessing the Progression of Chronic Renal Insufficiency
Protein Intake and Chronic Renal Insufficiency: Experimental Data
Dietary Protein Intake: Clinical Studies
Clinical Evidence of the Effects of Low Protein Diets
Conclusion
References
Chapter 15. Reducing Tryptophan Metabolites to Reduce Progression in Chronic Kidney Failure
Search for Uremic Toxins
Metabolism of Indoxyl Sulfate, a Tryptophan Metabolite
Protein Metabolite Theory as a Mechanism of CKD Progression
Indoxyl Sulfate Induces Reactive Oxygen Species (ROS) in the Kidney
Role of Organic Anion Transporters in Nephrotoxicity of Indoxyl Sulfate
Indoxyl Sulfate Reduces Klotho and Induces Senescence in the Kidney
Vascular Toxicity of Indoxyl Sulfate
Clinical Effects of AST-120
Conclusion
References
Chapter 16. Altering Serum Lipids to Reduce Progression of Chronic Kidney Disease
Kidney Disease and Dyslipidemia
Lipid Lowering and Pleiotropic Effects of Statins
Statins in Experimental Kidney Disease
Effects of Dyslipidemia and Statins on the Progression of Kidney Disease in Human Subjects
References
Chapter 17. Disorders of Phosphorus Homeostasis: Emerging Targets for Slowing Progression of Chronic Kidney Disease
Introduction
Role of Dietary Phosphorus Intake in Disturbances of Mineral Metabolism in CKD
Disorders of Phosphorus Homeostasis and Kidney Disease Progression
Dietary Phosphorus Restriction in CKD: Practical Considerations Moving Forward
Conclusions
References
Chapter 18. Alkalinization to Retard Progression of Chronic Kidney Failure
Epidemiology of Metabolic Acidosis in Kidney Disease
Mechanism of Acidosis in CKD
Animal Models of Kidney Damage With Acidosis
Animal Models of Treatment
Observational Studies in Humans
Recommendations
References
Chapter 19. Calcium, Phosphate, PTH, Vitamin D and FGF-23 in Chronic Kidney Disease
Introduction
Calcium Metabolism
Vitamin D
Phosphate Metabolism
Parathyroid Hormone
Fibroblast Growth Factor 23 (FGF-23)
Alterations in Mineral Metabolism in Ckd
Phosphate and Cardiovascular Disease (CVD)
Phosphate and Vascular Calcifications
Control of Serum Phosphate in CKD
Dietary Phosphorus Restriction
Inorganic Phosphorus and Food Additives
Dietary Phosphorus, Protein Intake and Phosphorus-Protein Ratio
Phosphorus Removal With Dialysis
Phosphate Binders
Therapy With Vitamin D Sterols
Calcimimetics
Conclusion
References
Chapter 20. Phosphate Metabolism and Fibroblast Growth Factor 23 in Chronic Kidney Disease
Introduction
Phosphate Metabolism in Health
Phosphate Metabolism Across the Spectrum of CKD
The Role of Phosphate and FGF-23 Excess in the Pathophysiology of CKD Outcomes
Therapeutic Approaches to Lowering Phosphate and FGF-23 Excess
Impact of Dietary Phosphate on Phosphate/FGF-23 Excess
Questions and Controversies
Conclusions
Acknowledgments
Disclosures
References
Chapter 21. Vitamin D in Kidney Disease
Normal Vitamin D Metabolism
Prevalence and Etiology of Deficiency in The Vitamin D Axis in CKD
Implications
Interventions
Other Compounds
Therapeutic Considerations
Summary
Acknowledgement
References
Chapter 22. Nutritional Management of Water, Sodium, Potassium, Chloride, and Magnesium in Kidney Disease and Kidney Failure
Sodium and Chloride
Water
Potassium
Magnesium
References
Chapter 23. Trace Elements, Toxic Metals, and Metalloids in Kidney Disease
Introduction
Alterations in Essential Trace Elements in Patients With Kidney Disease
Alterations in Nonessential Trace Elements, Metals, and Metalloids in Patients With Kidney Disease
Trace Element Abnormalities in Renal-Specific Syndromes
Diagnostic and Therapeutic Approaches
Conclusions
References
Chapter 24. Vitamin Metabolism and Requirements in Renal Disease and Renal Failure
Introduction
Structure and Physiological Role of Vitamins
Vitamin Intake in Chronic Renal Disease
Vitamins Status in Chronic Renal Disease
Vitamins as Therapy for People with Kidney Disease
Recommendations for Vitamin Supplementation and Vitamin Therapy in Renal Diseases
Conclusions
References
Chapter 25. Nutrition and Anemia in End-stage Renal Disease
Introduction
Iron
Vitamin C
Vitamin D
Folic Acid
Vitamin B6 (Pyridoxine)
Vitamin B12
Carnitine
Growth Hormone and Insulin-Like Growth Factor-I (IGF-I)
References
Chapter 26. Nutritional and Non-nutritional Management of the Nephrotic Syndrome
Introduction
Dietary Protein
Albumin Homeostasis in the Nephrotic Syndrome
Dietary Protein and Renal Injury
Effects of the Nephrotic Syndrome on Solid Tissue Proteins
Dietary Proteins as Potential Allergens Responsible for Renal Disease
Dietary Fat
The Effect of Altered Glomerular Permselectivity on Lipid Metabolism
Cardiovascular Effects of Hyperlipidemia in the Nephrotic Syndrome
Thromboembolic Complications
Effects of Lipids on Renal Disease
Polyunsaturated Fatty Acids
Derangements in Divalent Cation Metabolism in the Nephrotic Syndrome
Derangements in Salt and Water Metabolism in the Nephrotic Syndrome (Volume Homeostasis)
Recommendations for Nutritional and Non-Nutritional Treatment of the Nephrotic Syndrome
Acknowledgements
References
Chapter 27. Nutrition and Blood Pressure
Introduction
Obesity and Energy Intake
Individual Nutrients, Miscellaneous Substances and Blood Pressure
Nutritional Management Strategies for The Prevention or Treatment of Hypertension
Health Enhancing Diets and Lifestyles
Long-Term Adherence and Blood Pressure Responses to Health Enhancing Lifestyles
Challenges to Diet and Lifestyle Approaches for Preventing and Treating Hypertension
Conclusions and Recommendations
Key Points
References
Chapter 28. Effect of Obesity and the Metabolic Syndrome on Incident Kidney Disease and the Progression to Chronic Kidney Failure
Introduction
Definitions of Obesity/Metabolic Syndrome
Obesity and Metabolic Syndrome as Risk Factors for Incident CKD
Obesity and Metabolic Syndrome as Risk Factors for Progression of CKD
Pathophysiology of Obesity on the Kidney
Effect of Weight Loss Interventions on Kidney Disease
Conclusion
References
Chapter 29. Nutritional and Metabolic Management of Obesity and the Metabolic Syndrome in the Patient with Chronic Kidney Disease
Introduction
Obesity-Related Chronic Kidney Disease (CKD)
Obesity-Related Glomerulopathy
Measuring GFR
Metabolic Syndrome
Treatment of Obesity and Obesity-Related Kidney Disease
Bariatric Surgery (see also Chapter 28)
Metabolic Syndrome
References
Chapter 30. Bariatric Surgery and Renal Disease
Magnitude of Problem
Pathogenesis of Obesity
Clinical Manifestations
Medical Therapy
Role of Bariatric Surgery in Treatment of Morbid Obesity
Surgical Techniques of Bariatric Surgery (see Figure 30.1)
Outcomes of Bariatric Surgery
Renal Disease and Morbid Obesity
Pathogenesis of Renal Disease in Obesity
Role of Bariatric Surgery in Chronic Kidney Disease
Role of Bariatric Surgery in Transplant Candidates
Bariatric Surgery and Nephrolithiasis
Other Renal Effects of Bariatric Surgery
Future Research
References
Chapter 31. Nutritional and Metabolic Management of the Diabetic Patient with Chronic Kidney Disease and Chronic Renal Failure
Introduction
Glucose/Insulin Homeostasis
Value of Glycemic Control, and its Determination in CKD
Hypoglycemia
Diabetes/Bone and Mineral Metabolism
Dietary Protein Intake and Diabetic Kidney Disease
Salt Intake and Diabetic Kidney Disease
References
Chapter 32. Nutritional Management of Maintenance Hemodialysis Patients
Introduction
Factors Altering Nutrient Intake in Maintenance Hemodialysis Patients
Loss of Nutrients During Maintenance Hemodialysis Treatment
Importance of Pew and Diet as Patients Approach Esrd and Commence MHD
Assessment of Nutritional Status in MHD Patients
Acidemia and Protein Wasting
Goals of Nutritional Management of MHD Patients
Dietary Nutrient Requirements (see Table 32.3)
Management of Pew in MHD Patients
Treatment of Acute Catabolic Illness
Daily or Long Duration Hemodialysis and Nutritional Status
References
Chapter 33. Nutritional Management of End-Stage Renal Disease Patients Treated with Peritoneal Dialysis
Introduction
Type of Peritoneal Dialysis
Peritoneal Dialysis Solutions
Specific Effects of Peritoneal Dialysis on Nutritional Status and Metabolism
Dietary Recommendations for ESRD Patients Undergoing Peritoneal Dialysis
Protein-Energy Wasting in Peritoneal Dialysis Patients
Management of Protein-Energy Wasting in Patients Treated with Peritoneal Dialysis
References
Chapter 34. Nutritional Management of Kidney Transplant Recipients
Introduction
Anemia
Bone Disease
Diabetes Mellitus
Dyslipidemia
Hypertension
Food Safety
Hypophosphatemia
Overweight/Obesity
Malnutrition
Protein and Energy Requirements
Nutritional Management
Pretransplant Status and Posttransplant Outcome
Conclusion
Acknowledgements
References
Chapter 35. Nutritional Management of the Child with Kidney Disease
Introduction
Etiology of Protein-Energy Wasting
Assessment of Nutritional Status
Nutritional Requirements
Bone Mineral Metabolism
Acid–Base and Electrolytes
Vitamins and Micronutrients
Nutrition Management
References
Chapter 36. Nutritional Management of Acute Kidney Injury
Introduction
Metabolic Environment of the Patient with AKI
Metabolic Alterations Specifically Attributable to AKI
Metabolic Interventions of Controlling Catabolism
Clinical Studies on Protein Catabolism in AKI
Amino Acid/Protein Requirements in Patients with AKI
Carbohydrate Metabolism
Lipid Metabolism
Micronutrients and the Antioxidant System in AKI
Electrolytes
Metabolic and Nutritional Factors and the Prevention and Therapy of AKI
Impact of Renal Replacement Therapy (RRT) on Metabolism and Nutrient Balances
The Effect of Nutrition Status and Nutrient Supply on Prognosis
Practice of Clinical Nutrition in Patients with AKI
Oral Nutrition in Patients with AKI
Nutritional Support in Patients with AKI
Enteral Nutrition in AKI
Parenteral Nutrition in AKI
Complications of Nutritional Support
Monitoring of Nutrition Support in Patient with AKI
References
Chapter 37. Nutritional Management of Patients Treated with Continuous Renal Replacement Therapy
Introduction
Modes of CRRT
Generic Effects of CRRT on Energy Metabolism
Specific Effects on Nutrient Balance
Recommendations on Nutritional Therapy
Conclusion
Acknowledgements
References
Chapter 38. Anorexia and Appetite Stimulants in Chronic Kidney Disease
General Considerations
Prevalence of Anorexia, Methods of Assessment and Clinical Implications
Pathogenesis of Anorexia in CKD
Treatment of Anorexia in CKD
References
Chapter 39. Oral and Enteral Supplements in Kidney Disease and Kidney Failure
Introduction
Oral and Enteral (Tube Feeding) Nutrition in CKD Patients
Oral and Enteral Nutrition for Patients with Nephrotic Syndrome
Oral and Enteral Nutrition in Chronic Dialysis Patients
Oral and Enteral Nutrition in Acute Kidney Injury
Conclusions
References
Chapter 40. Intradialytic Parenteral Nutrition, Intraperitoneal Nutrition and Nutritional Hemodialysis
Introduction
Intradialytic Parenteral Nutrition (IDPN)
Randomized Prospective Controlled Trials of IDPN
Advantages and Disadvantages of IDPN
Indications for IDPN
IDPN in the United States
Nutritional Hemodialysis and Intraperitoneal Nutrition
References
Chapter 41. Therapeutic Use of Growth Factors in Renal Disease
Introduction
Treatment of Protein-Energy Wasting (PEW) in ESRD Patients
Therapeutic Use of Growth Factors in Renal Disease
Growth Factors in the Management of Wasting in Renal Disease
Conclusion
References
Chapter 42. Nutritional Prevention and Treatment of Kidney Stones
Introduction
Pathophysiology of Kidney Stone Formation
General Dietary Effects on Kidney Stones
Effect of Diet Based on Urinary Findings
Dietary Recommendations Based on Stone Type
Obesity and Kidney Stones
Melamine Stones
References
Chapter 43. Herbal Supplements in Patients with Kidney Disease
Introduction
Acute Kidney Injury
Chronic Kidney Disease
Five Herbals with Some Proven Efficacy
Transplant
Clinical Implications
References
Chapter 44. Drug–Nutrient Interactions in Renal Failure
Introduction
Effect of Food Intake on Drug Absorption
Effects of Nutrients on Drug Metabolism
Interactions of Food Supplements with Drugs
Drug-Induced Nutritional Deficiencies
Taurine and ACE-Inhibitor Effects
Nutrient Interactions with Oral Anticoagulants
Interactions of Calcineurin Inhibitors with Nutrients
Enteral Tube Feeding and Oral Drug Administration
References
Chapter 45. Exercise Training for Individuals with Advanced Chronic Kidney Disease
Introduction
Characteristics of Advanced CKD Patients
Value of Exercise and Physical Activity in Advanced CKD
Principles of Exercise Training
Patient Assessment
Components of the Exercise Training Prescription
Exercise Training Program Design for Patients with Advanced CKD
Components of the Exercise Training Session
Risks of Exercise in the Advanced CKD Patient
Urgent Need for Development of Renal Rehabilitation Programs
Summary
References
Chapter 46. Motivating the Kidney Disease Patient to Nutrition Adherence and Other Healthy Lifestyle Activities
Introduction
What is Motivational Interviewing?
What isn’t Motivational Interviewing?
Principles
Handling Resistance
Empirical Support
Applications in Kidney Disease Management
Learning Motivational Interviewing
Dissemination of Motivational Interviewing
Future Research Directions in Kidney Disease Management
Conclusions
References
Color Plates
Index
- No. of pages: 816
- Language: English
- Published: December 17, 2012
- Imprint: Academic Press
- Hardback ISBN: 9780123919342
- eBook ISBN: 9780123919359
JK
Joel D. Kopple
Joel D. Kopple, MD, editor of the book’s first three editions, is Professor Emeritus of Medicine and Public Health at the David Geffen School of Medicine at UCLA and UCLA Fielding School of Public Health, Los Angeles, CA, and is a member of the Division of Nephrology and Hypertension and The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California. Dr. Kopple was Chief of the Division of Nephrology and Hypertension at Harbor-UCLA Medical Center from 1982 to 2007. He has published over 600 scientific papers and book chapters and has edited or coedited 15 seminars and proceedings. Dr. Kopple is a former president of the National Kidney Foundation (NKF), the American Society of Parenteral and Enteral Nutrition, the International Society for Renal Nutrition and Metabolism, and the International Federation of Kidney Foundations and was a founder of World Kidney Day.
Affiliations and expertise
The Lundquist Institute at Harbor-UCLA Medica Center, David Geffen School of Medicine at UCLA and UCLA Fielding School of Public Health, Torrance and Los Angelese, CA, United StatesSM
Shaul G Massry
Shaul G. Massry, MD, editor of the book’s first three editions, is Professor Emeritus of Medicine and Physiology and Biophysics at the Keck School of Medicine, University of Southern California, Los Angeles, California. He served as Chief of its Division of Nephrology from 1974 to 2000. He has published over 600 scientific papers and over 80 book chapters, and he is editor or coeditor of 28 books. Dr. Massry has received honorary doctorates from 14 universities across Europe, including the oldest and prestigious Charles University (Prague, Czech Republic), The University of Bologna (Italy), and the University of Padua (Italy). Dr. Massry is a former president of the National Kidney Foundation (NKF).
Affiliations and expertise
Professor of Medicine, Physiology and Biophysics, University of Southern of California, Los Angeles, CA, United StatesKK
Kamyar Kalantar-Zadeh
Kamyar Kalantar-Zadeh, MD, PhD, MPH, editor of the book’s third edition and an Editor-in-Chief of the Journal of Renal Nutrition, is Professor of Medicine, Pediatrics, Public Health and Nursing Sciences, and Chief of Nephrology, University of California Irvine School of Medicine, Irvine, CA; Adjunct Professor of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA; and a staff physician in Veterans Affairs Hospital, Long Beach, CA. Dr. Kalantar is a former president of the International Society for Renal Nutrition and Metabolism and the International Federation of Kidney Foundations, co-chair of the joint steering committee of World Kidney Day, and Chair of the Medical Advisory Committee of the National Forum of the ESRD Networks. He has served as PI of a dozen National Institutes of Health grants and has coauthored over 800 manuscripts in peer-reviewed journals.
Affiliations and expertise
University of California Irvine School of Medicine, Orange, CA, US