Nutritional Management of Renal Disease

<p>Chapter 1. The Influence of Kidney Disease on Protein and Amino Acid Metabolism</p> <p>Introduction</p> <p>CKD Interrupts the Components of Protein Metabolism</p> <p>Defining Muscle Wasting</p> <p>Mechanisms of Muscle Wasting</p> <p>The Ubiquitin-Proteasome System</p> <p>Synergism of Proteolytic Pathways Causes Muscle Wasting in CKD</p> <p>Proteolytic Activities Present in Muscles of Patients</p> <p>Factors Triggering Muscle Wasting in CKD and Other Catabolic States</p> <p>Myostatin and the Regulation of Muscle Protein Wasting</p> <p>Myostatin in Muscle Increases in Catabolic Conditions</p> <p>Beneficial Responses from Blocking Myostatin in Models of Muscle Catabolism</p> <p>Blocking Myostatin can Suppress CKD-Induced Muscle Wasting</p> <p>CKD Changes the Concentrations of Certain Amino Acids</p> <p>Links Between Amino Acid and Protein Metabolism</p> <p>Conclusion</p> <p>References</p> <p>Chapter 2. Carbohydrate Metabolism in Kidney Disease and Kidney Failure</p> <p>Introduction</p> <p>Insulin Resistance</p> <p>Insulin Secretion</p> <p>Insulin Clearance</p> <p>Hypoglycemia</p> <p>Carbohydrate Metabolism in Patients with Renal Replacement Therapy</p> <p>Treatment of Diabetes Mellitus in Diabetics with CKD</p> <p>Drug Management in Diabetics with CKD (Figure 2.1)</p> <p>References</p> <p>Chapter 3. Altered Lipid Metabolism and Serum Lipids in Kidney Disease and Kidney Failure</p> <p>Introduction</p> <p>Plasma Lipid and Lipoprotein Profile in CKD/ESRD Patients</p> <p>The Nature and Mechanisms of CKD-Induced Lipid Abnormalities</p> <p>The Nature and Mechanisms of Adverse Effects of Lipid Disorders in CKD</p> <p>Treatment of CKD-Associated Dyslipidemia</p> <p>Potential Adverse Effects of Statins</p> <p>References</p> <p>Chapter 4. Uremic Toxicity</p> <p>Introduction</p> <p>Uremic Symptoms and Signs</p> <p>Toxic Effects of Uremic Plasma or Serum</p> <p>Definition of a Uremic Toxin</p> <p>Impact of Dialysis Treatment on Uremic Toxicity</p> <p>Toxicity of Inorganic Substances in Uremia</p> <p>Free Water-Soluble Low-Molecular-Weight Solutes</p> <p>Protein-Bound Solutes</p> <p>Middle Molecules</p> <p>General Conclusions</p> <p>Acknowledgement</p> <p>References</p> <p>Chapter 5. Inflammation in Chronic Kidney Disease</p> <p>General Considerations</p> <p>Multifactorial Causes of Inflammation in Chronic Kidney Disease</p> <p>Inflammation as a Cause of Protein-Energy Wasting</p> <p>Inflammation as a Catalyst of Other Risk Factors</p> <p>Other Consequences of Inflammation</p> <p>Monitoring Inflammation</p> <p>Treatment of Inflammation in Chronic Kidney Disease</p> <p>References</p> <p>Chapter 6. Catalytic (Labile) Iron in Kidney Disease</p> <p>Introduction</p> <p>Definition of Catalytic (Labile) Iron and its Importance in Tissue Injury</p> <p>Role of Catalytic Iron in Acute Kidney Injury</p> <p>Gentamicin-Induced Mobilization of Iron From Renal Cortical Mitochondria</p> <p>Evidence Suggesting a Role for Iron in Gentamicin-Induced Acute Renal Failure in Rats</p> <p>Catalytic Iron in Chronic Kidney Disease (Table 6.3)</p> <p>Catalytic Iron in Diabetic Nephropathy</p> <p>Catalytic Iron in Chronic Kidney Disease</p> <p>Concluding Comments</p> <p>References</p> <p>Chapter 7. Carbonyl Stress in Uremia</p> <p>Introduction</p> <p>Increased Age and other Protein Modifications</p> <p>Carbonyl Stress</p> <p>Clinical Consequences of Carbonyl Stress</p> <p>Nutrition and Carbonyl Stress</p> <p>References</p> <p>Chapter 8. Effect of Acidemia and Alkalemia on Nutrition and Metabolism</p> <p>Introduction</p> <p>Acute Responses to Acidosis and Alkalosis</p> <p>Comparing Effects of Acidemia to those of Starvation</p> <p>Endocrine Responses to Acidemia</p> <p>Calcium Metabolism</p> <p>Protein Malnutrition</p> <p>Metabolic Acidemia Stimulates the Ubiquitin/Proteasome Proteolytic Pathway</p> <p>Clinical Implications of Acidemia for Protein Nutrition</p> <p>References</p> <p>Chapter 9. Prevention and Management of Cardiovascular Disease in Kidney Disease and Kidney Failure</p> <p>Introduction</p> <p>Cardiovascular Risk Factors</p> <p>Management of CVD</p> <p>Conclusion</p> <p>References</p> <p>Chapter 10. Assessment of Protein and Energy Nutritional Status</p> <p>Introduction</p> <p>Definition of Protein and Energy Wasting</p> <p>Assessment of Protein Mass</p> <p>Assessment of Protein and Energy Homeostasis</p> <p>Summary and Recommendations</p> <p>References</p> <p>Chapter 11. Causes of Protein-Energy Wasting in Chronic Kidney Disease</p> <p>Introduction</p> <p>Causes of Pew in CKD</p> <p>Pathophysiology of Pew in CKD</p> <p>Endocrine and Hormonal Disorders</p> <p>Effect of Volume Overload</p> <p>Contribution of Co-Morbidities</p> <p>Altered Protein Kinetics in CKD</p> <p>Nutrient Loss During Dialysis</p> <p>Inflammation: Agent Provocateur of Pew</p> <p>Role of Metabolic Acidemia</p> <p>Oxidative Stress: Other Key Pathways</p> <p>Summary and Conclusion</p> <p>References</p> <p>Chapter 12. Protein-Energy Wasting as a Risk Factor of Morbidity and Mortality in Chronic Kidney Disease</p> <p>Introduction</p> <p>Pertinent Outcomes in Patients with CKD</p> <p>Association of Measures of Nutrition with Outcomes</p> <p>Nutrient Intake and Outcomes</p> <p>Body Size, Body Composition and Outcomes</p> <p>Laboratory Measures and Outcome</p> <p>Nutritional Scoring Systems and Outcomes</p> <p>Nutritional Interventions and Outcomes</p> <p>Conclusions</p> <p>References</p> <p>Chapter 13. Effect of Nutritional Status and Changes in Protein Intake on Renal Function</p> <p>Introduction</p> <p>Role of Specific AA</p> <p>Factors Mediating the Renal Response to Protein and Amino Acids</p> <p>Humoral Mediators</p> <p>Local Mediators</p> <p>Intrinsic Renal Mechanisms</p> <p>Effects of Nutritional Status or Protein Deprivation on Renal Function</p> <p>Levels of Plasma Creatinine and Serum Urea Nitrogen in Patients with Protein-Energy Malnutrition</p> <p>Concentration and Dilution of the Urine in Patients with Protein-Energy Malnutrition</p> <p>Acid Excretion and Acid-Base Balance in Patients with Calorie-Protein Malnutrition</p> <p>Effects of Chronic Protein-Energy Malnutrition on Renal Sodium Excretion</p> <p>Effects of Maternal Nutrition on Renal Development</p> <p>Protein Energy Wasting in Advanced Renal Disease</p> <p>References</p> <p>Chapter 14. Low Protein, Amino Acid and Ketoacid Diets to Slow the Progression of Chronic Kidney Disease and Improve Metabolic Control of Uremia</p> <p>Introduction</p> <p>Assessing the Progression of Chronic Renal Insufficiency</p> <p>Protein Intake and Chronic Renal Insufficiency: Experimental Data</p> <p>Dietary Protein Intake: Clinical Studies</p> <p>Clinical Evidence of the Effects of Low Protein Diets</p> <p>Conclusion</p> <p>References</p> <p>Chapter 15. Reducing Tryptophan Metabolites to Reduce Progression in Chronic Kidney Failure</p> <p>Search for Uremic Toxins</p> <p>Metabolism of Indoxyl Sulfate, a Tryptophan Metabolite</p> <p>Protein Metabolite Theory as a Mechanism of CKD Progression</p> <p>Indoxyl Sulfate Induces Reactive Oxygen Species (ROS) in the Kidney</p> <p>Role of Organic Anion Transporters in Nephrotoxicity of Indoxyl Sulfate</p> <p>Indoxyl Sulfate Reduces Klotho and Induces Senescence in the Kidney</p> <p>Vascular Toxicity of Indoxyl Sulfate</p> <p>Clinical Effects of AST-120</p> <p>Conclusion</p> <p>References</p> <p>Chapter 16. Altering Serum Lipids to Reduce Progression of Chronic Kidney Disease</p> <p>Kidney Disease and Dyslipidemia</p> <p>Lipid Lowering and Pleiotropic Effects of Statins</p> <p>Statins in Experimental Kidney Disease</p> <p>Effects of Dyslipidemia and Statins on the Progression of Kidney Disease in Human Subjects</p> <p>References</p> <p>Chapter 17. Disorders of Phosphorus Homeostasis: Emerging Targets for Slowing Progression of Chronic Kidney Disease</p> <p>Introduction</p> <p>Role of Dietary Phosphorus Intake in Disturbances of Mineral Metabolism in CKD</p> <p>Disorders of Phosphorus Homeostasis and Kidney Disease Progression</p> <p>Dietary Phosphorus Restriction in CKD: Practical Considerations Moving Forward</p> <p>Conclusions</p> <p>References</p> <p>Chapter 18. Alkalinization to Retard Progression of Chronic Kidney Failure</p> <p>Epidemiology of Metabolic Acidosis in Kidney Disease</p> <p>Mechanism of Acidosis in CKD</p> <p>Animal Models of Kidney Damage With Acidosis</p> <p>Animal Models of Treatment</p> <p>Observational Studies in Humans</p> <p>Recommendations</p> <p>References</p> <p>Chapter 19. Calcium, Phosphate, PTH, Vitamin D and FGF-23 in Chronic Kidney Disease</p> <p>Introduction</p> <p>Calcium Metabolism</p> <p>Vitamin D</p> <p>Phosphate Metabolism</p> <p>Parathyroid Hormone</p> <p>Fibroblast Growth Factor 23 (FGF-23)</p> <p>Alterations in Mineral Metabolism in Ckd</p> <p>Phosphate and Cardiovascular Disease (CVD)</p> <p>Phosphate and Vascular Calcifications</p> <p>Control of Serum Phosphate in CKD</p> <p>Dietary Phosphorus Restriction</p> <p>Inorganic Phosphorus and Food Additives</p> <p>Dietary Phosphorus, Protein Intake and Phosphorus-Protein Ratio</p> <p>Phosphorus Removal With Dialysis</p> <p>Phosphate Binders</p> <p>Therapy With Vitamin D Sterols</p> <p>Calcimimetics</p> <p>Conclusion</p> <p>References</p> <p>Chapter 20. Phosphate Metabolism and Fibroblast Growth Factor 23 in Chronic Kidney Disease</p> <p>Introduction</p> <p>Phosphate Metabolism in Health</p> <p>Phosphate Metabolism Across the Spectrum of CKD</p> <p>The Role of Phosphate and FGF-23 Excess in the Pathophysiology of CKD Outcomes</p> <p>Therapeutic Approaches to Lowering Phosphate and FGF-23 Excess</p> <p>Impact of Dietary Phosphate on Phosphate/FGF-23 Excess</p> <p>Questions and Controversies</p> <p>Conclusions</p> <p>Acknowledgments</p> <p>Disclosures</p> <p>References</p> <p>Chapter 21. Vitamin D in Kidney Disease</p> <p>Normal Vitamin D Metabolism</p> <p>Prevalence and Etiology of Deficiency in The Vitamin D Axis in CKD</p> <p>Implications</p> <p>Interventions</p> <p>Other Compounds</p> <p>Therapeutic Considerations</p> <p>Summary</p> <p>Acknowledgement</p> <p>References</p> <p>Chapter 22. Nutritional Management of Water, Sodium, Potassium, Chloride, and Magnesium in Kidney Disease and Kidney Failure</p> <p>Sodium and Chloride</p> <p>Water</p> <p>Potassium</p> <p>Magnesium</p> <p>References</p> <p>Chapter 23. Trace Elements, Toxic Metals, and Metalloids in Kidney Disease</p> <p>Introduction</p> <p>Alterations in Essential Trace Elements in Patients With Kidney Disease</p> <p>Alterations in Nonessential Trace Elements, Metals, and Metalloids in Patients With Kidney Disease</p> <p>Trace Element Abnormalities in Renal-Specific Syndromes</p> <p>Diagnostic and Therapeutic Approaches</p> <p>Conclusions</p> <p>References</p> <p>Chapter 24. Vitamin Metabolism and Requirements in Renal Disease and Renal Failure</p> <p>Introduction</p> <p>Structure and Physiological Role of Vitamins</p> <p>Vitamin Intake in Chronic Renal Disease</p> <p>Vitamins Status in Chronic Renal Disease</p> <p>Vitamins as Therapy for People with Kidney Disease</p> <p>Recommendations for Vitamin Supplementation and Vitamin Therapy in Renal Diseases</p> <p>Conclusions</p> <p>References</p> <p>Chapter 25. Nutrition and Anemia in End-stage Renal Disease</p> <p>Introduction</p> <p>Iron</p> <p>Vitamin C</p> <p>Vitamin D</p> <p>Folic Acid</p> <p>Vitamin B6 (Pyridoxine)</p> <p>Vitamin B12</p> <p>Carnitine</p> <p>Growth Hormone and Insulin-Like Growth Factor-I (IGF-I)</p> <p>References</p> <p>Chapter 26. Nutritional and Non-nutritional Management of the Nephrotic Syndrome</p> <p>Introduction</p> <p>Dietary Protein</p> <p>Albumin Homeostasis in the Nephrotic Syndrome</p> <p>Dietary Protein and Renal Injury</p> <p>Effects of the Nephrotic Syndrome on Solid Tissue Proteins</p> <p>Dietary Proteins as Potential Allergens Responsible for Renal Disease</p> <p>Dietary Fat</p> <p>The Effect of Altered Glomerular Permselectivity on Lipid Metabolism</p> <p>Cardiovascular Effects of Hyperlipidemia in the Nephrotic Syndrome</p> <p>Thromboembolic Complications</p> <p>Effects of Lipids on Renal Disease</p> <p>Polyunsaturated Fatty Acids</p> <p>Derangements in Divalent Cation Metabolism in the Nephrotic Syndrome</p> <p>Derangements in Salt and Water Metabolism in the Nephrotic Syndrome (Volume Homeostasis)</p> <p>Recommendations for Nutritional and Non-Nutritional Treatment of the Nephrotic Syndrome</p> <p>Acknowledgements</p> <p>References</p> <p>Chapter 27. Nutrition and Blood Pressure</p> <p>Introduction</p> <p>Obesity and Energy Intake</p> <p>Individual Nutrients, Miscellaneous Substances and Blood Pressure</p> <p>Nutritional Management Strategies for The Prevention or Treatment of Hypertension</p> <p>Health Enhancing Diets and Lifestyles</p> <p>Long-Term Adherence and Blood Pressure Responses to Health Enhancing Lifestyles</p> <p>Challenges to Diet and Lifestyle Approaches for Preventing and Treating Hypertension</p> <p>Conclusions and Recommendations</p> <p>Key Points</p> <p>References</p> <p>Chapter 28. Effect of Obesity and the Metabolic Syndrome on Incident Kidney Disease and the Progression to Chronic Kidney Failure</p> <p>Introduction</p> <p>Definitions of Obesity/Metabolic Syndrome</p> <p>Obesity and Metabolic Syndrome as Risk Factors for Incident CKD</p> <p>Obesity and Metabolic Syndrome as Risk Factors for Progression of CKD</p> <p>Pathophysiology of Obesity on the Kidney</p> <p>Effect of Weight Loss Interventions on Kidney Disease</p> <p>Conclusion</p> <p>References</p> <p>Chapter 29. Nutritional and Metabolic Management of Obesity and the Metabolic Syndrome in the Patient with Chronic Kidney Disease</p> <p>Introduction</p> <p>Obesity-Related Chronic Kidney Disease (CKD)</p> <p>Obesity-Related Glomerulopathy</p> <p>Measuring GFR</p> <p>Metabolic Syndrome</p> <p>Treatment of Obesity and Obesity-Related Kidney Disease</p> <p>Bariatric Surgery (see also Chapter 28)</p> <p>Metabolic Syndrome</p> <p>References</p> <p>Chapter 30. Bariatric Surgery and Renal Disease</p> <p>Magnitude of Problem</p> <p>Pathogenesis of Obesity</p> <p>Clinical Manifestations</p> <p>Medical Therapy</p> <p>Role of Bariatric Surgery in Treatment of Morbid Obesity</p> <p>Surgical Techniques of Bariatric Surgery (see Figure 30.1)</p> <p>Outcomes of Bariatric Surgery</p> <p>Renal Disease and Morbid Obesity</p> <p>Pathogenesis of Renal Disease in Obesity</p> <p>Role of Bariatric Surgery in Chronic Kidney Disease</p> <p>Role of Bariatric Surgery in Transplant Candidates</p> <p>Bariatric Surgery and Nephrolithiasis</p> <p>Other Renal Effects of Bariatric Surgery</p> <p>Future Research</p> <p>References</p> <p>Chapter 31. Nutritional and Metabolic Management of the Diabetic Patient with Chronic Kidney Disease and Chronic Renal Failure</p> <p>Introduction</p> <p>Glucose/Insulin Homeostasis</p> <p>Value of Glycemic Control, and its Determination in CKD</p> <p>Hypoglycemia</p> <p>Diabetes/Bone and Mineral Metabolism</p> <p>Dietary Protein Intake and Diabetic Kidney Disease</p> <p>Salt Intake and Diabetic Kidney Disease</p> <p>References</p> <p>Chapter 32. Nutritional Management of Maintenance Hemodialysis Patients</p> <p>Introduction</p> <p>Factors Altering Nutrient Intake in Maintenance Hemodialysis Patients</p> <p>Loss of Nutrients During Maintenance Hemodialysis Treatment</p> <p>Importance of Pew and Diet as Patients Approach Esrd and Commence MHD</p> <p>Assessment of Nutritional Status in MHD Patients</p> <p>Acidemia and Protein Wasting</p> <p>Goals of Nutritional Management of MHD Patients</p> <p>Dietary Nutrient Requirements (see Table 32.3)</p> <p>Management of Pew in MHD Patients</p> <p>Treatment of Acute Catabolic Illness</p> <p>Daily or Long Duration Hemodialysis and Nutritional Status</p> <p>References</p> <p>Chapter 33. Nutritional Management of End-Stage Renal Disease Patients Treated with Peritoneal Dialysis</p> <p>Introduction</p> <p>Type of Peritoneal Dialysis</p> <p>Peritoneal Dialysis Solutions</p> <p>Specific Effects of Peritoneal Dialysis on Nutritional Status and Metabolism</p> <p>Dietary Recommendations for ESRD Patients Undergoing Peritoneal Dialysis</p> <p>Protein-Energy Wasting in Peritoneal Dialysis Patients</p> <p>Management of Protein-Energy Wasting in Patients Treated with Peritoneal Dialysis</p> <p>References</p> <p>Chapter 34. Nutritional Management of Kidney Transplant Recipients</p> <p>Introduction</p> <p>Anemia</p> <p>Bone Disease</p> <p>Diabetes Mellitus</p> <p>Dyslipidemia</p> <p>Hypertension</p> <p>Food Safety</p> <p>Hypophosphatemia</p> <p>Overweight/Obesity</p> <p>Malnutrition</p> <p>Protein and Energy Requirements</p> <p>Nutritional Management</p> <p>Pretransplant Status and Posttransplant Outcome</p> <p>Conclusion</p> <p>Acknowledgements</p> <p>References</p> <p>Chapter 35. Nutritional Management of the Child with Kidney Disease</p> <p>Introduction</p> <p>Etiology of Protein-Energy Wasting</p> <p>Assessment of Nutritional Status</p> <p>Nutritional Requirements</p> <p>Bone Mineral Metabolism</p> <p>Acid–Base and Electrolytes</p> <p>Vitamins and Micronutrients</p> <p>Nutrition Management</p> <p>References</p> <p>Chapter 36. Nutritional Management of Acute Kidney Injury</p> <p>Introduction</p> <p>Metabolic Environment of the Patient with AKI</p> <p>Metabolic Alterations Specifically Attributable to AKI</p> <p>Metabolic Interventions of Controlling Catabolism</p> <p>Clinical Studies on Protein Catabolism in AKI</p> <p>Amino Acid/Protein Requirements in Patients with AKI</p> <p>Carbohydrate Metabolism</p> <p>Lipid Metabolism</p> <p>Micronutrients and the Antioxidant System in AKI</p> <p>Electrolytes</p> <p>Metabolic and Nutritional Factors and the Prevention and Therapy of AKI</p> <p>Impact of Renal Replacement Therapy (RRT) on Metabolism and Nutrient Balances</p> <p>The Effect of Nutrition Status and Nutrient Supply on Prognosis</p> <p>Practice of Clinical Nutrition in Patients with AKI</p> <p>Oral Nutrition in Patients with AKI</p> <p>Nutritional Support in Patients with AKI</p> <p>Enteral Nutrition in AKI</p> <p>Parenteral Nutrition in AKI</p> <p>Complications of Nutritional Support</p> <p>Monitoring of Nutrition Support in Patient with AKI</p> <p>References</p> <p>Chapter 37. Nutritional Management of Patients Treated with Continuous Renal Replacement Therapy</p> <p>Introduction</p> <p>Modes of CRRT</p> <p>Generic Effects of CRRT on Energy Metabolism</p> <p>Specific Effects on Nutrient Balance</p> <p>Recommendations on Nutritional Therapy</p> <p>Conclusion</p> <p>Acknowledgements</p> <p>References</p> <p>Chapter 38. Anorexia and Appetite Stimulants in Chronic Kidney Disease</p> <p>General Considerations</p> <p>Prevalence of Anorexia, Methods of Assessment and Clinical Implications</p> <p>Pathogenesis of Anorexia in CKD</p> <p>Treatment of Anorexia in CKD</p> <p>References</p> <p>Chapter 39. Oral and Enteral Supplements in Kidney Disease and Kidney Failure</p> <p>Introduction</p> <p>Oral and Enteral (Tube Feeding) Nutrition in CKD Patients</p> <p>Oral and Enteral Nutrition for Patients with Nephrotic Syndrome</p> <p>Oral and Enteral Nutrition in Chronic Dialysis Patients</p> <p>Oral and Enteral Nutrition in Acute Kidney Injury</p> <p>Conclusions</p> <p>References</p> <p>Chapter 40. Intradialytic Parenteral Nutrition, Intraperitoneal Nutrition and Nutritional Hemodialysis</p> <p>Introduction</p> <p>Intradialytic Parenteral Nutrition (IDPN)</p> <p>Randomized Prospective Controlled Trials of IDPN</p> <p>Advantages and Disadvantages of IDPN</p> <p>Indications for IDPN</p> <p>IDPN in the United States</p> <p>Nutritional Hemodialysis and Intraperitoneal Nutrition</p> <p>References</p> <p>Chapter 41. Therapeutic Use of Growth Factors in Renal Disease</p> <p>Introduction</p> <p>Treatment of Protein-Energy Wasting (PEW) in ESRD Patients</p> <p>Therapeutic Use of Growth Factors in Renal Disease</p> <p>Growth Factors in the Management of Wasting in Renal Disease</p> <p>Conclusion</p> <p>References</p> <p>Chapter 42. Nutritional Prevention and Treatment of Kidney Stones</p> <p>Introduction</p> <p>Pathophysiology of Kidney Stone Formation</p> <p>General Dietary Effects on Kidney Stones</p> <p>Effect of Diet Based on Urinary Findings</p> <p>Dietary Recommendations Based on Stone Type</p> <p>Obesity and Kidney Stones</p> <p>Melamine Stones</p> <p>References</p> <p>Chapter 43. Herbal Supplements in Patients with Kidney Disease</p> <p>Introduction</p> <p>Acute Kidney Injury</p> <p>Chronic Kidney Disease</p> <p>Five Herbals with Some Proven Efficacy</p> <p>Transplant</p> <p>Clinical Implications</p> <p>References</p> <p>Chapter 44. Drug–Nutrient Interactions in Renal Failure</p> <p>Introduction</p> <p>Effect of Food Intake on Drug Absorption</p> <p>Effects of Nutrients on Drug Metabolism</p> <p>Interactions of Food Supplements with Drugs</p> <p>Drug-Induced Nutritional Deficiencies</p> <p>Taurine and ACE-Inhibitor Effects</p> <p>Nutrient Interactions with Oral Anticoagulants</p> <p>Interactions of Calcineurin Inhibitors with Nutrients</p> <p>Enteral Tube Feeding and Oral Drug Administration</p> <p>References</p> <p>Chapter 45. Exercise Training for Individuals with Advanced Chronic Kidney Disease</p> <p>Introduction</p> <p>Characteristics of Advanced CKD Patients</p> <p>Value of Exercise and Physical Activity in Advanced CKD</p> <p>Principles of Exercise Training</p> <p>Patient Assessment</p> <p>Components of the Exercise Training Prescription</p> <p>Exercise Training Program Design for Patients with Advanced CKD</p> <p>Components of the Exercise Training Session</p> <p>Risks of Exercise in the Advanced CKD Patient</p> <p>Urgent Need for Development of Renal Rehabilitation Programs</p> <p>Summary</p> <p>References</p> <p>Chapter 46. Motivating the Kidney Disease Patient to Nutrition Adherence and Other Healthy Lifestyle Activities</p> <p>Introduction</p> <p>What is Motivational Interviewing?</p> <p>What isn’t Motivational Interviewing?</p> <p>Principles</p> <p>Handling Resistance</p> <p>Empirical Support</p> <p>Applications in Kidney Disease Management</p> <p>Learning Motivational Interviewing</p> <p>Dissemination of Motivational Interviewing</p> <p>Future Research Directions in Kidney Disease Management</p> <p>Conclusions</p> <p>References</p> <p>Color Plates</p> <p>Index</p>