Plant-based diets and postprandial hyperkalemia.

This Letter to the Editor is a response to St-Jules and Fouque and their interpretation of postprandial hyperkalemia, especially regarding plant-based diets. Based on the reviewed literature review, potassium kinetic studies cited by the authors include only 1 study with a food-based intervention that actually showed reduced postprandial hyperkalemia with plant-based diets. The remainder of the studies used potassium salts or supplements that behave differently compared with whole plant foods. As such, we recommend avoiding restriction of whole plant foods in patients with chronic kidney disease when solely based on the theoretical risk of postprandial hyperkalemia.

Climate crisis and nephrology: a review of climate change's impact on nephrology and how to combat it.

Climate change is worsening with tangible effects on our healthcare system. This review aims to examine the repercussions of the climate change on nephrology and explore potential strategies to mitigate its impact. This review examines dialysis's environmental impact, resource recycling methods, and plant-based diets for kidney health. Recent research highlights the advantages of plant-based diets in managing and preventing chronic kidney disease (CKD) and its complications. Integrating these practices can significantly lessen the environmental impact of nephrology. PURPOSE OF REVIEW: The aim of this study is to discuss the bidirectional relationship of climate change and kidney disease and the impact of nephrology on climate change and to discuss potential solutions. RECENT FINDINGS: Each dialysis session consumes significant amounts of resource; reusing them will aid the environment. Plant-based diets slow renal disease and have a lower carbon footprint, making them ecologically friendly. SUMMARY: Climate change is a growing threat to population health and healthcare. Rising temperatures raise the risk of kidney problems. Dialysis treatments also impact the environment through its high resource requirements while generating high volumes of waste and greenhouse gases. Opportunities exist to reduce the environmental impact of dialysis treatments. Plant-based diets serve to benefit both kidney disease and the environment.

Polypoid Lymphangiectasia in the Sigmoid Colon: A Case Report of a Rare Entity.

Intestinal polypoid lymphangiectasia is an uncommon disorder involving an improperly formed enteric lymphatic system. It is characterized by lymphatic vessel dilatation with impaired drainage or obstruction of the lymph from the intestine. In this report, we present a case of a 73-year-old male patient with chronic intermittent left lower quadrant abdominal pain for one year who was found to have a sigmoid colon polyp on a colonoscopy. Upon microscopic examination, the polyp revealed dilated lymphatic vessels staining strongly for D2-40 (lymphatic vessel marker), supporting the diagnosis of polypoid lymphangiectasia. Intestinal lymphangiectasia has a broad differential diagnosis, warranting histopathological examination for a definitive diagnosis.--------------.

Significance of Chronic Kidney Disease on Morbidity and Mortality in Hospitalized Patients With COVID-19.

Background: Patients with comorbid illnesses are at risk for worse outcomes with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19). Our research examined patients with chronic kidney disease (CKD) to establish whether it remains an independent risk factor for mortality and morbidity in patients with COVID-19. Methods: We conducted a retrospective cohort study using an electronic patient database in 2020. An observational dataset from 149 hospitals comprising a United States-based health system (HCA Healthcare) was analyzed. Hospitalized patients (N=11 086), aged 18 and above, with a COVID-19 polymerase chain reaction positive result between January 1, 2020, and September 1, 2020, were included in the initial data set.Primary outcomes were in-hospital death or discharge to hospice in patients with COVID-19. Secondary outcomes were individual components of the primary outcome including intensive care unit (ICU) admission, ventilator dependency, development of acute kidney injury (AKI), and in-hospital death. Baseline patient characteristics were recorded, including demographic variables and comorbidities. Results: A total of 11 086 patients were included in the analysis. The study group included patients with CKD (5543 patients). Patients in the control group (5543 patients) were propensity matched for age, race, sex, and ethnicity. The primary outcome of in-hospital death or discharge to hospice was observed in 20.96% of patients with CKD compared to 11.91% of the control group with an odds ratio of 1.58 (confidence interval 1.37-1.80). ICU admission was required for 37.20% of patients in the CKD group and 21.63% of patients in the control group (P < .001). Ventilator dependency was found in 14.41% of patients in the CKD group and 8.59% of patients in the control group (P < .01). Development of AKI was seen in 5.65% of patients in the CKD group and 2.90% of patients in the control group (P < .01). A logistic regression model confirmed an independent association between underlying CKD and in-hospital death or discharge to hospice in patients with COVID-19. Conclusion: Our study confirms an independent association between underlying CKD and poor outcomes among hospitalized patients with COVID-19, including in-hospital death or discharge to hospice.

Surface presentation of the noncanonical Wnt5a motif to cytotoxic CD8+ T-cells promotes their mechanotransduction and activation.

We report here strategic functionalization of the Wnt5a mimetic peptide ligand Foxy5 on a polydimethylsiloxane elastomer substrate to enhance the mechanotransduction and activation of cytotoxic CD8+ T cells by triggering the noncanonical Wnt signaling. This new mechanoregulatory ligand platform can be widely applied in the fundamental research of mechano-immunology and further the development of novel immunotherapies.