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Iskalni niz: "avtor" (Aljoša Kuzmanovski) .

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1.
Targeting protein-bound uremic toxins : a dual approach with medium cut-off membrane dialysis and a dietary intervention - a randomized controlled study
Tjaša Herič, Tjaša Vivoda, Špela Bogataj, Aljoša Kuzmanovski, Joško Osredkar, Joanna Giebułtowicz, Jernej Pajek, 2026, izvirni znanstveni članek

Povzetek: Background/Objectives: Protein-bound uremic toxins (PBUTs), particularly p-cresyl sulfate (PCS) and indoxyl sulfate (IS), are associated with cardiovascular toxicity and increased mortality. Conventional hemodialysis (HD) removes PBUTs poorly, and the efficacy of medium cut-off (MCO) dialyzer membranes remains uncertain. Furthermore, PBUT production is influenced by gut microbial metabolism and can be modified through diet. We hypothesized that MCO dialysis would provide superior clearance of PCS and IS compared with online hemodiafiltration (OL-HDF), and that combining MCO dialysis with increased dietary fiber and short-chain fatty acid (SCFA) intake would further reduce PBUT levels. Methods: In this prospective randomized trial, 62 maintenance HD patients underwent a 2-week wash-in period with high-flux HD (HF-HD) and were then randomized to MCO-HD (EXP) or OL-HDF (CON). After a 4-week intervention with the assigned dialysis modality, both groups continued with the same dialysis treatment and received an 8-week dietary intervention consisting of 19 g/day fiber and 1 g/day sodium propionate. The study concluded with a 4-week wash-out period on HF-HD. Primary outcomes were total serum PCS and IS levels measured at four timepoints. Results: Fifty-two patients completed the study. No significant changes in PCS or IS were observed after the dialysis-only intervention. PCS levels remained stable throughout the study. When the aligned dialysis regimen was combined with the dietary intervention, IS levels were significantly lower in the CON than in the EXP group (31.5 ± 10.3 vs. 42.0 ± 15.8 µmol/L; p = 0.006), with a partial rebound after wash-out in the CON group (39.6 ± 20.9 µmol/L; p = 0.003). Conclusions: While MCO-HD and OL-HDF had a similar effect on serum PCS and IS concentrations, only OL-HDF combined with the dietary intervention significantly reduced IS levels.
Ključne besede: fiber supplementation, indoxyl sulfate, medium cut-off dialyzer, p-cresyl sulfate, protein-bound uremic toxins
Objavljeno v DiRROS: 24.04.2026; Ogledov: 144; Prenosov: 156
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2.
Lost and not found : randomized controlled trial of cognitive behavioural therapy for weight-loss in patients with chronic kidney disease
Katja Kurnik Mesarič, Jana Kodrič, Špela Bogataj, Andreja Marn-Pernat, Aljoša Kuzmanovski, Bernarda Logar Zakrajšek, Jernej Pajek, 2025, izvirni znanstveni članek

Povzetek: Introduction: Managing obesity in patients with chronic kidney disease is crucial for managing disease progression. Psychological interventions, particularly cognitive behavioral therapy, can support lifestyle changes. This study aimed to evaluate the efficacy of a cognitive behavioral therapy intervention for obesity management in patients with chronic kidney disease. Methods: Forty patients with chronic kidney disease (stages 2–4) were randomized to either an intervention group (nutritional and physical activity counseling and 16-week cognitive behavioral therapy) or a control group (nutritional and physical activity counseling only). Primary outcomes were body mass index (BMI) and proteinuria. Results: The intervention group lost an average of 5.42 kg (BMI decrease: 1.82 kg/m²), compared to 1.53 kg (BMI decrease: 0.53 kg/m²) in the control group. A significant group-by-time interaction was observed for BMI (F(1,36) = 32.24, p = 0.004, ŋ²=0.21), favoring the intervention group. Effects remained significant at three-month follow-up, with an average weight loss of 4.63 kg (BMI decrease: 1.59 kg/m²) in the intervention group and 2.51 kg (BMI decrease: 0.87 kg/m²) in control group (F(2,70) = 5.54, p = 0.026, ŋ²=0.12). Changes in proteinuria did not differ between groups. Conclusion: Cognitive behavioral therapy was effective and well-tolerated for promoting weight loss with most of the lost weight maintained at the three-month follow-up. This intervention may offer a valuable non-pharmacological treatment option for weight management in patients with chronic kidney disease.
Ključne besede: sport, chronic kidney disease, cognitive behavioral therapy, obesity, weight management, improve patient well-being, weight-loss
Objavljeno v DiRROS: 20.01.2026; Ogledov: 299; Prenosov: 185
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