Nutritional and Metabolic Landscape in CKD and ESKD: Mechanisms, Biomarkers, and Integrative Management

Nutritional and metabolic derangements are hallmarks of chronic kidney disease (CKD) and end-stage kidney disease (ESKD), profoundly affecting patient morbidity and mortality. Beyond the well-recognized syndrome of protein–energy wasting (PEW), these patients navigate a complex landscape of metabolic reprogramming, including impaired carbohydrate metabolism, altered lipid profiles, and chronic mineral and bone disorders. The uremic milieu further disrupts the intestinal barrier and reshapes the gut microbiome, contributing to systemic inflammation and the accumulation of metabolic byproducts.Despite advances in renal replacement therapy, maintaining an appropriate balance of macro- and micronutrients remains a clinical challenge. Emerging areas of interest include the “gut–kidney axis,” the metabolic consequences of specific uremic toxins, and the effects of lifestyle interventions on metabolic health. There is also a critical need for objective, noninvasive tools to assess nutritional status and metabolic flux in real time. This Research Topic seeks to provide a comprehensive overview of these evolving themes, integrating basic science with clinical perspectives to address the full spectrum of metabolic challenges in patients with CKD/ESKD.This Research Topic aims to collect high-quality evidence that expands our understanding of the broader nutritional and metabolic challenges in the CKD/ESKD population. Our goal is to move beyond conventional dietary assessment by examining the molecular underpinnings of metabolic dysfunction, from cellular energy failure to systemic hormonal imbalances. We aim to highlight innovative diagnostic approaches—including metabolomics, proteomics, and novel sensing technologies—for early detection of nutritional risk. Furthermore, this topic intends to evaluate integrative management strategies encompassing pharmacological therapies, personalized nutrition, and digital health interventions to optimize metabolic homeostasis. By fostering a multidisciplinary dialogue, we hope to identify actionable targets to improve long-term clinical outcomes and enhance quality of life for patients with kidney disease.We invite submissions that address the diverse facets of nutrition and metabolism in kidney disease. We are particularly interested in manuscripts focused on the following themes:• Metabolic reprogramming: Alterations in glucose, lipid, and amino acid metabolism in uremic states• Gut–kidney axis: The role of the microbiome and gut-derived metabolites in nutritional status and metabolic health in CKD/ESKD• Micronutrients and electrolytes: Management of vitamins, trace elements, and mineral metabolism (including potassium, phosphorus, and calcium)• Novel diagnostics: Advanced body composition assessment, metabolomics, and wearable technologies for metabolic monitoring• Integrative interventions: Effects of specialized diets (e.g., low-protein diets), physical activity, and pharmacological modulators on metabolic outcomes• Precision nutrition: Strategies to individualize nutritional therapy based on genetic or metabolic profilingWe welcome Original Research, Systematic Reviews, Meta-analyses, Clinical Trials, Reviews, Study Protocol and Evidence-based Case Reports. Topic editors: Bo Yang, Dian Fu, Cheng Xue, Jeanette Mary Andrade Source: https://www.frontiersin.org/research-topics/78718/nutritional-and-metabolic-landscape-in-ckd-and-eskd-mechanisms-biomarkers-and-integrative-management