Abstract: FR-PO515

High Protein Intake Is Associated with Higher Mortality in Patients with Non-Dialysis Dependent CKD

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 304 CKD: Epidemiology, Outcomes - Non-Cardiovascular

Authors

  • Akhtar, Jawed, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Mahmoud, Mahmoud A., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Arif, Faisal M., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Wallick, Angela M, Department of Veterans Affairs, Memphis, Tennessee, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States
  • Molnar, Miklos Zsolt, University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Wall, Barry M., University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Kovesdy, Csaba P., University of Tennessee Health Science Center, Memphis, Tennessee, United States
Background

High protein intake is associated with worse progression of CKD in patients with non-dialysis dependent CKD (NDD-CKD), but its effects on mortality are unclear.

Methods

We examined 854 NDD-CKD US veterans followed at a tertiary medical center. We estimated dietary protein intake (DPI) from urea nitrogen and creatinine measured from morning spot urine collections and using the Maroni formula. The associations of baseline DPI (analyzed as a continuous variable using splines, and divided into quartiles) with all-cause mortality was examined in Cox models adjusted for demographics, comorbidities, medication use, baseline estimated GFR and proteinuria.

Results

Patients were 66±11 years old, 96% were men, 59% were African American and 55% were diabetic. The baseline estimated GFR was 38±21 ml/min/1.73m2. Higher DPI was associated with higher mortality (Figure). Compared to the second quartile, the hazard ratios (95%CI) of mortality associated with quartiles 1, 3 and 4 of DPI were 1.24 (0.76-2.01), 1.41 (0.88-2.26) and 2.17 (1.38-3.37), respectively.

Conclusion

In patients with moderate and advanced NDD-CKD, high DPI is associated with higher all-cause mortality. Further studies are needed to determine the amount of DPI providing optimal outcomes in this patient population.

Funding

  • NIDDK Support