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Kidney Week

Abstract: SA-PO1042

Dietary Protein Intake, Protein Energy Wasting, and Progression of CKD

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Kang, Eunjeong, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Lee, Sung Woo, Eulji General Hospital, Seoul, Korea (the Republic of)
  • Ahn, Curie, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Oh, Kook-Hwan, Seoul National University Hospital, Seoul, Korea (the Republic of)
Background

There have been a paucity of literatures regarding on the effect of dietary protein intake (DPI) on the progression of chronic kidney disease (CKD), in conjunction with the potential hazard of protein-energy wasting (PEW).

Methods

The database of a large-scaled multicenter prospective study in Korea of 2238 patients enrolled from 2011–2016 was reviewed. After excluding 319 with missing data to define DPI and PEW, and 347 with collecting 24-hour urine incompletely, the study included 1572 non-dialysis CKD patients. CKD progression was defined by a >50% estimated glomerular filtration rate (eGFR) decline, serum creatinine doubling, or dialysis initiation.

Results

During mean 41.6 months’ follow-up period, 296 CKD patients (18.8%) progressed. Cross-sectionally, increased DPI was significantly associated with increased eGFR. Similarly, increased DPI tertile was significantly associated with increased renal survival in Kaplan-Meier curve analysis (Log-rank P <0.001). In multivariate Cox proportional hazard regression analysis, the hazard ratio (95% confidence interval) of the third vs. first tertile was 0.685 (0.495-0.948, P = 0.022). However, the statistical significance of DPI tertile group on CKD progression was lost when variables related to PEW were added as covariates. In penalized spline curve analysis, the adjusted odds ratio of PEW was significantly increased as DPI increased.

Conclusion

DPI per se was not a major determinant of CKD progression. Instead, intimate association between reduced DPI and PEW may be more important than DPI per se to predict CKD progression.

Funding

  • Government Support - Non-U.S.