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Abstract: FR-OR126

Dietary Fiber Intake, Myocardial Injury, and Major Adverse Cardiovascular Events among ESRD Patients: A Prospective Cohort Study

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

  • Wang, Angela Yee Moon, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
  • Wang, Mei, Chinese University of Hong Kong, Prince of Wales Hospital (Previous), Hong Kong, Hong Kong
  • Sanderson, John E., Chinese University of Hong Kong, Prince of Wales Hospital (Previous), Hong Kong, Hong Kong
  • Chan, Iris, Prince of Wales Hospital, Hong Kong, Hong Kong
  • Lam, Christopher W., Macau University Science Technology, Macau, Macau, China
  • Woo, Jean, The Chinese University of Hong Kong, Hong Kong SAR, China
Background

Dialysis patients are frequently advised to restrict fruits, vegetables, wholegrain or nuts intake due to their high potassium or phosphate content. The importance of fiber intake in relation to cardiovascular health in dialysis patients is not known.

Methods

Two hundred and nineteen prevalent dialysis patients was prospectively recruited from a university teaching hospital and regional dialysis center and followed for 4 years. Dietary fiber intake was estimated using a 7-day validated food frequency dietary questionnaire and examined in relation to a composite of major adverse cardiovascular events (MACE).

Results

Higher fiber intake was associated with less inflammation, lower serum cardiac troponin T, N-terminal pro-brain natriuretic peptide and less cardiac hypertrophy. During 4 years’ follow-up, 127 patients were complicated with one or more MACE. Higher fiber intake (hazard ratio [HR], 0.87, 95% confidence intervals [CI], 0.80 – 0.94) and higher fiber intake density (HR, 0.85, 95% CI, 0.74 – 0.97) were associated with a lower risk of MACE on univariate analysis. In the multivariable Cox regression analysis, higher fiber intake predicted a lower risk of MACE (adjusted HR, 0.89, 95% CI, 0.81 – 0.97, P=0.008) independent of other clinical, demographic, biochemical, hemodynamic, adequacy parameters, dietary protein and energy intake, as well as inflammatory and cardiac markers. Similarly, fiber intake density retained significance in predicting MACE both as a continuous variable [adjusted HR, 0.87, 95% CI, 0.77 – 0.99] and when stratified into tertiles, adjusting for the same confounders. Those in the lower tertile of fiber intake density showed an increased hazard for MACE [adjusted HR, 1.78, 95% CI, 1.13 – 2.80] compared to those in the upper tertile.

Conclusion

Higher dietary fiber intake and fiber nutrient density were associated with less inflammation, less myocardial hypertrophy and injury and predicted a lower risk of MACE in dialysis patients. These data form an important basis for a randomized controlled trial to examine the effects of fiber supplementation on cardiovascular outcomes in dialysis patients.

Funding

  • Government Support - Non-U.S.