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Abstract: SA-PO798

Metabolomics of Dietary Protein Sources and CKD Progression in Children

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Rebholz, Casey, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Chen, Jingsha, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Abraham, Alison G., Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Xu, Yunwen, Johns Hopkins School of Public Health, Baltimore, Maryland, United States
  • Betoko, Aisha, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Warady, Bradley A., Children's Mercy Kansas City, Kansas City, Missouri, United States
  • Rhee, Eugene P., Massachusetts General Hospital, Newton, Massachusetts, United States
  • Furth, Susan L., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Coresh, Josef, Welch Center for Prevention, Epidemiology & Clinical Research, Baltimore, Maryland, United States
  • Denburg, Michelle, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
Background

Recent evidence suggests that source of dietary protein may influence kidney disease risk. We aimed to characterize the plasma metabolome of plant and animal sources of protein and to determine whether dietary protein-related metabolites were associated with CKD progression in children.

Methods

Metabolites were measured using an untargeted platform (Metabolon) in baseline plasma specimens from 488 Chronic Kidney Disease in Children (CKiD) participants. We assessed the cross-sectional association between protein source (plant, animal) and metabolites using linear regression adjusted for age, sex, race, BMI, glomerular vs. non-glomerular diagnosis, and eGFR, and statistical significance was determined using a false discovery rate <0.05 to account for multiple comparisons. Metabolites that were significantly associated with protein were included in the prospective analysis with CKD progression (renal replacement therapy or ≥50% eGFR decline) after accounting for proteinuria, anemia, hypertension, and serum albumin in addition to the same covariates in the cross-sectional analysis.

Results

A total of 94 (9.9% of 949) known serum metabolites were significantly associated with animal protein and 45 (4.7% of 949) metabolites were significantly associated with plant protein. Only one metabolite was significantly associated with both animal and plant protein: phenylacetate. For the prospective analysis, 23 animal protein-related metabolites (24.5% of 94) and 8 plant protein-related metabolites (17.8% of 45) were associated with CKD progression, including 21 lipids, 3 amino acids, 3 cofactors and vitamins, 2 xenobiotics, 1 peptide, and 1 nucleotide (p<0.05; Table).

Conclusion

An untargeted metabolomic platform identified multiple blood metabolites that were associated with animal and plant protein consumption and CKD progression. These findings could inform more nuanced dietary recommendations for children with CKD regarding protein source.

Funding

  • NIDDK Support