ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

ASN / Education & Meetings / Kidney Week /

Please note that you are viewing an archived section from 2019 and some content may be unavailable. To unlock all content for 2019, please visit the archives.

Abstract: SA-PO795

Dietary Protein Intake, Kidney Function, and Mortality in a Nationally Representative Cohort

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Narasaki, Yoko, Tokushima University, Irvine, California, United States
  • Okuda, Yusuke, University of California, Irvine, Irvine, California, United States
  • Moore, Linda W., Houston Methodist Hospital, Houston, Texas, United States
  • You, Amy Seung, University of California, Irvine, Irvine, California, United States
  • Nakata, Tracy, UC Irvine, Orange, California, United States
  • Nguyen, Danh V., University of California Irvine, Huntington Beach, California, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States
  • Rhee, Connie, University of California Irvine, Huntington Beach, California, United States
Background

In the general population, high protein diets (Paleo, Atkins, ketogenic) have gained popularity as a means to promote weight loss and avoid excess carbohydrate consumption. Yet in chronic kidney disease (CKD), evidence suggests low dietary protein intake (DPI) leads to attenuation of kidney function decline, although there remains concern about risk of protein-energy wasting. We thus sought to examine the association of DPI with mortality risk in a nationally representative cohort stratified by estimated glomerular filtration rate (eGFR).

Methods

We examined the association of daily DPI normalized to actual body weight (g/kg actual weight [AW]/day) ascertained by 24-hour dietary recall, with all-cause mortality among 27,604 continuous NHANES adult participants (1999-2010) stratified by low vs. normal eGFR (<60 vs. ≥60ml/min/1.72m2, respectively) in adjusted Cox models. We also examined the relationship between high biologic value (HBV) protein consumption with mortality.

Results

In participants with low eGFR (N=1999), high DPI ≥1.4g/kg AW/day was associated with higher death risk, while lower DPI levels were not associated with mortality (ref: 0.6-<1.0): HRs (95%CI): 1.09 (0.90, 1.32), 1.03 (0.82, 1.29), and 1.37 (1.02, 1.85) for DPI <0.6, 0.6-<1.0, 1.0-<1.4, and ≥1.4g/kg AW/day, respectively. Yet in those with normal eGFR (N=25,605), low DPI <0.6g/kg AW/day was associated with higher mortality, whereas higher DPI levels were not associated with death. In those with low eGFR, the highest two tertiles of HBV consumption were associated with higher death risk (ref: lowest tertile), whereas no association of HBV intake with mortality was observed with normal eGFR.

Conclusion

In participants with low eGFR, higher DPI and HBV consumption were associated with higher mortality, whereas lower DPI was associated with higher mortality in those with normal eGFR. Further studies are needed to elucidate the specific pathways between higher DPI and HBV consumption and mortality in those with CKD.

Funding

  • NIDDK Support