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Kidney Week

Abstract: PO0460

The Association Between Dietary Fiber Intake and Clinical Outcomes in CKD: A Report from the Chronic Renal Insufficiency Cohort (CRIC)

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Brar, Sumeet Singh, Case Western Reserve University, Cleveland, Ohio, United States
  • Delozier, Sarah, Case Western Reserve University, Cleveland, Ohio, United States
  • Pradhan, Nishi, Case Western Reserve University, Cleveland, Ohio, United States
  • Rahman, Mahboob, Case Western Reserve University, Cleveland, Ohio, United States
  • Dobre, Mirela A., Case Western Reserve University, Cleveland, Ohio, United States
Background

Standard dietary interventions for individuals with chronic kidney disease (CKD) consist of reductions in salt, phosphorus, potassium, and protein intake, with no specific guidance regarding dietary fiber intake. In animal models of kidney disease, a diet high in amylose resistant starch has been found to trigger a reduction in inflammation and CKD progression. It is unclear whether low dietary fiber intake is associated with a higher risk of incident kidney disease progression, cardiovascular disease, and overall mortality in individuals with CKD.

Methods

A total of 3791 participants with chronic kidney disease and information on dietary fiber intake at the baseline visit in the Chronic Renal Insufficiency Cohort (CRIC) Study were included in the analyses. Cox proportional hazards models adjusted for sociodemographic, comorbidities, medications and laboratory data, including eGFR and proteinuria were used to analyze the association between dietary fiber intake and clinical outcomes.

Results

The mean age was 59±11 years, 46% were female, 47% had diabetes, and the average eGFR was 48±17 ml/min/1.73m2. The average dietary fiber intake was 17.3±9.6 g. After a median follow up of 8.8±4.5 years, there was an inverse association between crude death rates and baseline dietary fiber intake: increasing from 3.1 per 100 person-years (PY) for the highest to 3.4 per 100 PY for the lowest fiber tertile. After multivariable adjustments, individuals in the middle and low fiber tertiles were at greater risk of death compared to those in the highest fiber tertile (HR[95%CI], 1.18 [1.01, 1.38], p =0.04 and 1.10 (0.94, 1.29), 0.24, respectively). We found no significant association between dietary fiber intake and kidney and cardiovascular disease outcomes. Results were similar in sensitivity analyses by subgroups defined by age, gender, ethnicity, diabetes, eGFR (< and >/= 45 ml/min/1.73m2), and proteinuria.

Conclusion

Dietary fiber intake may be associated with the risk of death, but not with cardiovascular outcomes or kidney disease progression in individuals with CKD. Future intervention trials should investigate whether a diet enriched in fibers would influence mortality and other clinical outcomes.

Funding

  • Other NIH Support