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Abstract: SA-PO470

Validation and Application of Serum Urea Nitrogen-Based Protein Intake Assessment Equation in Diabetic Kidney Disease (DKD) Cohort

Session Information

Category: Diabetic Kidney Disease

  • 702 Diabetic Kidney Disease: Clinical

Authors

  • Li, Qiuling, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
  • Wang, Wenjian, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
Background

Our previous studies have established an equation based on serum urea nitrogen in CKD stage 3 patients prospectively, however, its application remains unknown in other stages patients.We aimed to verify the DPI equation in different CKD patients and explored the survival analysis. We applied this equation in our DKD cohort and NHANES cohort.

Methods

We retrospectively collected the clinical data from patients diagnosed with CKD in Guangdong Provincial People's Hospital from January 2015 to September 2022. End points included 50% reduction of eGFR, ESRD, and the occurrence of major cardiocerebrovascular event. We used Maroni’s formula as a reference in our research to evaluate the applicability of DPIsUCR equation and prognosis difference in patients with different DPI levels were further analyzed. In application cohort, we retrospectively collected the clinical data from patients diagnosed with DKD in Guangdong Provincial People's Hospital from January 2015 to September 2022 and NHANES cohort from 1999 to 2018 respectively. The endpoint events of different DPI levels were analyzed using the propensity score matching method to further confirm the clinical utility of this equation.

Results

The DPIsUCR equation is more distinguishable in CKD stage 3 patients and DKD cohort, and it’s well correlated with the DPI evaluated by Maroni’s formula among CKD stage 1~2 and stage 4 patients as well as in DKD patients.
Kaplan-Meier analysis showed patients with low DPI (<0.8 g/kg. d) has a better survival prognosis than high DPI (>1.0 g/kg. d) evaluated by DPIsUCR equation or Maroni’s formula, especially in CKD stage 3~4 patients.
Analysis of data from 820 eligible valid cases in the DKD cohort revealed that, low protein diet improved outcomes.
Also, analysis of data from 1723 eligible valid cases in the NHANES cohort revealed that, low protein diet improved outcomes and delay time to endpoint, especially in advanced CKD stage 3~4 patients. In the CKD cohort with diabetes history, restricted protein diets improved outcomes, and although there was a trend, there was no significant difference in results.

Conclusion

The DPIsUCR equation is applicable in CKD stage 1~4 patients and DKD cohorts. Patients with DPIsUCR≤ 1.0 g/kg. d generally have a better prognosis.Our study reveals DPIsUCR equation identify patients with LPD effectively in CKD and NHANES cohort.

Funding

  • Private Foundation Support