Abstract: TH-PO920
Dietary Potassium and Fiber Intake and Health-Related Quality of Life in a Multicenter Prospective Hemodialysis Cohort
Session Information
- Health Maintenance, Nutrition, Metabolism - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Narasaki, Yoko, University of California Irvine School of Medicine, Irvine, California, United States
- Kalantar-Zadeh, Kamyar, Harbor-UCLA Medical Center, Torrance, California, United States
- Han, Seung Hyeok, Yonsei University, Seoul, Seoul, Korea (the Republic of)
- Chang, Tae ik, National Health Insurance Service, Wonju, Gangwon-do, Korea (the Republic of)
- Kalantar, Diana Sunhee, University of California Irvine School of Medicine, Irvine, California, United States
- Nakata, Tracy, University of California Irvine School of Medicine, Irvine, California, United States
- Nguyen, Danh V., University of California Irvine School of Medicine, Irvine, California, United States
- Rhee, Connie, University of California Irvine School of Medicine, Irvine, California, United States
Background
Guidelines recommend dietary potassium (K) restriction in ESKD patients due to concerns about hyperkalemic CV events. However, K-rich foods tend to be from heart-healthy sources with high fiber content. We examined the relationship of dietary K and fiber intake with health-related quality of life (HRQOL) in a prospective HD cohort.
Methods
Among 583 HD patients from the multicenter NIH MADRAD cohort recruited across 16 outpatient dialysis clinics, information regarding dietary K intake was obtained using protocolized Food Frequency Questionnaires (FFQs) and HRQOL was assessed using Short Form 36 surveys administered over 10/2011-9/2022. We examined associations of dietary K intake categorized as tertiles with HRQOL using linear mixed effect models. We also examined different pairings of dietary K and fiber intake across four exposure groups (low K/low fiber, low K/high fiber, high K/low fiber, high K/high fiber) with HRQOL.
Results
In expanded case-mix + laboratory analyses, the highest tertile of absolute dietary K intake was associated with better trajectory of physical functioning and physical component scores (PCS) over time (ref: lowest tertile): Estimates (β) (95%CI) +8.33 (+3.59, +13.08) and +1.48 (-0.13, +3.09) (Fig A). Similarly, the highest dietary K tertile in residual models were associated with better trajectory of PCS and energy/fatigue (Fig B). In adjusted analyses of pairings of dietary K/fiber intake in the absolute (Fig C) and residual models (Fig D), patients with high K/high fiber intake had better physical functioning and PCS vs. those with low K/low fiber intake.
Conclusion
In a prospective HD cohort, higher dietary K and fiber intake were associated with better HRQOL, particularly related to physical function domains. Further studies are needed to determine the causal mechanisms linking dietary intake and physical function in this population.
Funding
- NIDDK Support