Abstract: FR-PO0133
Association Analysis of Protein Intake and Renal Recovery in Patients with Acute Kidney Disease (AKD)
Session Information
- AKI: Epidemiology and Clinical Trials
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Lertsuttimetta, Thana, Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Peerapornratana, Sadudee, Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Srisawat, Nattachai, Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Lumlertgul, Nuttha, Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Avihingsanon, Yingyos, Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Eiam-Ong, Somchai, Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Kittiskulnam, Piyawan, Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Background
Low protein diet, 0.6-0.8 g/kg/day, demonstrates a benefit for slowing chronic kidney disease (CKD) progression whereas high protein diet of ≥1.0-1.2 g/kg/day has been recommended in the settings of acute kidney injury (AKI). However, an optimal daily protein intake (DPI) for patients with acute kidney disease (AKD), which represents a transition from AKI to CKD, is not well-established.
Methods
We extracted a longitudinal data of patients at post-AKI clinic using electronic medical records (n=303). All AKD patients who had regular visits within 90-180 days after the onset of AKI were identified. DPI was estimated using normalized protein nitrogen appearance (nPNA) from 24-hour urine collection. Cox proportional hazard models were performed to examine the associations between protein intake and outcomes. The primary outcome was a relationship between DPI and recovery of kidney function. The association between protein intake and dialysis-dependence was also assessed.
Results
A total of 144 patients with AKD were included in the final analysis. The mean age of the participants was 61.8±16.8 years with 60.4% male. Mean baseline serum creatinine was 1.2±0.5 mg/dL with 29.9% of participants had pre-existing CKD. Approximately three-fourths of patients experienced severe AKI (31.2% had sepsis), of whom 54.2% required acute dialysis. During a mean follow up of 116.5 days after onset of AKI, 63 patients (43.8%) had complete reversal. The mean estimated DPI was 0.8±0.4 g/kg/day. The amount of protein intake was not associated with renal recovery in the unadjusted analysis (all p>0.05). However, protein intake of more than 1.2 g/kg/day was significantly associated with worsening of renal function (HR 2.5; 95%CI 1.0-5.9, p=0.04) after adjusting for age, pre-existing CKD, causes of AKI, and serum albumin. In the subgroup analysis of patients without pre-existing kidney disease (n=101), DPI was also not correlated with developing of the new onset of CKD (p=0.80).
Conclusion
DPI has not been associated with renal recovery among patients with AKD. However, high protein intake appears to be correlated with deterioration of renal function during AKD in multivariable Cox proportional hazard model. Future randomized controlled trials are warranted to verify these findings.