Renal Division, Department of Medicine, Peking University First Hospital, Beijing, People's Republic of China.
Institute of Nephrology, Peking University, Beijing, People's Republic of China.
Br J Nutr. 2019 Nov 14;122(9):996-1005. doi: 10.1017/S0007114519001764.
Higher fibre intake reduced all-cause and cardiovascular mortality among healthy population, but such data in dialysis patients are limited. We aimed to examine these associations in patients on peritoneal dialysis (PD). This single-centre prospective cohort study enrolled 881 incident PD patients between October 2002 and August 2014. All patients were followed until death, transfer to haemodialysis, renal transplantation or until being censored in June 2018. Demographic data were collected at baseline. Biochemical, dietary and nutrition data were examined at baseline and thereafter at regular intervals to calculate the average values throughout the study. The outcomes were defined as all-cause and cardiovascular death. Cox proportional regression models were applied to explore the relationship between fibre intake and outcomes. Participants with higher fibre intake were more likely to be younger, male and have better residual renal function and serum lipids at baseline. They were prone to maintain better nutrient status, higher blood pressure and lower inflammatory status at baseline and afterwards. Neither baseline nor time-averaged fibre intake did show protective effects on all-cause mortality after multivariate adjustment in the whole cohort. Among non-diabetic PD patients, an independent association between fibre intake and all-cause mortality was found, in which each 1 g/d increase in time-averaged fibre intake correlated to 13 % of reduction in all-cause mortality. We did not observe any benefits of fibre intake in the CVD mortality for both whole cohort and subgroups. The present study revealed that higher dietary fibre intake appeared to have a protective effect on all-cause mortality in non-diabetic PD patients, which suggest that PD patients should be encouraged to eat a diet rich in fibres.
膳食纤维摄入量较高可降低健康人群的全因死亡率和心血管死亡率，但透析患者的相关数据有限。我们旨在研究腹膜透析（PD）患者中这些相关性。这项单中心前瞻性队列研究纳入了 2002 年 10 月至 2014 年 8 月期间的 881 例新诊断 PD 患者。所有患者随访至死亡、转血液透析、肾移植或 2018 年 6 月截尾。基线时收集人口统计学数据。基线时和此后定期检查生化、饮食和营养数据，以计算整个研究期间的平均值。结局定义为全因死亡和心血管死亡。应用 Cox 比例风险回归模型来探讨膳食纤维摄入量与结局之间的关系。膳食纤维摄入量较高的患者更可能在基线时年龄较小、为男性、且残余肾功能和血清脂质更好。他们在基线和之后更倾向于维持更好的营养状况、更高的血压和更低的炎症状态。在整个队列的多变量调整后，基线或时间平均膳食纤维摄入量均未显示对全因死亡率有保护作用。在非糖尿病 PD 患者中，发现膳食纤维摄入量与全因死亡率之间存在独立相关性，其中时间平均膳食纤维摄入量每增加 1 g/d，全因死亡率降低 13%。我们未观察到膳食纤维摄入量对全因死亡率和心血管死亡率有任何获益。本研究表明，较高的膳食纤维摄入量似乎对非糖尿病 PD 患者的全因死亡率有保护作用，这表明应鼓励 PD 患者摄入富含纤维的饮食。
