Kwon Yu-Jin, Lee Hye Sun, Park Go Eun, Kim Hyung-Mi, Lee Jung Joo, Kim Woo Jeong, Lee Ji-Won
Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, South Korea.
Front Nutr. 2022 Apr 4;9:850109. doi: 10.3389/fnut.2022.850109. eCollection 2022.
Over the past decades, the optimum protein intake for patients with chronic kidney disease (CKD) has been an important, controversial issue. Dietary protein restriction has been commonly recommended for patients with CKD for preserving kidney function. However, evidence of the associations between long-term protein intake and mortality is not consistent in patients with CKD. Therefore, we aimed to examine the associations between total protein intake and all-cause mortality in Korean adults with CKD.
From three sub-cohorts of the Korean Genome and Epidemiology Study (KoGES) starting from 2001, total 3,892 participants with eGFR < 60 mL/min/1.73 m (CKD stage 3-5) were included in this study. Dietary data were collected using food-frequency questionnaires at baseline. Deaths were followed from 2001 to 2019. Cox proportional hazards regression model was used to evaluate the association between protein intake and all-cause mortality.
During a median follow-up (min-max) of 11.1 years (0.3-15.1), 602 deaths due to all causes of mortality were documented. After adjustment for covariates, higher total protein intake was not associated with all-cause mortality [highest vs. lowest quintile of total protein intake (g/kg/day) and proportion (%) (Q5 vs. Q1), HR = 1.14 (0.75-1.72), and HR = 0.87 (0.67-1.13)] in CKD stage 3-5 patients.
Dietary protein intake was not associated with mortality from all causes in patients with CKD. Further research is needed to establish optimal protein intake levels and examine the impact of the dietary source of protein on various health outcomes and mortality in CKD.
在过去几十年中，慢性肾脏病（CKD）患者的最佳蛋白质摄入量一直是一个重要且存在争议的问题。饮食蛋白质限制通常被推荐给CKD患者以保护肾功能。然而，长期蛋白质摄入量与死亡率之间关联的证据在CKD患者中并不一致。因此，我们旨在研究韩国成年CKD患者的总蛋白质摄入量与全因死亡率之间的关联。
从2001年开始的韩国基因组与流行病学研究（KoGES）的三个亚队列中，共有3892名估算肾小球滤过率（eGFR）<60 mL/min/1.73 m²（CKD 3 - 5期）的参与者纳入本研究。在基线时使用食物频率问卷收集饮食数据。随访时间为2001年至2019年。采用Cox比例风险回归模型评估蛋白质摄入量与全因死亡率之间的关联。
在中位随访时间（最小值 - 最大值）11.1年（0.3 - 15.1）期间，记录了602例各种原因导致的死亡。在对协变量进行调整后，较高的总蛋白质摄入量与CKD 3 - 5期患者的全因死亡率无关[总蛋白质摄入量（g/kg/天）和比例（%）的最高五分位数与最低五分位数相比（Q5 vs. Q1），风险比（HR） = 1.14（0.75 - 1.72），以及HR = 0.87（0.67 - 1.13）]。
CKD患者的饮食蛋白质摄入量与全因死亡率无关。需要进一步研究以确定最佳蛋白质摄入量水平，并研究蛋白质饮食来源对CKD患者各种健康结局和死亡率的影响。
