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Higher protein intake is associated with increased risk for incident end-stage renal disease among blacks with diabetes in the Southern Community Cohort Study.
Nutr Metab Cardiovasc Dis 2016; 26(12):1079-1087NM

Abstract

BACKGROUND AND AIMS

Diabetes, a risk factor for end-stage renal disease (ESRD), is associated with impaired protein metabolism. We investigated whether protein intake is associated with ESRD and whether the risk is higher among blacks with diabetes.

METHODS AND RESULTS

We conducted a nested case-control study of ESRD within the Southern Community Cohort Study, a prospective study of low-income blacks and whites in the southeastern US (2002-2009). Through 2012, 1057 incident ESRD cases were identified by linkage with the United States Renal Data System and matched to 3198 controls by age, sex, and race. Dietary intakes were assessed from a validated food frequency questionnaire at baseline. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed from logistic regression models that included matching variables, BMI, education, income, hypertension, total energy intake, and percent energy from saturated and polyunsaturated fatty acids. Mean (±SD) daily energy intake from protein was higher among ESRD cases than controls (15.7 ± 3.3 vs. 15.1 ± 3.1%, P < 0.0001). For a 1% increase in percent energy intake from protein, the adjusted ORs (95% CIs) for ESRD were 1.06 (1.02-1.10) for blacks with diabetes, 1.02 (0.98-1.06) for blacks without diabetes, 0.99 (0.90-1.09) for whites with diabetes and 0.94 (0.84-1.06) for whites without diabetes. Protein intake in g/kg/day was also associated with ESRD (4th vs. 1st quartile OR = 1.76; 95% CI: 1.17-2.65).

CONCLUSION

Our results raise the possibility that among blacks with diabetes, increased dietary protein is associated with increased incidence of ESRD. Studies on how protein intake and metabolism affect ESRD are needed.

Authors+Show Affiliations

Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Center for Kidney Disease, Nashville, TN 37232, USA.Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Center for Kidney Disease, Nashville, TN 37232, USA.Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, USA; International Epidemiology Institute, Rockville, MD 20850, USA.Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Vanderbilt Center for Kidney Disease, Nashville, TN 37232, USA.Vanderbilt Center for Kidney Disease, Nashville, TN 37232, USA; Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, USA.Vanderbilt Center for Kidney Disease, Nashville, TN 37232, USA; Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, USA. Electronic address: edmond.kabagambe@vanderbilt.edu.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, American Recovery and Reinvestment Act
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

27562875

Citation

Malhotra, R, et al. "Higher Protein Intake Is Associated With Increased Risk for Incident End-stage Renal Disease Among Blacks With Diabetes in the Southern Community Cohort Study." Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, vol. 26, no. 12, 2016, pp. 1079-1087.
Malhotra R, Cavanaugh KL, Blot WJ, et al. Higher protein intake is associated with increased risk for incident end-stage renal disease among blacks with diabetes in the Southern Community Cohort Study. Nutr Metab Cardiovasc Dis. 2016;26(12):1079-1087.
Malhotra, R., Cavanaugh, K. L., Blot, W. J., Ikizler, T. A., Lipworth, L., & Kabagambe, E. K. (2016). Higher protein intake is associated with increased risk for incident end-stage renal disease among blacks with diabetes in the Southern Community Cohort Study. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 26(12), pp. 1079-1087. doi:10.1016/j.numecd.2016.07.009.
Malhotra R, et al. Higher Protein Intake Is Associated With Increased Risk for Incident End-stage Renal Disease Among Blacks With Diabetes in the Southern Community Cohort Study. Nutr Metab Cardiovasc Dis. 2016;26(12):1079-1087. PubMed PMID: 27562875.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Higher protein intake is associated with increased risk for incident end-stage renal disease among blacks with diabetes in the Southern Community Cohort Study. AU - Malhotra,R, AU - Cavanaugh,K L, AU - Blot,W J, AU - Ikizler,T A, AU - Lipworth,L, AU - Kabagambe,E K, Y1 - 2016/07/21/ PY - 2016/02/18/received PY - 2016/07/15/revised PY - 2016/07/17/accepted PY - 2016/8/27/pubmed PY - 2017/8/2/medline PY - 2016/8/27/entrez KW - Blacks KW - Cohort KW - Diabetes KW - ESRD KW - Protein KW - Renal disease SP - 1079 EP - 1087 JF - Nutrition, metabolism, and cardiovascular diseases : NMCD JO - Nutr Metab Cardiovasc Dis VL - 26 IS - 12 N2 - BACKGROUND AND AIMS: Diabetes, a risk factor for end-stage renal disease (ESRD), is associated with impaired protein metabolism. We investigated whether protein intake is associated with ESRD and whether the risk is higher among blacks with diabetes. METHODS AND RESULTS: We conducted a nested case-control study of ESRD within the Southern Community Cohort Study, a prospective study of low-income blacks and whites in the southeastern US (2002-2009). Through 2012, 1057 incident ESRD cases were identified by linkage with the United States Renal Data System and matched to 3198 controls by age, sex, and race. Dietary intakes were assessed from a validated food frequency questionnaire at baseline. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed from logistic regression models that included matching variables, BMI, education, income, hypertension, total energy intake, and percent energy from saturated and polyunsaturated fatty acids. Mean (±SD) daily energy intake from protein was higher among ESRD cases than controls (15.7 ± 3.3 vs. 15.1 ± 3.1%, P < 0.0001). For a 1% increase in percent energy intake from protein, the adjusted ORs (95% CIs) for ESRD were 1.06 (1.02-1.10) for blacks with diabetes, 1.02 (0.98-1.06) for blacks without diabetes, 0.99 (0.90-1.09) for whites with diabetes and 0.94 (0.84-1.06) for whites without diabetes. Protein intake in g/kg/day was also associated with ESRD (4th vs. 1st quartile OR = 1.76; 95% CI: 1.17-2.65). CONCLUSION: Our results raise the possibility that among blacks with diabetes, increased dietary protein is associated with increased incidence of ESRD. Studies on how protein intake and metabolism affect ESRD are needed. SN - 1590-3729 UR - https://www.unboundmedicine.com/medline/citation/27562875/Higher_protein_intake_is_associated_with_increased_risk_for_incident_end_stage_renal_disease_among_blacks_with_diabetes_in_the_Southern_Community_Cohort_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0939-4753(16)30116-8 DB - PRIME DP - Unbound Medicine ER -