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Dietary Protein Intake, Protein Energy Wasting, and the Progression of Chronic Kidney Disease: Analysis from the KNOW-CKD Study.
Nutrients. 2019 Jan 08; 11(1)N

Abstract

Studies on the effect of dietary protein intake (DPI) on chronic kidney disease (CKD) progression, along with the potential hazard of protein-energy wasting (PEW), are scarce. We evaluated the association between DPI and kidney function both cross-sectionally and longitudinally, particularly emphasizing the role of PEW, in a large-scale, observational, multicenter, prospective study. We enrolled 1572 patients with non-dialysis CKD between 2011 and 2016. CKD progression was defined by a >50% estimated glomerular filtration rate (eGFR) decrease, serum creatinine doubling, or dialysis initiation. A Cox proportional hazard regression analysis was conducted. During the mean follow-up period of 41.6 months, CKD progression was observed in 296 patients. Cross-sectionally, increased DPI was significantly associated with increased eGFR. Similarly, increased DPI tertile was significantly associated with increased renal survival in a Kaplan⁻Meier curve analysis. In the multivariate Cox proportional hazard regression analysis, the statistical significance of the DPI tertile group in CKD progression was lost when PEW-related variables were added as covariates. In penalized spline curve analysis, the adjusted odds ratio of PEW significantly increased as DPI decreased. DPI, per se was not a major determinant of CKD progression. An intimate association between reduced DPI and PEW may be a more important predictor of CKD progression than DPI.

Authors+Show Affiliations

Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University, Seoul 01830, Korea. neplsw@gmail.com.Department of Internal Medicine, College of Medicine, Catholic University of Korea, Seoul 06591, Korea. kimcmc@catholic.ac.kr.Department of Internal Medicine, Inje University, Busan Paik Hospital, Busan 47392, Korea. yeonghnl@inje.ac.kr.Department of Internal Medicine, Gachon University, Gil Hospital, Incheon 21565, Korea. jwkpsj79@hanmail.net.Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03082, Korea. suepark@snu.ac.kr. Cancer Research Institute, Seoul National University, Seoul 08826, Korea. suepark@snu.ac.kr. Department of Biomedical Science, Seoul National University Graduate School, Seoul 03081, Korea. suepark@snu.ac.kr.Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul 03722, Korea. khchoi6@yumc.yonsei.ac.kr.Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Korea. curie@snu.ac.kr.Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Korea. ohchris@hanmail.net.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30626166

Citation

Lee, Sung Woo, et al. "Dietary Protein Intake, Protein Energy Wasting, and the Progression of Chronic Kidney Disease: Analysis From the KNOW-CKD Study." Nutrients, vol. 11, no. 1, 2019.
Lee SW, Kim YS, Kim YH, et al. Dietary Protein Intake, Protein Energy Wasting, and the Progression of Chronic Kidney Disease: Analysis from the KNOW-CKD Study. Nutrients. 2019;11(1).
Lee, S. W., Kim, Y. S., Kim, Y. H., Chung, W., Park, S. K., Choi, K. H., Ahn, C., & Oh, K. H. (2019). Dietary Protein Intake, Protein Energy Wasting, and the Progression of Chronic Kidney Disease: Analysis from the KNOW-CKD Study. Nutrients, 11(1). https://doi.org/10.3390/nu11010121
Lee SW, et al. Dietary Protein Intake, Protein Energy Wasting, and the Progression of Chronic Kidney Disease: Analysis From the KNOW-CKD Study. Nutrients. 2019 Jan 8;11(1) PubMed PMID: 30626166.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary Protein Intake, Protein Energy Wasting, and the Progression of Chronic Kidney Disease: Analysis from the KNOW-CKD Study. AU - Lee,Sung Woo, AU - Kim,Yong-Soo, AU - Kim,Yeong Hoon, AU - Chung,Wookyung, AU - Park,Sue K, AU - Choi,Kyu Hun, AU - Ahn,Curie, AU - Oh,Kook-Hwan, Y1 - 2019/01/08/ PY - 2018/12/03/received PY - 2018/12/11/revised PY - 2019/01/04/accepted PY - 2019/1/11/entrez PY - 2019/1/11/pubmed PY - 2019/3/21/medline KW - chronic kidney disease KW - dietary protein intake KW - nutrition KW - progression KW - protein energy wasting JF - Nutrients JO - Nutrients VL - 11 IS - 1 N2 - Studies on the effect of dietary protein intake (DPI) on chronic kidney disease (CKD) progression, along with the potential hazard of protein-energy wasting (PEW), are scarce. We evaluated the association between DPI and kidney function both cross-sectionally and longitudinally, particularly emphasizing the role of PEW, in a large-scale, observational, multicenter, prospective study. We enrolled 1572 patients with non-dialysis CKD between 2011 and 2016. CKD progression was defined by a >50% estimated glomerular filtration rate (eGFR) decrease, serum creatinine doubling, or dialysis initiation. A Cox proportional hazard regression analysis was conducted. During the mean follow-up period of 41.6 months, CKD progression was observed in 296 patients. Cross-sectionally, increased DPI was significantly associated with increased eGFR. Similarly, increased DPI tertile was significantly associated with increased renal survival in a Kaplan⁻Meier curve analysis. In the multivariate Cox proportional hazard regression analysis, the statistical significance of the DPI tertile group in CKD progression was lost when PEW-related variables were added as covariates. In penalized spline curve analysis, the adjusted odds ratio of PEW significantly increased as DPI decreased. DPI, per se was not a major determinant of CKD progression. An intimate association between reduced DPI and PEW may be a more important predictor of CKD progression than DPI. SN - 2072-6643 UR - https://www.unboundmedicine.com/medline/citation/30626166/Dietary_Protein_Intake_Protein_Energy_Wasting_and_the_Progression_of_Chronic_Kidney_Disease:_Analysis_from_the_KNOW_CKD_Study_ DB - PRIME DP - Unbound Medicine ER -