Nutrients. 2019;11(1):nu11010121.
Dietary Protein Intake, Protein Energy Wasting, and the Progression of Chronic Kidney Disease: Analysis from the KNOW-CKD Study.
제1저자 이성우 · 교신저자 오국환
소속 (10)
- 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.
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.
Keywords
chronic kidney diseasedietary protein intakenutritionprogressionprotein energy wasting
Figures
그림 출처: PubMed Central 공개 논문 (PMC6356719)
Conflict of interest statement
The authors declare no conflict of interest.
그 밖의 정보
- 출판 형태
- Journal Article
- 저널
- Nutrients · eISSN 2072-6643
- 전자 출판
- 2019-01-08
- MeSH
- Creatinine / blood · Cross-Sectional Studies · Diet* · Dietary Proteins / administration & dosage · Disease Progression · Feeding Behavior* · Female · Glomerular Filtration Rate · Humans · Kaplan-Meier Estimate · Kidney / pathology / physiopathology · Longitudinal Studies · Male · Middle Aged · Odds Ratio · Proportional Hazards Models · Prospective Studies · Protein-Energy Malnutrition / complications · Renal Dialysis* · Renal Insufficiency · Renal Insufficiency, Chronic / blood / physiopathology / therapy
- Substances
- Dietary Proteins · Creatinine
- 연구비
- Korea Centers for Disease Control & Prevention 2011E3300300, 2012E3301100, 2013E3301600, 2013E3301601, 2013E3301602, and 2016E3300200
- 참고문헌
- 43편