Xihui Liu1, Zhao Hu2, Xiao Xu3, Ziqian Li3, Yuan Chen3, Jie Dong4. 1. Department of Nephrology, Qilu Hospital of Shandong University, Jinan, China; Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health and Key Laboratory of Renal Disease, Ministry of Education, Beijing, China; Department of Nephrology, Linyi People's Hospital, Linyi, China. 2. Department of Nephrology, Qilu Hospital of Shandong University, Jinan, China. 3. Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health and Key Laboratory of Renal Disease, Ministry of Education, Beijing, China. 4. Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health and Key Laboratory of Renal Disease, Ministry of Education, Beijing, China. Electronic address: jie.dong@bjmu.edu.cn.
Abstract
BACKGROUND AND AIMS: Plant-based protein intake is associated with all-cause and/or cardiovascular disease (CVD) mortality in general population, but such data are scarce in dialysis patients. Thus, we examined the associations of plant-based protein-total protein ratio with all-cause and CVD mortality in patients on peritoneal dialysis (PD). METHODS AND RESULTS: The study enrolled 884 incident patients who started PD between October 2002 and August 2014. All demographic and laboratory data were recorded at baseline. Repeated measurements for laboratory and nutrition parameters were recorded at regular intervals and thus calculated as time-averaged values. Multivariable Cox regression models were used to estimate the hazard ratio (HR) of plant-based protein-total protein ratio and mortality based on baseline and time-averaged covariates, respectively. There were 437 (49%) patients died during a mean follow-up period of 45 months, of which 178 (40.8%) were due to CVD. Each 10% in increase in time-averaged plant-based protein-total protein ratio was associated with a reduction of 71% (95% CI, 90%-14%) and 89% (95% CI, 98%-29%) for all-cause and CVD mortality, respectively. Based on examination on interactive effects, we further found both baseline and time-averaged plant-based protein-total protein ratio were inversely associated with all-cause and CVD mortality in the subgroups of female, age ≥60 years, and albumin >35 g/L. CONCLUSIONS: The present study suggested that a diet with a higher plant-based protein-total protein ratio is associated with lower all-cause and CVD mortality in PD patients, and is more significant in female and elderly patients, and those without hypoalbuminemia.
BACKGROUND AND AIMS: Plant-based protein intake is associated with all-cause and/or cardiovascular disease (CVD) mortality in general population, but such data are scarce in dialysis patients. Thus, we examined the associations of plant-based protein-total protein ratio with all-cause and CVDmortality in patients on peritoneal dialysis (PD). METHODS AND RESULTS: The study enrolled 884 incident patients who started PD between October 2002 and August 2014. All demographic and laboratory data were recorded at baseline. Repeated measurements for laboratory and nutrition parameters were recorded at regular intervals and thus calculated as time-averaged values. Multivariable Cox regression models were used to estimate the hazard ratio (HR) of plant-based protein-total protein ratio and mortality based on baseline and time-averaged covariates, respectively. There were 437 (49%) patientsdied during a mean follow-up period of 45 months, of which 178 (40.8%) were due to CVD. Each 10% in increase in time-averaged plant-based protein-total protein ratio was associated with a reduction of 71% (95% CI, 90%-14%) and 89% (95% CI, 98%-29%) for all-cause and CVDmortality, respectively. Based on examination on interactive effects, we further found both baseline and time-averaged plant-based protein-total protein ratio were inversely associated with all-cause and CVDmortality in the subgroups of female, age ≥60 years, and albumin >35 g/L. CONCLUSIONS: The present study suggested that a diet with a higher plant-based protein-total protein ratio is associated with lower all-cause and CVDmortality in PD patients, and is more significant in female and elderly patients, and those without hypoalbuminemia.
Authors: Naya Huang; Huiyan Li; Li Fan; Qian Zhou; Dongying Fu; Lin Guo; Chunyan Yi; Xueqing Yu; Haiping Mao Journal: Front Med (Lausanne) Date: 2021-12-01