Yu-Jin Kwon1, Kyongmin Park2,3, Jun-Hyuk Lee4,5. 1. Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, 16995, Republic of Korea. 2. Department of Family Medicine, Hanyang University College of Medicine, Seoul, 04763, Republic of Korea. 3. Department of Medicine, Graduate School of Hanyang University, Seoul, 04763, Republic of Korea. 4. Department of Medicine, Graduate School of Hanyang University, Seoul, 04763, Republic of Korea. swpapa@eulji.ac.kr. 5. Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, 68 Hangeulbiseok-ro, Nowon-gu, Seoul, 01830, Republic of Korea. swpapa@eulji.ac.kr.
Abstract
PURPOSE: Dietary protein intake can modulate renal health. However, the effect of dietary protein restriction on kidney function in the general population remains unclear. This study aimed to examine the association between total protein intake and new-onset chronic kidney disease (CKD) in Korean adults. METHODS: We included 7339 participants from the Korean Genome and Epidemiology Study. Participants were divided into low-protein diet (LPD, < 0.8 g/kg/day), normal-protein diet (NPD, 0.8-1.3 g/kg/day), and high-protein diet (HPD, > 1.3 g/kg/day) groups. New-onset CKD was defined as two consecutive events of estimated glomerular filtration rate < 60 mL/min/1.73 m2. Multivariable Cox hazard regression analysis was conducted to examine the association of total protein intake with new-onset CKD. Subgroup analyses according to diabetes mellitus (DM) status were performed. We performed the same analyses by dividing participants into total protein, plant protein, and animal protein intake tertiles. RESULTS: During a median follow-up of 13.7 years, 633 (8.7%) participants newly developed CKD. The fully adjusted hazard ratios (HR) with 95% confidence interval (CI) for incident CKD of the LPD and HPD groups compared with the NPD group were 1.49 (1.18-1.87) and 0.63 (0.45-0.87), respectively. The HR (95% CI) of the highest tertile group of plant protein intake for incident CKD was 0.72 (0.54-0.93), compared with that of the lowest tertile group. Similar trends were observed only in the non-DM subgroup, not in the DM subgroup. CONCLUSION: Protein intake, especially plant proteins, was negatively associated with the incidence of new-onset CKD in middle-aged and older Korean adults.
PURPOSE: Dietary protein intake can modulate renal health. However, the effect of dietary protein restriction on kidney function in the general population remains unclear. This study aimed to examine the association between total protein intake and new-onset chronic kidney disease (CKD) in Korean adults. METHODS: We included 7339 participants from the Korean Genome and Epidemiology Study. Participants were divided into low-protein diet (LPD, < 0.8 g/kg/day), normal-protein diet (NPD, 0.8-1.3 g/kg/day), and high-protein diet (HPD, > 1.3 g/kg/day) groups. New-onset CKD was defined as two consecutive events of estimated glomerular filtration rate < 60 mL/min/1.73 m2. Multivariable Cox hazard regression analysis was conducted to examine the association of total protein intake with new-onset CKD. Subgroup analyses according to diabetes mellitus (DM) status were performed. We performed the same analyses by dividing participants into total protein, plant protein, and animal protein intake tertiles. RESULTS: During a median follow-up of 13.7 years, 633 (8.7%) participants newly developed CKD. The fully adjusted hazard ratios (HR) with 95% confidence interval (CI) for incident CKD of the LPD and HPD groups compared with the NPD group were 1.49 (1.18-1.87) and 0.63 (0.45-0.87), respectively. The HR (95% CI) of the highest tertile group of plant protein intake for incident CKD was 0.72 (0.54-0.93), compared with that of the lowest tertile group. Similar trends were observed only in the non-DM subgroup, not in the DM subgroup. CONCLUSION: Protein intake, especially plant proteins, was negatively associated with the incidence of new-onset CKD in middle-aged and older Korean adults.
Authors: Kyle J Foreman; Neal Marquez; Andrew Dolgert; Kai Fukutaki; Nancy Fullman; Madeline McGaughey; Martin A Pletcher; Amanda E Smith; Kendrick Tang; Chun-Wei Yuan; Jonathan C Brown; Joseph Friedman; Jiawei He; Kyle R Heuton; Mollie Holmberg; Disha J Patel; Patrick Reidy; Austin Carter; Kelly Cercy; Abigail Chapin; Dirk Douwes-Schultz; Tahvi Frank; Falko Goettsch; Patrick Y Liu; Vishnu Nandakumar; Marissa B Reitsma; Vince Reuter; Nafis Sadat; Reed J D Sorensen; Vinay Srinivasan; Rachel L Updike; Hunter York; Alan D Lopez; Rafael Lozano; Stephen S Lim; Ali H Mokdad; Stein Emil Vollset; Christopher J L Murray Journal: Lancet Date: 2018-10-16 Impact factor: 79.321
Authors: Mingyang Song; Teresa T Fung; Frank B Hu; Walter C Willett; Valter D Longo; Andrew T Chan; Edward L Giovannucci Journal: JAMA Intern Med Date: 2016-10-01 Impact factor: 21.873