Journal
NUTRITION
Volume 95, Issue -, Pages -Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.nut.2021.111564
Keywords
Dietary protein intake; Hemodialysis; Mortality; Cardiovascular mortality; Cohort study
Categories
Funding
- Clinical Research Program of Nanfang Hospital, Southern Medical University [2019CR021]
- Key Clinical Research Program of Southern Medical Uni-versity [LC2019ZD005]
- National Science and Technology Major Project of China [2020ZX09201017]
- National Key Technology Support Program of China [2015BAI12B07]
- High-level Matching Funds of Nanfang Hospital [2014070]
- Science and Technology Planning Project of Guangzhou [2014Y2-00098]
- National Natural Science Foundation of China [81730019]
- Outstanding Youths Development Scheme of Nanfang Hospital, Southern Medical University [2017J009]
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This study explored the relationship between dietary protein intake (DPI) and mortality in Chinese MHD patients. It found that a DPI of 1.0 to < 1.4 g/kg IBW/d was associated with lower risks of all-cause and CV mortality. The study also identified a stronger positive association between DPI and all-cause mortality in women compared to men.
Objectives: The association between dietary protein intake (DPI) and mortality in people receiving maintenance hemodialysis (MHD) remains uncertain. We aimed to explore the relationship of DPI with all-cause and cardiovascular (CV) mortality, and to examine the possible modifiers for the associations, in Chinese MHD patients.Methods: This multicenter prospective cohort study was conducted in eight outpatient dialysis centers in South China. We enrolled 1044 MHD patients in 2014 and 2015. The DPI was assessed using a 3-d 24-h dietary recall. Using Cox proportional hazard models, we estimated the hazard ratios (HRs) with their corresponding 95% confidence intervals (CIs) for all analyzed end points.Results: During a median follow-up of 45 mo, there were 354 (33.9%) deaths, 210 of which were CV related. Compared with patients with a DPI of 1.0 to < 1.4 g/kg ideal body weight (IBW)/d, a significantly higher risk of all-cause mortality was found in those with a DPI < 1.0 g/kg IBW/d (adjusted HR, 1.84; 95% CI, 1.42-2.38) or > 1.4 g/kg IBW/d (adjusted HR, 1.49; 95% CI, 1.00-2.22). Similar trends were found for CV mortality. Moreover, we found a significantly stronger positive association between DPI (> 1.4 versus 1.0 to < 1.4 g/kg IBW/ d) and all-cause mortality in women (adjusted HR, 2.05; 95% CI, 1.00-4.22) than in men (adjusted HR, 0.89; 95% CI, 0.49-1.63; P for interaction = 0.0487).Conclusion: In Chinese MHD patients, a DPI of 1.0 to < 1.4 g/kg IBW/d was associated with lower risks of all cause and CV mortality.(c) 2021 Elsevier Inc. All rights reserved.
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