Higher dietary protein intake linked to increased mortality, ESRD risk for patients with CKD

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Hisham Abu Farsak

WASHINGTON — Data presented at ASN Kidney Week suggested higher dietary protein intake is associated with increased risk for all-cause mortality and ESRD in patients with chronic kidney disease, with researchers also observing a decline in dietary protein intake with progressive loss of kidney function.

“Protein energy wasting is common in patients with CKD, but the trajectory of dietary protein intake in patients with worsening CKD and the outcomes associated with dietary protein intake in this population are unclear,” Hisham Abu Farsak, MD, of the University of Tennessee Health Science Center, and colleagues wrote in a poster abstract.

Using a median of seven urine samples from 605 patients with CKD (mean eGFR at baseline, 37 mL/min/1.73m²), researchers estimated daily excretion of urea nitrogen to calculate dietary protein intake. Patients were followed for a mean of 3.8 years. During this time, 210 patients died and 121 developed ESRD. After adjusting for demographic characteristics, smoking status, eGFR and comorbidities, researchers determined higher baseline dietary protein intake was associated with both increased mortality and ESRD risk (adjusted hazard ratios of 1.015 and 1.023, respectively, for 1 gm/kg of body weight per day higher dietary protein intake).

In addition, researchers observed a linear decrease in dietary protein intake of 0.92 gm/kg of body weight per day for every 15 mL/min/1.73m² lower eGFR, with a steeper decline seen with eGFR below 20 ml/min/1.73m².

“Since higher dietary protein intake was associated with higher mortality, nephrologists should recommend restricted intakes for patients with CKD stages 3 to 5,” Abu Farsak told Healio Nephrology in an on-site interview. He recommended a daily intake of less than 0.8 gm/kg of body weight. – by Melissa J. Webb

Reference:

Abu Farsak H, et al. Abstract FR-PO268. Presented at: ASN Kidney Week; Nov. 7-10, 2019; Washington, D.C.

Disclosure: Abu Farsak reports no relevant financial disclosures.