Higher protein intake may be linked to lower mortality in some older adults with CKD
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Key takeaways:
- Patients with higher total protein intake had a lower risk for mortality.
- Hazard ratios were lower in patients without CKD than in those with the condition.
Higher intake of total, animal and plant protein may be linked to lower mortality in older adults with mild or moderate chronic kidney disease, according to a cohort study.
“The fact that associations with mortality were comparable for plant and animal protein was perhaps surprising, given that plant protein might have a lower impact on remaining nephrons, mitigate glomerular hyperfiltration, reduce proteinuria, preserve kidney function and protect from metabolic derangements,” Adrián Carballo-Casla, PhD, of the Karolinska Institutet and Stockholm University, told Healio. “On the other hand, animal-based protein has higher biological value and anabolic potential, so its intake may translate into improved nutritional status.”
To determine the associations of varying intakes on all-cause mortality in patients with CKD vs. those without the condition, researchers evaluated 8,543 adults aged 60 years or older, and recorded 14,399 observations. Patients were community-dwelling adults recruited between 2001 and 2017 from the Study on Cardiovascular Health, Nutrition and Frailty in Older Adults in Spain 1 and 2, and the Swedish National Study on Aging and Care in Kungsholmen.
Patients were followed from 2021 to 2024, and data were analyzed from 2023 to 2024.
Carballo-Casla and colleagues measured cumulative protein intake, estimated by diet histories and food surveys, as the exposure. Main outcome was 10-year all-cause mortality, determined with national death registers. During follow-up, 1,468 patients died.
According to the findings, patients with higher total protein intake had a lower risk for mortality. Adjusted hazard ratio for 1 g/kg/d vs. 0.80 g/kg/d was 0.88, data showed, indicating a relationship between protein and survival. Similar ties were found for plant and animal protein, with HRs of 0.80 and 0.88 per 0.20-g/kg/d increment, respectively.
Hazard ratios were lower in patients without CKD than in those with the condition.
“These findings suggest that the benefits of proteins may outweigh the downsides in older adults with mild or moderate CKD, in whom disease progression may play a more limited role in survival,” Carballo-Casla said. “Accordingly, it may not be warranted to advise older adults with mild CKD to avoid high protein intake (>1.30 g/kg/d), and to those with moderate CKD to restrict protein intake to 0.60 [g/kg/d] to 0.80 g/kg/d.”
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