Dietary Protein Sources and Risk for Incident Chronic Kidney Disease

Results From the Atherosclerosis Risk in Communities (ARIC) Study

Bernhard Haring, Elizabeth Selvin, Menglu Liang, Josef Coresh, Morgan Grams, Natalia Petruski-Ivleva, Lyn M. Steffen, Casey Rebholz

Research output: Contribution to journalArticle

Abstract

Objective: Dietary protein restriction is recommended for patients with moderate to severe renal insufficiency. Long-term data on the relationship between dietary protein sources and risk for incident kidney disease in individuals with normal kidney function are largely missing. This study aimed to assess the association between dietary protein sources and incident chronic kidney disease (CKD). Design: Prospective cohort. Setting: Atherosclerosis Risk in Communities study participants from 4 US communities. Subjects: A total of 11,952 adults aged 44-66 years in 1987-1989 who were free of diabetes mellitus, cardiovascular disease, and had an estimated glomerular filtration rate (eGFR) ≥ 60 mL/minute/1.73 m2. Main Outcome Measure: A 66-item food frequency questionnaire was used to assess food intake. CKD stage 3 was defined as a decrease in eGFR of ≥25% from baseline resulting in an eGFR of less than 60 mL/minute/1.73 m2; CKD-related hospitalization; CKD-related death; or end-stage renal disease. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression. Results: During a median follow-up of 23 years, there were 2,632 incident CKD cases. Red and processed meat consumption was associated with increased CKD risk (HRQ5 vs. Q1: 1.23, 95% CI: 1.06-1.42, ptrend = 0.01). In contrast, higher dietary intake of nuts, legumes, and low-fat dairy products was associated with lower CKD risk (nuts: HRQ5 vs. Q1: 0.81, 95% CI: 0.72-0.92, ptrend <0.001; low-fat dairy products: HRQ5 vs. Q1: 0.75, 95% CI: 0.65-0.85, ptrend <0.001; legumes: HRQ5 vs. Q1: 0.83, 95% CI: 0.72-0.95, ptrend = 0.03). Conclusion: There were varied associations of specific dietary protein sources with risk of incident CKD; with red and processed meat being adversely associated with CKD risk; and nuts, low-fat dairy products, and legumes being protective against the development of CKD.

Original languageEnglish (US)
JournalJournal of Renal Nutrition
DOIs
StateAccepted/In press - 2016

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Dietary Proteins
Chronic Renal Insufficiency
Atherosclerosis
Nuts
Dairy Products
Confidence Intervals
Glomerular Filtration Rate
Fabaceae
Fats
Kidney Diseases
Chronic Kidney Failure
Renal Insufficiency
Diabetes Mellitus
Hospitalization
Cardiovascular Diseases
Eating
Outcome Assessment (Health Care)
Kidney
Food

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Nephrology

Cite this

@article{d5eca8837edb4504ac79f42ce97d7bce,
title = "Dietary Protein Sources and Risk for Incident Chronic Kidney Disease: Results From the Atherosclerosis Risk in Communities (ARIC) Study",
abstract = "Objective: Dietary protein restriction is recommended for patients with moderate to severe renal insufficiency. Long-term data on the relationship between dietary protein sources and risk for incident kidney disease in individuals with normal kidney function are largely missing. This study aimed to assess the association between dietary protein sources and incident chronic kidney disease (CKD). Design: Prospective cohort. Setting: Atherosclerosis Risk in Communities study participants from 4 US communities. Subjects: A total of 11,952 adults aged 44-66 years in 1987-1989 who were free of diabetes mellitus, cardiovascular disease, and had an estimated glomerular filtration rate (eGFR) ≥ 60 mL/minute/1.73 m2. Main Outcome Measure: A 66-item food frequency questionnaire was used to assess food intake. CKD stage 3 was defined as a decrease in eGFR of ≥25{\%} from baseline resulting in an eGFR of less than 60 mL/minute/1.73 m2; CKD-related hospitalization; CKD-related death; or end-stage renal disease. Hazard ratios (HRs) and 95{\%} confidence intervals (CIs) were estimated using Cox proportional hazards regression. Results: During a median follow-up of 23 years, there were 2,632 incident CKD cases. Red and processed meat consumption was associated with increased CKD risk (HRQ5 vs. Q1: 1.23, 95{\%} CI: 1.06-1.42, ptrend = 0.01). In contrast, higher dietary intake of nuts, legumes, and low-fat dairy products was associated with lower CKD risk (nuts: HRQ5 vs. Q1: 0.81, 95{\%} CI: 0.72-0.92, ptrend <0.001; low-fat dairy products: HRQ5 vs. Q1: 0.75, 95{\%} CI: 0.65-0.85, ptrend <0.001; legumes: HRQ5 vs. Q1: 0.83, 95{\%} CI: 0.72-0.95, ptrend = 0.03). Conclusion: There were varied associations of specific dietary protein sources with risk of incident CKD; with red and processed meat being adversely associated with CKD risk; and nuts, low-fat dairy products, and legumes being protective against the development of CKD.",
author = "Bernhard Haring and Elizabeth Selvin and Menglu Liang and Josef Coresh and Morgan Grams and Natalia Petruski-Ivleva and Steffen, {Lyn M.} and Casey Rebholz",
year = "2016",
doi = "10.1053/j.jrn.2016.11.004",
language = "English (US)",
journal = "Journal of Renal Nutrition",
issn = "1051-2276",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Dietary Protein Sources and Risk for Incident Chronic Kidney Disease

T2 - Results From the Atherosclerosis Risk in Communities (ARIC) Study

AU - Haring, Bernhard

AU - Selvin, Elizabeth

AU - Liang, Menglu

AU - Coresh, Josef

AU - Grams, Morgan

AU - Petruski-Ivleva, Natalia

AU - Steffen, Lyn M.

AU - Rebholz, Casey

PY - 2016

Y1 - 2016

N2 - Objective: Dietary protein restriction is recommended for patients with moderate to severe renal insufficiency. Long-term data on the relationship between dietary protein sources and risk for incident kidney disease in individuals with normal kidney function are largely missing. This study aimed to assess the association between dietary protein sources and incident chronic kidney disease (CKD). Design: Prospective cohort. Setting: Atherosclerosis Risk in Communities study participants from 4 US communities. Subjects: A total of 11,952 adults aged 44-66 years in 1987-1989 who were free of diabetes mellitus, cardiovascular disease, and had an estimated glomerular filtration rate (eGFR) ≥ 60 mL/minute/1.73 m2. Main Outcome Measure: A 66-item food frequency questionnaire was used to assess food intake. CKD stage 3 was defined as a decrease in eGFR of ≥25% from baseline resulting in an eGFR of less than 60 mL/minute/1.73 m2; CKD-related hospitalization; CKD-related death; or end-stage renal disease. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression. Results: During a median follow-up of 23 years, there were 2,632 incident CKD cases. Red and processed meat consumption was associated with increased CKD risk (HRQ5 vs. Q1: 1.23, 95% CI: 1.06-1.42, ptrend = 0.01). In contrast, higher dietary intake of nuts, legumes, and low-fat dairy products was associated with lower CKD risk (nuts: HRQ5 vs. Q1: 0.81, 95% CI: 0.72-0.92, ptrend <0.001; low-fat dairy products: HRQ5 vs. Q1: 0.75, 95% CI: 0.65-0.85, ptrend <0.001; legumes: HRQ5 vs. Q1: 0.83, 95% CI: 0.72-0.95, ptrend = 0.03). Conclusion: There were varied associations of specific dietary protein sources with risk of incident CKD; with red and processed meat being adversely associated with CKD risk; and nuts, low-fat dairy products, and legumes being protective against the development of CKD.

AB - Objective: Dietary protein restriction is recommended for patients with moderate to severe renal insufficiency. Long-term data on the relationship between dietary protein sources and risk for incident kidney disease in individuals with normal kidney function are largely missing. This study aimed to assess the association between dietary protein sources and incident chronic kidney disease (CKD). Design: Prospective cohort. Setting: Atherosclerosis Risk in Communities study participants from 4 US communities. Subjects: A total of 11,952 adults aged 44-66 years in 1987-1989 who were free of diabetes mellitus, cardiovascular disease, and had an estimated glomerular filtration rate (eGFR) ≥ 60 mL/minute/1.73 m2. Main Outcome Measure: A 66-item food frequency questionnaire was used to assess food intake. CKD stage 3 was defined as a decrease in eGFR of ≥25% from baseline resulting in an eGFR of less than 60 mL/minute/1.73 m2; CKD-related hospitalization; CKD-related death; or end-stage renal disease. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression. Results: During a median follow-up of 23 years, there were 2,632 incident CKD cases. Red and processed meat consumption was associated with increased CKD risk (HRQ5 vs. Q1: 1.23, 95% CI: 1.06-1.42, ptrend = 0.01). In contrast, higher dietary intake of nuts, legumes, and low-fat dairy products was associated with lower CKD risk (nuts: HRQ5 vs. Q1: 0.81, 95% CI: 0.72-0.92, ptrend <0.001; low-fat dairy products: HRQ5 vs. Q1: 0.75, 95% CI: 0.65-0.85, ptrend <0.001; legumes: HRQ5 vs. Q1: 0.83, 95% CI: 0.72-0.95, ptrend = 0.03). Conclusion: There were varied associations of specific dietary protein sources with risk of incident CKD; with red and processed meat being adversely associated with CKD risk; and nuts, low-fat dairy products, and legumes being protective against the development of CKD.

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