Dietary Protein Sources and Risk for Incident Chronic Kidney Disease: Results From the Atherosclerosis Risk in Communities (ARIC) Study
Dietary Protein Sources and Risk for Incident Chronic Kidney Disease: Results From the Atherosclerosis Risk in Communities (ARIC) Study
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DOI：
10.1053/j.jrn.2016.11.004
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发表时间：
2017-07-01
影响因子：
3.2
通讯作者：
Rebholz, Casey M.
中科院分区：
文献类型：
--
作者：
Haring, Bernhard;Selvin, Elizabeth;Rebholz, Casey M.
目的：建议中重度肾功能不全患者限制蛋白质饮食。在肾功能正常的个体中，关于膳食蛋白质来源与肾脏疾病发生风险之间关系的长期数据在很大程度上缺失。本研究旨在评估膳食蛋白质来源与慢性肾脏疾病（CKD）发病率之间的关系。设计：前瞻性队列。背景：社区动脉粥样硬化风险研究参与者来自美国4个社区。对象：1987-1989年共11952名年龄在44-66岁之间，无糖尿病、心血管疾病、肾小球滤过率(eGFR) >= 60 mL/min /1.73 m的成年人(2)。主要结果测量：使用66项食物频率问卷来评估食物摄入量。CKD 3期被定义为eGFR较基线下降bb0 = 25%，导致eGFR低于60 mL/min /1.73 m(2)；CKD-related住院治疗;CKD-related死亡;或终末期肾病。采用Cox比例风险回归估计风险比（hr）和95%置信区间（CIs）。结果：在中位随访23年期间，有2632例CKD事件。食用红肉和加工肉类与CKD风险增加相关（HRQ5 vs. Q1: 1.23, 95% CI: 1.06-1.42, p（趋势）= 0.01）。相比之下，较高的饮食摄入坚果、豆类和低脂乳制品与较低的CKD风险相关(坚果：HRQ5 vs. Q1: 0.81, 95% CI: 0.72-0.92, p（趋势）< 0.001；低脂乳制品：HRQ5 vs. Q1: 0.75, 95% CI: 0.65-0.85, p（趋势）< 0.001；豆类：HRQ5 vs. Q1: 0.83, 95% CI: 0.72-0.95, p（趋势）= 0.03)。结论：特定膳食蛋白质来源与CKD发生风险存在不同程度的关联；红肉和加工肉类与ckrisk负相关；坚果、低脂乳制品和豆类可以预防慢性肾病的发生。(C) 2016年由国家肾脏基金会，Inc。版权所有。
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 m(2).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 m(2); 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, p(trend) = 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, p(trend) < 0.001; low-fat dairy products: HRQ5 vs. Q1: 0.75, 95% CI: 0.65-0.85, p(trend) < 0.001; legumes: HRQ5 vs. Q1: 0.83, 95% CI: 0.72-0.95, p(trend)= 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 withCKDrisk; andnuts, low-fat dairy products, and legumesbeing protective against the development ofCKD. (C) 2016 by the National Kidney Foundation, Inc. All rights reserved.