한빛사논문
- 조회437
Ga Young Heo 1, Hee Byung Koh 1, Hyo Jeong Kim 1, Kyung Won Kim 1, Chan Young Jung 1, Hyung Woo Kim 1, Tae Ik Chang 2, Jung Tak Park 1, Tae-Hyun Yoo 1, Shin-Wook Kang 1, Seung Hyeok Han 1
1Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul
2Department of Internal Medicine, National Health Insurance Service Medical Center, Ilsan Hospital, Goyangshi, Gyeonggi-do, South Korea
Address for Correspondence: Seung Hyeok Han, MD, PhD
Abstract
Rationale & objective: Data suggest that various dietary interventions slow kidney disease progression and improve clinical outcomes for those with chronic kidney disease (CKD). However, the association between plant protein intake and incident CKD has been uncertain.
Study design: Prospective cohort study.
Setting & participants: 117,809 participants who completed at least 1 dietary questionnaire and had an estimated glomerular filtration rate (eGFR) ≥ 60mL/min/1.73m2, a urinary albumin-creatinine ratio (UACR)<30mg/g, and no history of CKD.
Exposure: Daily plant protein intake in g/kg/day.
Outcome: Incident CKD based on the International Classification of Diseases, 10th Revision (ICD-10) or the Office of Population Censuses and Surveys Classification of Interventions and Procedures, version 4 (OPCS-4) codes.
Analytical approach: A cause-specific proportional hazards analysis incorporating competing risks that treated death occurring before incident CKD as a competing event.
Results: During a median follow-up period of 9.9 years, incident CKD occurred in 3,745 participants (3.2%; incidence rate, 3.2 per 1,000 person-years). In a multivariable model, the adjusted hazard ratio (AHR) for the second, third, and highest quartiles of plant protein intake was 0.90 (95% CI, 0.82-0.99), 0.83 (95% CI, 0.75-0.92), and 0.82 (95% CI, 0.73-0.93), respectively, compared with the lowest quartile. Modeled as a continuous variable, the AHR per 0.1g/kg/day plant protein intake increase was 0.96 (95% CI, 0.93-0.99). This beneficial association was also consistent in secondary analyses for which CKD was defined based on codes or 2 consecutive measures of eGFR<60mL/min/1.73m2 or UACR>30mg/g. Various sensitivity analyses demonstrated consistent findings.
Limitations: Potential incomplete dietary assessments; limited generalizability due to the characteristics of participants in the UK Biobank Study.
Conclusions: In this large, prospective cohort study, greater dietary plant protein intake was associated with a lower risk of incident CKD. Further interventional studies demonstrating the kidney-protective benefits of plant protein intake are warranted.
논문정보
- Research article
- 2023년 12월 (BRIC 등록일 2024-01-04)
- 국내 연구진
- 의약학 > 응용의학
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