Higher Dietary Protein Intake Associated with Reduced Mortality in Chronic Kidney Disease Patients
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Reviewed & Translated by Dat Tien Nguyen, B.A, ScM.
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Posted on September 27th, 2024
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Older adults require higher protein intake to maintain good health due to factors like reduced physical activity, appetite, and increased insulin/protein resistance. However, for individuals with chronic kidney disease (CKD), high protein intake can worsen their condition. As a result, it is recommended that patients with stage 3 to 5 CKD limit their daily protein consumption to less than 0.8 grams per kilogram of body weight. While it's well-established that restricted protein intake helps slow CKD progression, the broader impact of such a diet on overall health and mortality remains unclear.
To address this question, a prospective cohort study was conducted in Sweden and Spain, involving over 14,000 health records of participants aged 60 and older. Among them, 4,789 had chronic kidney disease (CKD), defined by an estimated glomerular filtration rate of less than 60 mL/min/1.73 m² and elevated urine albumin levels. Approximately 85% of these CKD patients were classified as having stage 3 disease, with most of the remainder at stage 2. Dietary protein intake was estimated through questionnaires and averaged around 1.15 g/kg/day, with two-thirds sourced from animals and the rest from plant-based foods such as vegetables, grains, and legumes. Over a 10-year monitoring period, the analysis revealed that higher protein intake was associated with a decreased risk of mortality in CKD patients. Those consuming 1.4 g of protein per kilogram of body weight daily experienced a 27% reduction in mortality risk compared to those with an intake of 0.8 g/kg/day. Additionally, a 12% reduction was observed for those consuming 1.0 g/kg/day, and a 21% reduction for those at 1.2 g/kg/day. The study found no significant differences in mortality risk between animal and plant protein sources. These findings align with other research, such as a smaller Japanese study (259 participants), which also showed that higher protein intake was linked to a lower risk of all-cause mortality over four years. The authors suggested that the benefits of higher protein intake, such as supporting the musculoskeletal system and boosting immune function, outweigh the risks of CKD progression. They recommended future studies address limitations by including patients with more severe CKD, more diverse ethnic groups, and a focus on plant-based protein sources.
To address this question, a prospective cohort study was conducted in Sweden and Spain, involving over 14,000 health records of participants aged 60 and older. Among them, 4,789 had chronic kidney disease (CKD), defined by an estimated glomerular filtration rate of less than 60 mL/min/1.73 m² and elevated urine albumin levels. Approximately 85% of these CKD patients were classified as having stage 3 disease, with most of the remainder at stage 2. Dietary protein intake was estimated through questionnaires and averaged around 1.15 g/kg/day, with two-thirds sourced from animals and the rest from plant-based foods such as vegetables, grains, and legumes. Over a 10-year monitoring period, the analysis revealed that higher protein intake was associated with a decreased risk of mortality in CKD patients. Those consuming 1.4 g of protein per kilogram of body weight daily experienced a 27% reduction in mortality risk compared to those with an intake of 0.8 g/kg/day. Additionally, a 12% reduction was observed for those consuming 1.0 g/kg/day, and a 21% reduction for those at 1.2 g/kg/day. The study found no significant differences in mortality risk between animal and plant protein sources. These findings align with other research, such as a smaller Japanese study (259 participants), which also showed that higher protein intake was linked to a lower risk of all-cause mortality over four years. The authors suggested that the benefits of higher protein intake, such as supporting the musculoskeletal system and boosting immune function, outweigh the risks of CKD progression. They recommended future studies address limitations by including patients with more severe CKD, more diverse ethnic groups, and a focus on plant-based protein sources.