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Association of Plant Protein Intake With Risk of Incident CKD: A UK Biobank Study

Authors
 Ga Young Heo  ;  Hee Byung Koh  ;  Hyo Jeong Kim  ;  Kyung Won Kim  ;  Chan Young Jung  ;  Hyung Woo Kim  ;  Tae Ik Chang  ;  Jung Tak Park  ;  Tae-Hyun Yoo  ;  Shin-Wook Kang  ;  Seung Hyeok Han 
Citation
 AMERICAN JOURNAL OF KIDNEY DISEASES, Vol.82(6) : 687-697.e1, 2023-12 
Journal Title
AMERICAN JOURNAL OF KIDNEY DISEASES
ISSN
 0272-6386 
Issue Date
2023-12
MeSH
Biological Specimen Banks ; Glomerular Filtration Rate ; Humans ; Plant Proteins* ; Prospective Studies ; Renal Insufficiency, Chronic* / epidemiology ; Risk Factors ; United Kingdom / epidemiology
Keywords
Chronic kidney disease ; plant protein ; primary prevention ; protein intake
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.

Plain-language summary: Plant-based diets confer various health benefits, including lowering the risk of cardiovascular disease and certain cancers. However, the relationship between plant protein intake and the risk of chronic kidney disease (CKD) remains unclear. Our study investigated the association between plant protein intake and the development of CKD. Using the UK Biobank Study data, we found that participants with a higher plant protein intake had a lower risk of developing CKD. Our finding suggests that a higher dietary intake of plant-based protein may be beneficial for kidney health and provides insight into dietary interventions to prevent CKD in primary care settings.
Full Text
https://www.sciencedirect.com/science/article/pii/S0272638623007424
DOI
10.1053/j.ajkd.2023.05.007
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kim, Hyung Woo(김형우) ORCID logo https://orcid.org/0000-0002-6305-452X
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/197188
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