Lower energy intake associated with higher risk of cardiovascular mortality in chronic kidney disease patients on a low-protein diets.

IF 4.4 2区医学 Q1 NUTRITION & DIETETICS

Nutrition Journal Pub Date : 2024-07-15 DOI:10.1186/s12937-024-00980-y

Yao Liu, Fei Deng, Ping Zhou, Cong Peng, ChunPeng Xie, Wuyu Gao, Qianyu Yang, Tingyu Wu, Xiang Xiao

{"title":"Lower energy intake associated with higher risk of cardiovascular mortality in chronic kidney disease patients on a low-protein diets.","authors":"Yao Liu, Fei Deng, Ping Zhou, Cong Peng, ChunPeng Xie, Wuyu Gao, Qianyu Yang, Tingyu Wu, Xiang Xiao","doi":"10.1186/s12937-024-00980-y","DOIUrl":null,"url":null,"abstract":"Objective: An increasing number of studies shown that inadequate energy intake causes an increase in adverse incidents in chronic kidney disease (CKD) patients on low-protein diets (LPD). The study aimed to investigate the relationship between energy intake and cardiovascular mortality in CKD patients on a LPD.Methods: This was a cross-sectional study, a total of 4264 CKD patients were enrolled from the NHANES database between 2009 and 2018. Restricted cubic spline plots and Cox regression analysis were used to analyze the association between energy intake and cardiovascular mortality in CKD patients on a LPD. Additionally, a nomogram was constructed to estimate cardiovascular survival in CKD patients on a LPD.Results: Among CKD patients on a LPD in the United States, 90.05% had an energy intake of less than 25 kcal/kg/day, compared to 36.94% in CKD patients on a non-LPD. Energy intake and cardiovascular mortality showed a linear relationship in CKD patients on a LPD, while a 'U-shaped' relationship was observed in CKD patients on a non-LPD. Multifactorial Cox regression models revealed that for Per-standard deviation (Per-SD) decrement in energy intake, the risk of cardiovascular mortality increased by 41% (HR: 1.41, 95% CI: 1.12, 1.77; P = 0.004) in CKD patients on a LPD. The concordance index of the nomogram was 0.79 (95% CI, 0.75, 0.83).Conclusion: CKD patients, especially those on a LPD, have significantly inadequate energy intake. Lower energy intake is associated with higher cardiovascular mortality in CKD patients on a LPD.","PeriodicalId":19203,"journal":{"name":"Nutrition Journal","volume":"23 1","pages":"75"},"PeriodicalIF":4.4000,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11247864/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nutrition Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12937-024-00980-y","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: An increasing number of studies shown that inadequate energy intake causes an increase in adverse incidents in chronic kidney disease (CKD) patients on low-protein diets (LPD). The study aimed to investigate the relationship between energy intake and cardiovascular mortality in CKD patients on a LPD.

Methods: This was a cross-sectional study, a total of 4264 CKD patients were enrolled from the NHANES database between 2009 and 2018. Restricted cubic spline plots and Cox regression analysis were used to analyze the association between energy intake and cardiovascular mortality in CKD patients on a LPD. Additionally, a nomogram was constructed to estimate cardiovascular survival in CKD patients on a LPD.

Results: Among CKD patients on a LPD in the United States, 90.05% had an energy intake of less than 25 kcal/kg/day, compared to 36.94% in CKD patients on a non-LPD. Energy intake and cardiovascular mortality showed a linear relationship in CKD patients on a LPD, while a 'U-shaped' relationship was observed in CKD patients on a non-LPD. Multifactorial Cox regression models revealed that for Per-standard deviation (Per-SD) decrement in energy intake, the risk of cardiovascular mortality increased by 41% (HR: 1.41, 95% CI: 1.12, 1.77; P = 0.004) in CKD patients on a LPD. The concordance index of the nomogram was 0.79 (95% CI, 0.75, 0.83).

Conclusion: CKD patients, especially those on a LPD, have significantly inadequate energy intake. Lower energy intake is associated with higher cardiovascular mortality in CKD patients on a LPD.

查看原文本刊更多论文

低蛋白饮食的慢性肾病患者能量摄入较低与心血管死亡风险较高有关。

目的：越来越多的研究表明，能量摄入不足会导致低蛋白饮食（LPD）的慢性肾脏病（CKD）患者不良事件的增加。本研究旨在调查低蛋白饮食的慢性肾脏病患者的能量摄入与心血管死亡率之间的关系：这是一项横断面研究，2009年至2018年期间，共有4264名CKD患者从NHANES数据库中注册。研究采用限制立方样条图和 Cox 回归分析方法，分析接受 LPD 的 CKD 患者能量摄入与心血管疾病死亡率之间的关系。此外，还构建了一个提名图来估算接受低密度脂蛋白血症治疗的 CKD 患者的心血管存活率：结果：在美国接受低密度脂蛋白胆固醇治疗的 CKD 患者中，90.05% 的能量摄入量低于 25 千卡/千克/天，而在非低密度脂蛋白胆固醇治疗的 CKD 患者中，这一比例为 36.94%。接受低密度脂蛋白胆固醇治疗的慢性肾脏病患者的能量摄入量与心血管死亡率呈线性关系，而接受非低密度脂蛋白胆固醇治疗的慢性肾脏病患者的能量摄入量与心血管死亡率呈 "U "型关系。多因素 Cox 回归模型显示，能量摄入量每标准差（Per-SD）下降，低密度脂蛋白血症患者的心血管死亡风险增加 41%（HR：1.41，95% CI：1.12，1.77；P = 0.004）。提名图的一致性指数为 0.79 (95% CI, 0.75, 0.83)：结论：慢性肾脏病患者，尤其是接受低密度脂蛋白血症治疗的患者，能量摄入明显不足。结论：接受低密度脂蛋白血症治疗的慢性肾脏病患者，尤其是低密度脂蛋白血症患者，能量摄入不足与心血管死亡率升高有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Nutrition Journal NUTRITION & DIETETICS-

CiteScore

9.80

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Nutrition Journal publishes surveillance, epidemiologic, and intervention research that sheds light on i) influences (e.g., familial, environmental) on eating patterns; ii) associations between eating patterns and health, and iii) strategies to improve eating patterns among populations. The journal also welcomes manuscripts reporting on the psychometric properties (e.g., validity, reliability) and feasibility of methods (e.g., for assessing dietary intake) for human nutrition research. In addition, study protocols for controlled trials and cohort studies, with an emphasis on methods for assessing dietary exposures and outcomes as well as intervention components, will be considered. Manuscripts that consider eating patterns holistically, as opposed to solely reductionist approaches that focus on specific dietary components in isolation, are encouraged. Also encouraged are papers that take a holistic or systems perspective in attempting to understand possible compensatory and differential effects of nutrition interventions. The journal does not consider animal studies. In addition to the influence of eating patterns for human health, we also invite research providing insights into the environmental sustainability of dietary practices. Again, a holistic perspective is encouraged, for example, through the consideration of how eating patterns might maximize both human and planetary health.