Evidence map›Paper›PMID 33742197›Full record

ArticleThe American journal of clinical nutrition2021

Dietary protein intake, kidney function, and survival in a nationally representative cohort.

Yoko Narasaki, Yusuke Okuda, Linda W Moore, Amy S You, Ekamol Tantisattamo, Jula K Inrig, Tsuyoshi Miyagi, Tracy Nakata, Csaba P Kovesdy, Danh V Nguyen and 2 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of clinical nutrition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
2.4field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 31 citations in OpenAlex.

  1. Article
  2. Review
  3. Review
  4. Review
  5. Article
  6. The safety of a low-protein diet in older adults with advanced chronic kidney disease.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024
    Observational
  7. Review
  8. Article
  9. Review
  10. Article
  11. Article
  12. Review
  13. Review
  14. Review
  15. Nutritional and Dietary Management of Chronic Kidney Disease Under Conservative and Preservative Kidney Care Without Dialysis.Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation · 2023
    Review
  16. Article
  17. Article
  18. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 2 countries.

Yoko NarasakiHarold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA.
Yusuke OkudaHarold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA.
Linda W MooreDepartment of Surgery, Houston Methodist Hospital, Houston, TX, USA.
Amy S YouHarold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA.
Ekamol TantisattamoHarold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA.
Jula K InrigHarold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA.
Tsuyoshi MiyagiDepartment of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus School of Medicine, Okinawa, Japan.
Tracy NakataHarold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA.
Csaba P KovesdyDivision of Nephrology, University of Tennessee Health Science Center, Memphis, TN, USA.
Danh V NguyenHarold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA.
Kamyar Kalantar-ZadehHarold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA.
Connie M RheeHarold Simmons Center for Chronic Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California Irvine, Orange, CA, USA.ORCID 0000-0002-9703-6469
University of California, Irvine · USMethodist Hospital · USUniversity of Tennessee Health Science Center · USUniversity of the Ryukyus · JP

Funding

Multilevel Time-Dynamic Modeling of Hospitalization and Survival in Patients on DialysisR01DK092232 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KURUM, ESRA, NGUYEN, DANH V · 2011 to 2025
$4.9M
A Randomized Controlled Trial of Thyroid Hormone Supplementation in Hemodialysis PatientsR01DK122767 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI RHEE, CONNIE MEEYOUNG · 2019 to 2023
$3.3M
Defining Optimal Transitions of Care in Advanced Kidney Disease: Conservative Management vs. Dialysis ApproachesR01DK124138 · NIDDK · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KALANTAR-ZADEH, KAMYAR, RHEE, CONNIE MEEYOUNG · 2020 to 2024
$2.9M
Transition of Care in CKD (TC-CKD)U01DK102163 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI JACOBSEN, STEVEN J, KALANTAR-ZADEH, KAMYAR · 2014 to 2018
$2.8M
MALNUTRITION, DIET AND RACIAL DISPARITIES IN CKDK24DK091419 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI KALANTAR-ZADEH, KAMYAR · 2011 to 2020
$1.8M
Novel Saliva-based Renal Function Test PlatformR44DK116383 · NIDDK · INTELLIGENT OPTICAL SYSTEMS, INC. · PI KALANTAR-ZADEH, KAMYAR, NGUYEN, TRONG · 2018 to 2020
$1.7M
A Pilot Feasibility Trial of Thyroid Hormone Replacement in Dialysis PatientsR03DK114642 · NIDDK · UNIVERSITY OF CALIFORNIA-IRVINE · PI RHEE, CONNIE MEEYOUNG · 2017 to 2018
$155k
NIDDK NIH HHS K24 DK091419NIDDK NIH HHS R01 DK092232NIDDK NIH HHS R01 DK122767NIDDK NIH HHS R01 DK124138NIDDK NIH HHS R03 DK114642NIDDK NIH HHS R44 DK116383NIDDK NIH HHS U01 DK102163
6 · The paper itself

Abstract

backgroundHigh-protein diets (e.g., Paleo, Atkins, South Beach, ketogenic) have gained popularity as a means to promote weight loss and avoid excess carbohydrate consumption. Yet in chronic kidney disease (CKD) patients, evidence suggests low dietary protein intake (DPI) leads to attenuation of kidney function decline, although concerns remain for risk of protein-energy wasting.

objectivesTo examine associations of DPI with mortality in a nationally representative cohort of US adults, stratified by kidney function.

methodsWe examined the association between daily DPI scaled to actual body weight (ABW), ascertained by 24-h dietary recall, with all-cause mortality among 27,604 continuous NHANES adult participants (1999-2010), stratified according to impaired versus normal kidney function (estimated glomerular filtration rates <60 compared with ≥60 ml/min/1.72 m2, respectively), using multivariable Cox models. We also examined the relation between high biological value (HBV) protein consumption with mortality.

resultsIn participants with impaired kidney function, a high DPI of ≥1.4 g/kg ABW/day was associated with higher mortality, while lower DPI levels were not associated with mortality (reference, 0.6 to <1.0 g/kg ABW/day): the adjusted HRs (aHRs) were 1.09 (95% CI: 0.90, 1.32), 1.03 (95% CI: 0.82, 1.29), and 1.37 (95% CI: 1.02, 1.85) for DPI <0.6, 1.0 to <1.4, and ≥1.4 g/kg ABW/day, respectively. Yet in participants with normal kidney function, a low DPI of <0.6 g/kg ABW/day was associated with higher mortality, whereas higher DPI levels were not associated with death: the aHRs were 1.18 (95% CI: 1.04, 1.34), 0.92 (95% CI: 0.81, 1.04), and 0.99 (95% CI: 0.85, 1.16) for DPI <0.6, 1.0 to <1.4, and ≥1.4 g/kg ABW/day, respectively. The highest 2 tertiles of HBV consumption were associated with higher mortality in participants with impaired kidney function.

conclusionsAmong participants with impaired kidney function, a higher DPI and greater HBV consumption were associated with higher mortality, whereas a lower DPI was associated with higher mortality in those with normal kidney function. Further studies are needed to elucidate the specific pathways between higher DPI and mortality in CKD.

Indexed as

Body WeightCohort StudiesDietary ProteinsDiet RecordsExerciseGlomerular Filtration RateHumansKidneyKidney Function TestsMortalityRisk FactorsUnited StatesDietary Proteinschronic kidney diseasedietary proteinkidney functionmortalitysurvival, NHANES

Identifiers

PMID33742197
PMCPMC8246621
OpenAlexW3139465628

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.