Associations of low-carbohydrate with mortality in chronic kidney disease
Diet management is an effective way to retard the progression of chronic kidney disease (CKD). However, very few studies investigated the influence of carbohydrate intake on CKD patients. In this prospective cohort study, the associations between carbohydrate intake and all-cause mortality were inve...
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| Veröffentlicht in: | Renal failure 2023-12, Vol.45 (1), p.2202284-2202284 |
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| creator | Ren, Qidong Zhou, Yangzhong Luo, Huiting Chen, Gang Han, Yan Zheng, Ke Qin, Yan Li, Xuemei |
| description | Diet management is an effective way to retard the progression of chronic kidney disease (CKD). However, very few studies investigated the influence of carbohydrate intake on CKD patients. In this prospective cohort study, the associations between carbohydrate intake and all-cause mortality were investigated in US adult CKD patients.
Multivariable Cox proportional hazard models and iso-caloric replacement analysis were used to investigate the associations between the macronutrients and the all-cause mortality risk. Total 3683 US adult CKD patients 20 years or older from the National Health and Nutrition Examination Survey (NHANES, 2003-2014) were analyzed (mean age ± SD, 62.4 ± 17.1; 56.5% female), of which 1082 participants with CKD died with a median follow-up time of 67 (IQR 36-99) months.
Most macronutrients were non-linearly associated with all-cause mortality risk, including carbohydrates and sugar. Participants with CKD had lower mortality risk when consuming 30-45% energy from carbohydrates (average HR 0.76, 95%CI 0.62-0.93, compared with 60%), 5-20% energy from sugar (average HR 0.75, 95% CI 0.59-0.96 compared with 40%). Replacing the energy intake from carbohydrates with protein (up to 30%) and/or replacing the sugar with non-sugar carbohydrates (up to 55%) reduced the all-cause mortality risk, while the total energy intake remained constant.
Diet advice should be given according to the current diet status, and constituents of carbohydrates should also be taken into consideration. |
| doi_str_mv | 10.1080/0886022X.2023.2202284 |
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Multivariable Cox proportional hazard models and iso-caloric replacement analysis were used to investigate the associations between the macronutrients and the all-cause mortality risk. Total 3683 US adult CKD patients 20 years or older from the National Health and Nutrition Examination Survey (NHANES, 2003-2014) were analyzed (mean age ± SD, 62.4 ± 17.1; 56.5% female), of which 1082 participants with CKD died with a median follow-up time of 67 (IQR 36-99) months.
Most macronutrients were non-linearly associated with all-cause mortality risk, including carbohydrates and sugar. Participants with CKD had lower mortality risk when consuming 30-45% energy from carbohydrates (average HR 0.76, 95%CI 0.62-0.93, compared with 60%), 5-20% energy from sugar (average HR 0.75, 95% CI 0.59-0.96 compared with 40%). Replacing the energy intake from carbohydrates with protein (up to 30%) and/or replacing the sugar with non-sugar carbohydrates (up to 55%) reduced the all-cause mortality risk, while the total energy intake remained constant.
Diet advice should be given according to the current diet status, and constituents of carbohydrates should also be taken into consideration.</description><identifier>ISSN: 0886-022X</identifier><identifier>EISSN: 1525-6049</identifier><identifier>DOI: 10.1080/0886022X.2023.2202284</identifier><identifier>PMID: 37271873</identifier><language>eng</language><publisher>England: Taylor & Francis</publisher><subject>Adult ; Carbohydrates ; Chronic kidney disease ; Clinical Study ; Energy intake ; Female ; Humans ; Kidney diseases ; low carbohydrate diet ; Male ; Mortality ; Nutrition Surveys ; Proportional Hazards Models ; Prospective Studies ; Renal Insufficiency, Chronic ; Sugar</subject><ispartof>Renal failure, 2023-12, Vol.45 (1), p.2202284-2202284</ispartof><rights>2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group 2023</rights><rights>2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This work is licensed under the Creative Commons Attribution – Non-Commercial License http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group 2023 The Author(s)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c511t-29ea80f9b1fdc38b041ecc434fb7949ee29d6a790520c4822657a5bf936979983</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10243376/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10243376/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,27502,27924,27925,53791,53793,59143,59144</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37271873$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ren, Qidong</creatorcontrib><creatorcontrib>Zhou, Yangzhong</creatorcontrib><creatorcontrib>Luo, Huiting</creatorcontrib><creatorcontrib>Chen, Gang</creatorcontrib><creatorcontrib>Han, Yan</creatorcontrib><creatorcontrib>Zheng, Ke</creatorcontrib><creatorcontrib>Qin, Yan</creatorcontrib><creatorcontrib>Li, Xuemei</creatorcontrib><title>Associations of low-carbohydrate with mortality in chronic kidney disease</title><title>Renal failure</title><addtitle>Ren Fail</addtitle><description>Diet management is an effective way to retard the progression of chronic kidney disease (CKD). However, very few studies investigated the influence of carbohydrate intake on CKD patients. In this prospective cohort study, the associations between carbohydrate intake and all-cause mortality were investigated in US adult CKD patients.
Multivariable Cox proportional hazard models and iso-caloric replacement analysis were used to investigate the associations between the macronutrients and the all-cause mortality risk. Total 3683 US adult CKD patients 20 years or older from the National Health and Nutrition Examination Survey (NHANES, 2003-2014) were analyzed (mean age ± SD, 62.4 ± 17.1; 56.5% female), of which 1082 participants with CKD died with a median follow-up time of 67 (IQR 36-99) months.
Most macronutrients were non-linearly associated with all-cause mortality risk, including carbohydrates and sugar. Participants with CKD had lower mortality risk when consuming 30-45% energy from carbohydrates (average HR 0.76, 95%CI 0.62-0.93, compared with 60%), 5-20% energy from sugar (average HR 0.75, 95% CI 0.59-0.96 compared with 40%). Replacing the energy intake from carbohydrates with protein (up to 30%) and/or replacing the sugar with non-sugar carbohydrates (up to 55%) reduced the all-cause mortality risk, while the total energy intake remained constant.
Diet advice should be given according to the current diet status, and constituents of carbohydrates should also be taken into consideration.</description><subject>Adult</subject><subject>Carbohydrates</subject><subject>Chronic kidney disease</subject><subject>Clinical Study</subject><subject>Energy intake</subject><subject>Female</subject><subject>Humans</subject><subject>Kidney diseases</subject><subject>low carbohydrate diet</subject><subject>Male</subject><subject>Mortality</subject><subject>Nutrition Surveys</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Renal Insufficiency, Chronic</subject><subject>Sugar</subject><issn>0886-022X</issn><issn>1525-6049</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>0YH</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><sourceid>DOA</sourceid><recordid>eNp9kUtvEzEURi0EomnhJ4BGYsNmgt-PFVQVhUiV2IDEzrrj8TQOE7vYE6L59zgkrSgLNrZkn3uurz-EXhG8JFjjd1hriSn9vqSYsiWtK9X8CVoQQUUrMTdP0eLAtAfoDJ2XssGYCK3oc3TGFFVEK7ZAq8tSkgswhRRLk4ZmTPvWQe7Seu4zTL7Zh2ndbFOeYAzT3ITYuHVOMbjmR-ijn5s-FA_Fv0DPBhiLf3naL9C3649frz63N18-ra4ub1onCJlaajxoPJiODL1jusOceOc440OnDDfeU9NLUAYLih3XlEqhQHSDYdIoYzS7QKujt0-wsXc5bCHPNkGwfw5SvrWQp-BGbzUFaTiWXmPMOXPgBAXdyW4QjtaO1fX-6LrbdVvfOx-nDOMj6eObGNb2Nv2yBFPOmJLV8PZkyOnnzpfJbkNxfhwh-rQrltYJFJaasIq--QfdpF2O9a8qpYggnGJVKXGkXE6lZD88vIZge0je3idvD8nbU_K17vXfozxU3UddgQ9HIMQh5S3sUx57O8E8pjxkiC4Uy_7f4zdS770D</recordid><startdate>202312</startdate><enddate>202312</enddate><creator>Ren, Qidong</creator><creator>Zhou, Yangzhong</creator><creator>Luo, Huiting</creator><creator>Chen, Gang</creator><creator>Han, Yan</creator><creator>Zheng, Ke</creator><creator>Qin, Yan</creator><creator>Li, Xuemei</creator><general>Taylor & Francis</general><general>Taylor & Francis Ltd</general><general>Taylor & Francis Group</general><scope>0YH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7XB</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>202312</creationdate><title>Associations of low-carbohydrate with mortality in chronic kidney disease</title><author>Ren, Qidong ; Zhou, Yangzhong ; Luo, Huiting ; Chen, Gang ; Han, Yan ; Zheng, Ke ; Qin, Yan ; Li, Xuemei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c511t-29ea80f9b1fdc38b041ecc434fb7949ee29d6a790520c4822657a5bf936979983</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Carbohydrates</topic><topic>Chronic kidney disease</topic><topic>Clinical Study</topic><topic>Energy intake</topic><topic>Female</topic><topic>Humans</topic><topic>Kidney diseases</topic><topic>low carbohydrate diet</topic><topic>Male</topic><topic>Mortality</topic><topic>Nutrition Surveys</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Renal Insufficiency, Chronic</topic><topic>Sugar</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ren, Qidong</creatorcontrib><creatorcontrib>Zhou, Yangzhong</creatorcontrib><creatorcontrib>Luo, Huiting</creatorcontrib><creatorcontrib>Chen, Gang</creatorcontrib><creatorcontrib>Han, Yan</creatorcontrib><creatorcontrib>Zheng, Ke</creatorcontrib><creatorcontrib>Qin, Yan</creatorcontrib><creatorcontrib>Li, Xuemei</creatorcontrib><collection>Taylor & Francis Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Renal failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ren, Qidong</au><au>Zhou, Yangzhong</au><au>Luo, Huiting</au><au>Chen, Gang</au><au>Han, Yan</au><au>Zheng, Ke</au><au>Qin, Yan</au><au>Li, Xuemei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Associations of low-carbohydrate with mortality in chronic kidney disease</atitle><jtitle>Renal failure</jtitle><addtitle>Ren Fail</addtitle><date>2023-12</date><risdate>2023</risdate><volume>45</volume><issue>1</issue><spage>2202284</spage><epage>2202284</epage><pages>2202284-2202284</pages><issn>0886-022X</issn><eissn>1525-6049</eissn><abstract>Diet management is an effective way to retard the progression of chronic kidney disease (CKD). However, very few studies investigated the influence of carbohydrate intake on CKD patients. In this prospective cohort study, the associations between carbohydrate intake and all-cause mortality were investigated in US adult CKD patients.
Multivariable Cox proportional hazard models and iso-caloric replacement analysis were used to investigate the associations between the macronutrients and the all-cause mortality risk. Total 3683 US adult CKD patients 20 years or older from the National Health and Nutrition Examination Survey (NHANES, 2003-2014) were analyzed (mean age ± SD, 62.4 ± 17.1; 56.5% female), of which 1082 participants with CKD died with a median follow-up time of 67 (IQR 36-99) months.
Most macronutrients were non-linearly associated with all-cause mortality risk, including carbohydrates and sugar. Participants with CKD had lower mortality risk when consuming 30-45% energy from carbohydrates (average HR 0.76, 95%CI 0.62-0.93, compared with 60%), 5-20% energy from sugar (average HR 0.75, 95% CI 0.59-0.96 compared with 40%). Replacing the energy intake from carbohydrates with protein (up to 30%) and/or replacing the sugar with non-sugar carbohydrates (up to 55%) reduced the all-cause mortality risk, while the total energy intake remained constant.
Diet advice should be given according to the current diet status, and constituents of carbohydrates should also be taken into consideration.</abstract><cop>England</cop><pub>Taylor & Francis</pub><pmid>37271873</pmid><doi>10.1080/0886022X.2023.2202284</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Carbohydrates Chronic kidney disease Clinical Study Energy intake Female Humans Kidney diseases low carbohydrate diet Male Mortality Nutrition Surveys Proportional Hazards Models Prospective Studies Renal Insufficiency, Chronic Sugar |
| title | Associations of low-carbohydrate with mortality in chronic kidney disease |
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