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Title Diabetic Chronic Kidney Disease participants have lower daily protein intake and 24-hour urinary phosphate excretion (24uP)
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Type Poster Presentation |
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Theme 18th Asian Colloquium in Nephrology (18th ACN 2019) |
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Topic Dialysis: Nutrition |
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Main Author Charmaine Sia1 |
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Presenting Author Charmaine Sia1 |
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Co-Author Leanne Leong1 2 Weng Kin Wong1 Titus Lau1 Jimmy Teo1 2 |
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Department / Institution / Country Nephrology / National University Hospital Singapore / Singapore1 Division of Nephrology, Department of Medicine / Yong Loo Lin School of Medicine, National University of Singapore / Singapore2 |
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Abstract Content: Introduction, Method, Result, Conclusion Introduction Higher serum phosphate concentration (sP, mg/dL) is associated with increased risks of cardiovascular disease events and death in chronic kidney disease (CKD). We hypothesize that diets affect phosphate intake between diabetic and non-diabetic participants. Assuming that daily protein intake (DPI, g/day) reflects phosphate intake, and in turn 24uP(mg), we compared 24uP and DPI in a CKD population.
Methods We investigated 232 non-dialysis CKD participants of which 119 are diabetic from the Asian Kidney Disease Study. Following a 24-hr urine collection, participants underwent glomerular filtration rate (mGFR, mL/min/1.73m2) measurement using Tc99mDTPA, and provided spot urine and blood samples. Data were analyzed on JMP using standard statistical tests. We compared sP, 24uP, and DPI by age, gender, ethnicity CKD status, phosphate binders use, and mGFR. A multivariate linear regression analysis was performed with 24uP as the outcome, and adjusting for the diabetes status, DPI, and the standard adjustors of age, gender, and ethnicity.
Results In diabetic participants: mean age=61.8±9.3 years, males (64, 53.3%), phosphate binder use (7, 6%), mGFR=44±23, 24 (20%) had mGFR >60, 53 (45%) had mGFR 30-60, 42 (35%) had mGFR <30. In non-diabetic participants: mean age=54.9±14.8 years, males (56, 46.7%), phosphate binder use (9, 8%), mGFR=60±29, 48 (42%) had mGFR >60, 46 (41%) had mGFR 30-60, 19 (17%) had mGFR <30. Diabetic participants had a lower 24uP (376.7±191.3 vs. 456.0±256.4, p<0.01) and DPI (51.2±16.9 vs. 56.2±21.5, p<0.01), while sP was higher (3.7±0.7 vs. 3.4±0.6, p<0.01). In all participants, 24uP was positively correlated with mGFR (24uP=281.6+2.18×mGFR, p<0.01) and DPI (24uP=-56.7±8.5×DPI, p<0.01). The multivariate analysis showed that only DPI correlated with 24uP (p<0.01).
Conclusion Diabetic CKD participants had a lower DPI and 24uP compared to non-diabetic participants. After adjusting for mGFR, diabetes status, and standard adjustors, only DPI reflects 24uP. |