TY - JOUR
T1 - High dietary phosphorus density is a risk factor for incident chronic kidney disease development in diabetic subjects
T2 - A community-based prospective cohort study
AU - Yoon, Chang Yun
AU - Park, Jung Tak
AU - Jhee, Jong Hyun
AU - Noh, Juhwan
AU - Kee, Youn Kyung
AU - Seo, Changhwan
AU - Lee, Misol
AU - Cha, Min Uk
AU - Kim, Hyoungnae
AU - Park, Seohyun
AU - Yun, Hae Ryong
AU - Jung, Su Young
AU - Han, Seung Hyeok
AU - Yoo, Tae Hyun
AU - Kang, Shin Wook
N1 - Publisher Copyright:
© 2017 American Society for Nutrition.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Background: High serum phosphorus concentrations are associated with an increased risk of cardiovascular disease and progression of chronic kidney disease (CKD). However, the relation between dietary phosphorus intake and CKD development has not been well evaluated. Objective: In this study, we investigated the impact of dietary phosphorus density on the development of incident CKD in a cohort of subjects with normal renal function. Design: Data were retrieved from the Korean Genome and Epidemiology Study, a prospective community-based cohort study. The study cohort consisted of subjects aged 40-69 y, who were followed up biennially from 2001 to 2014. A total of 873 subjects with diabetes mellitus (DM) and 5846 subjects without DM (non-DM) were included in the final analysis. The primary endpoint was incident CKD, defined as a composite of estimated glomerular filtration rate <60 mL≥ min-1≥ 1.73 m-2 and/or the development of proteinuria. Results: In the DM and non-DM groups, the mean ages of the participants were 55.6 ± 8.7 and 51.4 ± 8.6 y, the numbers of male subjects were 454 (52.0%) and 2784 (47.6%), and the mean estimated glomerular filtration rates were 91.6 ± 14.0 and 94.5 6 14.0 mL· min-1· 1.73 m-2, respectively. The mean values of dietary phosphorus density, defined as the ratio of a single-day dietary phosphorus amount to the total daily calorie intake, were 0.51 6 0.08 mg/kcal in the DM group and 0.51 ± 0.07 mg/kcal in the non-DM group. During the follow-up, CKD newly developed in 283 (32.4%) and 792 subjects (13.5%) in the DM and non-DM groups, respectively. When the subjects were divided into quartiles according to the dietary phosphorus density in each group, the highest quartile was significantly associated with the development of incident CKD by multiple Cox proportional hazard analysis in the DM group (P = 0.02) but not in the non-DM group (P = 0.72). Conclusions: High dietary phosphorus density is associated with an increased risk of CKD development in DM patients with normal renal function. The causality in this association needs to be tested in a randomized controlled trial. Am J Clin Nutr 2017;106:311-21.
AB - Background: High serum phosphorus concentrations are associated with an increased risk of cardiovascular disease and progression of chronic kidney disease (CKD). However, the relation between dietary phosphorus intake and CKD development has not been well evaluated. Objective: In this study, we investigated the impact of dietary phosphorus density on the development of incident CKD in a cohort of subjects with normal renal function. Design: Data were retrieved from the Korean Genome and Epidemiology Study, a prospective community-based cohort study. The study cohort consisted of subjects aged 40-69 y, who were followed up biennially from 2001 to 2014. A total of 873 subjects with diabetes mellitus (DM) and 5846 subjects without DM (non-DM) were included in the final analysis. The primary endpoint was incident CKD, defined as a composite of estimated glomerular filtration rate <60 mL≥ min-1≥ 1.73 m-2 and/or the development of proteinuria. Results: In the DM and non-DM groups, the mean ages of the participants were 55.6 ± 8.7 and 51.4 ± 8.6 y, the numbers of male subjects were 454 (52.0%) and 2784 (47.6%), and the mean estimated glomerular filtration rates were 91.6 ± 14.0 and 94.5 6 14.0 mL· min-1· 1.73 m-2, respectively. The mean values of dietary phosphorus density, defined as the ratio of a single-day dietary phosphorus amount to the total daily calorie intake, were 0.51 6 0.08 mg/kcal in the DM group and 0.51 ± 0.07 mg/kcal in the non-DM group. During the follow-up, CKD newly developed in 283 (32.4%) and 792 subjects (13.5%) in the DM and non-DM groups, respectively. When the subjects were divided into quartiles according to the dietary phosphorus density in each group, the highest quartile was significantly associated with the development of incident CKD by multiple Cox proportional hazard analysis in the DM group (P = 0.02) but not in the non-DM group (P = 0.72). Conclusions: High dietary phosphorus density is associated with an increased risk of CKD development in DM patients with normal renal function. The causality in this association needs to be tested in a randomized controlled trial. Am J Clin Nutr 2017;106:311-21.
UR - http://www.scopus.com/inward/record.url?scp=85021820517&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85021820517&partnerID=8YFLogxK
U2 - 10.3945/ajcn.116.151654
DO - 10.3945/ajcn.116.151654
M3 - Article
C2 - 28592606
AN - SCOPUS:85021820517
SN - 0002-9165
VL - 106
SP - 311
EP - 321
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 1
ER -
