High-protein diet with renal hyperfiltration is associated with rapid decline rate of renal function: A community-based prospective cohort study

Jong Hyun Jhee, Youn Kyung Kee, Seohyun Park, Hyoungnae Kim, Jung Tak Park, Seung Hyeok Han, Shin Wook Kang, Tae Hyun Yoo

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Background: The effect of a high-protein diet with renal hyperfiltration (RHF) on decline of kidney function has rarely been explored. We investigated the association between a high-protein diet, RHF and declining kidney function. Methods: A total of 9226 subjects from the Korean Genome and Epidemiology Study, a community-based prospective study (2001-14), were enrolled and classified into quartiles according to daily amount of protein intake based on food frequency questionnaires. RHF was defined as estimated glomerular filtration rate (eGFR) with residuals of >95th percentile after adjustment for age, sex, history of hypertension or diabetes, height and weight. Rapid decline of renal function was defined as decline rate of eGFR >3 mL/min/1.73 m2/year. Results: The relative risk of RHF was 3.48-fold higher in the highest than in the lowest protein intake quartile after adjustment for confounding factors [95% confidence interval (CI) 1.39-8.71]. The mean eGFR decline rate was faster as quartiles of protein intake increased. Furthermore, the highest quartile was associated with 1.32-fold increased risk of rapid eGFR decline (95% CI 1.02-1.73). When subjects were divided into two groups with or without RHF, the highest quartile was associated with a rapid decline in renal function only in RHF subjects (odds ratio 3.35; 95% CI 1.07-10.51). The sensitivity analysis using the Korean National Health and Nutrition Examination Survey (2008-15) data with 40 113 subjects showed that higher quartile was associated with increased risk for RHF. Conclusions: A high-protein diet increases the risk of RHF and a rapid renal function decline in the general population. These findings suggest that a high-protein diet has a deleterious effect on renal function in the general population.

Original languageEnglish
Pages (from-to)98-106
Number of pages9
JournalNephrology Dialysis Transplantation
Issue number1
Publication statusPublished - 2020 Jan 1

Bibliographical note

Funding Information:
This research was supported by a grant from the Ministry for Health and Welfare, Republic of Korea. The epidemiologic data used in this study were obtained from the KoGES (4851-302) of the Korea Centers for Disease Control and Prevention, Republic of Korea and the Korea National Health and Nutrition Examination Survey (KNHANES IV, V and VI) from 2008 to 2015, Republic of Korea. This study was supported by a research grant from Inha University Hospital. The funding source had no role in the conception of the study or the collection, analysis and interpretation of the data; writing of the manuscript; or the decision to submit for publication.

Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation


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