Abstract: SA-OR70
Association of Dietary Potassium and Fiber Intake with Death Risk in a Prospective Hemodialysis Cohort
Session Information
- Nutritional and Lifestyle Interventions to Promote Health in CKD
November 04, 2023 | Location: Room 109, Pennsylvania Convention Center
Abstract Time: 04:48 PM - 04:57 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1500 Health Maintenance, Nutrition, and Metabolism
Authors
- Narasaki, Yoko, University of California Irvine School of Medicine, Irvine, California, United States
- Kalantar-Zadeh, Kamyar, Harbor-UCLA Medical Center, Torrance, California, United States
- Han, Seung Hyeok, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
- Chang, Tae ik, National Health Insurance Service, Wonju, Gangwon-do, Korea (the Republic of)
- Kalantar, Diana Sunhee, University of California Irvine School of Medicine, Irvine, California, United States
- Nakata, Tracy, University of California Irvine School of Medicine, Irvine, California, United States
- Nguyen, Danh V., University of California Irvine School of Medicine, Irvine, California, United States
- Rhee, Connie, University of California Irvine School of Medicine, Irvine, California, United States
Background
In ESKD patients, guidelines recommend dietary potassium (K) restriction given concerns about potential hyperkalemia leading to malignant arrhythmias and mortality. Yet there are sparse data informing recommendations for dietary K intake in this population. We examined the relationship between dietary K intake and death risk in a prospective HD cohort.
Methods
In 687 hemodialysis patients from the multi-center NIH MADRAD cohort recruited from 16 outpatient dialysis clinics, dietary K intake data were obtained using protocolized Food Frequency Questionnaires (FFQs) administered over 10/2011-9/2022. We examined associations of dietary K intake categorized as tertiles with mortality using multivariable Cox regression. Given the high fiber content of plant-based K-rich foods, we also examined different pairings of dietary K and fiber intake across four exposure groups (low K/low fiber, low K/high fiber, high K/low fiber, high K/high fiber) with survival.
Results
In expanded case-mix analyses, the lowest dietary K intake tertile was associated with higher mortality (ref: highest tertile): HR (95%CI) 1.58 (1.07, 2.33) (Fig A). After further adjustment for laboratory+nutritional covariates, associations showed greater magnitude of risk: HR (95%CI) 1.66 (1.11, 2.49). In adjusted analyses of dietary K/fiber pairings, patients with low K/low fiber intake and those with high K/low fiber intake had worse survival vs. those with high K/high fiber intake: HRs (95%CIs) 1.45 (1.04, 2.00) and 1.51 (1.03, 2.28), respectively (Fig B).
Conclusion
In a prospective HD cohort, lower dietary K intake was associated with higher mortality. When examined in combination with fiber intake, both low K/low fiber and high K/low fiber intake were associated with worse survival. These findings suggest excessive dietary K restriction as well as high K intake from foods with lower fiber content (animal-based sources) may be deleterious in HD patients. Further studies are needed to determine the optimal amount and sources of dietary K intake in ESKD.
Funding
- NIDDK Support