Association of dietary proteins with serum creatinine and estimated glomerular filtration rate in a general population sample: the CHRIS study

Abstract

Background Diet is known to affect kidney function. However, population-based studies provide contrasting evidence, resulting in a poor understanding of the effect of proteins from specific foods on kidney health. Methods We analyzed the effect of total daily protein intake (TDPI) and source-specific daily protein intake (DPI) on fasting serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) in the Cooperative Health Research In South Tyrol (CHRIS) cross-sectional study (n = 5889), using the GA2LEN food frequency questionnaire for TDPI and DPI estimation. We fitted multivariable adjusted mixed models of SCr and eGFR on TDPI and DPI quartiles (Q1-Q4) in the overall sample, and after removing individuals with known hypertension, diabetes or chronic kidney disease (CKD). Results Higher TDPI as well as DPI from overall animal sources, fish, and poultry, were associated with higher SCr (trend test p, ptrend < 0.01), with larger effect after excluding individuals with known hypertension, diabetes or CKD. The eGFR was lower at higher TDPI (Q4 vs Q1: − 1.6 ml/min/1.73 m2; 95% CI − 2.5, − 0.7; ptrend = 3e−4) and DPI from fish (Q4 vs Q1: − 2.1 ml/min/1.73 m2; 95% CI − 2.9, − 1.20; ptrend = 4.3e−6), overall animal source (Q4 vs Q1: − 1.6 ml/min/1.73 m2; 95% CI −2.5, − 0.8), processed meat (Q4 vs Q1: − 1.4 ml/min/1.73 m2; ptrend = 0.027), red meat, offal and processed meat (Q4 vs Q1: − 1.4 ml/min/1.73 m2; ptrend = 0.015) and poultry (Q4 vs Q1: − 0.9 ml/min/1.73 m2; ptrend = 0.015). Conclusions TDPI and DPI from specific animal sources were positively associated with SCr and negatively associated with eGFR. Lacking an alternative marker of kidney function, confounding involving muscle mass metabolism cannot be fully excluded. Graphical abstract

Association of a dietary inflammatory index with cardiometabolic, endocrine, liver, renal and bones biomarkers: cross-sectional analysis of the UK Biobank study

“…Creatinine originates from creatine during muscle breakdown and from dietary protein (27). Thus, protein-rich diets are likely to increase creatinine levels (25,26). These results are consistent with earlier research indicating a higher incidence of kidney disease among individuals with proinflammatory diets (28).…”

“…In contrast, those with a proinflammatory diet had elevated levels of these markers. The elevated creatinine and urate levels observed in the pro-inflammatory diet group could be attributed to the higher meat content in their diets (25,26). Creatinine originates from creatine during muscle breakdown and from dietary protein (27).…”

Association between Consumption of Dietary Supplements and Chronic Kidney Disease Prevalence: Results of the Korean Nationwide Population-Based Survey

“…According to a prospective cohort study based on the Korean Genome and Epidemiology Study conducted between 2001 and 2014, high total protein intake-induced renal hyperfiltration causes fast eGFR decline in healthy adults with normal renal function [ 41 ]. A large Italian general-population study also evaluated the effects of protein intake on serum creatinine and eGFR through questionnaire [ 42 ]. Results showed an association between protein intake and decreased renal function, and also confirmed the association between higher protein diets and eGFR levels, even excluding participants with known diabetes, hypertension or CKD.…”

“…According to a recent study, the average dietary protein intake of Koreans is almost twice the estimated average requirement [ 43 ]. Therefore, additional protein supplementation can lead to an excessive protein load on the body and renal damage in several ways through increased glomerular pressure and an additional acid load on the kidney [ 42 , 44 , 45 ]. Therefore, protein supplementation should be prescribed with particular caution in patients with kidney disease, and further evaluation of the effects of prolonged exposure to high protein intake on renal function in healthy subjects is warranted.…”

Advancing Precision Medicine in South Tyrol, Italy: A Public Health Development Proposal for a Bilingual, Autonomous Province

“…The Institute of Biomedicine of the European Academy (EURAC) Research Centre and the South Tyrolean Health Service are working together within the framework of the population study CHRIS (Cooperative Health Research in South Tyrol) [ 40 ]. This study investigated the roles of genetic predisposition, lifestyle, and environment under such conditions [ 41 , 42 , 43 , 44 , 45 , 46 , 47 ]. The focus was on cardiovascular, neurological, and metabolic diseases.…”