S-454 Phosphate-Dense Diet Correlates with Decline Renal Function in Diabetic Individuals = S-454 Phosphate-Dense Diet Correlates with Decline Renal Function in Diabetic Individuals

다국어 초록 (Multilingual Abstract)

Background: We investigated that whether high Pi diet would affects the incidence of renal dysfunction in subjects with diabetes whose are most concerned about declining kidney function. Methods: The Korean Genome and Epidemiology Study (KoGES), a prospective community-based cohort study was used to conduct the present work. The study cohort consisted of 40- to 69-year-old residents, and the followed-up biennially from 2001 to 2014. Total of 873 diabetic and 5,846 non-diabetic subjects were included. The primary end point was a composite of eGFR ＜60 ml/min/1.73 m2 or the development of proteinuria. Results: The mean age was 55.6±8.7 and 51.4±8.6 years in diabetic and non-diabetic groups, and 454 (52.0%) in diabetic and 2,784 (47.6%) in non-diabetic individuals were men. The mean eGFR and Pi-dense diet (Pi/total intake) were 91.6±14.0 ml/min/1.73 m2 and 0.51±0.08 mg/kcal in diabetic group, 94.5±14.0 ml/min/1.73 m2 and 0.51±0.07 mg/kcal in non-diabetic group, respectively. Each of diabetic and non-diabetic subjects were divided into four groups according to the degree of Pi-dense diet. During a mean follow-up duration of 100.0±41.4 months in diabetic subjects and 115.4±33.8 months in non-diabetic subjects, incidence of decline renal function was observed in 283 (32.4%) and 792 (13.5%) subjects in the diabetes and non-diabetes groups. Multiple Cox proportional hazard analysis adjusted for multiple confounding factors revealed that the most Pi-dense diet group had a significantly more declining renal function events than the lesser Pi-dense diet groups in diabetic subjects (p＝0.022). In contrast, there was no significant difference in the rate of declining renal function events among the groups in non-diabetic individuals (p＝0.719). Conclusions: These results assuming that Pi-dense diet would affect decline renal function even in individuals with preserved renal function.