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Protein intake and its relationship with frailty in chronic kidney disease

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A Correction to this article was published on 05 April 2024

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Abstract

Introduction

Patients with chronic kidney disease (CKD) are susceptible to frailty because of a range of nutrition-related factors. While protein restriction is commonly advised to preserve kidney function in patients with CKD, insufficient protein intake could potentially exacerbate frailty risk. This study aimed to elucidate the relationship between frailty and protein intake in patients with CKD.

Methods

This cross-sectional study enrolled patients with CKD stage 3–5. Frailty and prefrailty were assessed using the Japanese version of the Cardiovascular Health Study (J-CHS) criteria. To estimate dietary protein intake, Maroni's formula based on 24-h urine collection was used. The potential association between frailty/pre-frailty and protein intake was investigated using a logistic regression analysis.

Results

Ninety-seven individuals with CKD were included in the study, with a median age of 73.0 years (interquartile range: 67.0, 82.0). Among them, 34 were women (35.1%), and the estimated glomerular filtration rate (eGFR) was 36.3 mL/min/1.73 m2 (interquartile range: 26.9, 44.1). Frailty and pre-frailty were identified in 13.4% and 55.7% of participants, respectively. Comparing the groups, protein intake in the frailty/pre-frailty group (0.83 g/kgBW/day [0.72, 0.93]) was lower than that in the robust group (0.89 g/kgBW/day [0.84, 1.19], p = 0.002). Upon logistic regression analysis, protein intake exhibited an independent association with frailty/pre-frailty (odds ratio: 0.72, 95% confidence interval: 0.59–0.89, p = 0.003).

Conclusion

Reduced protein intake in patients with CKD is associated with frailty and pre-frailty. It is advisable to ensure that patients with CKD who are at risk of frailty consume an adequate amount of protein.

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Acknowledgements

The authors have no acknowledgments to make for the present study.

Funding

This research did not receive any funding from agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Rehabilitation, Niigata Rinko Hospital, Niigata, Japan

    Nobuyuki Shirai

  2. Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata, 951-8510, Japan

    Nobuyuki Shirai, Suguru Yamamoto & Ichiei Narita

  3. Internal Medicine, Niigata Rinko Hospital, Niigata, Japan

    Yutaka Osawa

  4. Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan

    Atsuhiro Tsubaki

  5. Department of Physical Therapy, School of Health Science, Fukushima Medical University, Fukushima, Japan

    Shinichiro Morishita

  6. Department of Health and Nutrition, Faculty of Human Life Studies, University of Niigata Prefecture, Niigata, Japan

    Toshiko Murayama

Authors
  1. Nobuyuki Shirai
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  2. Suguru Yamamoto
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  3. Yutaka Osawa
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  4. Atsuhiro Tsubaki
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  5. Shinichiro Morishita
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  6. Toshiko Murayama
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  7. Ichiei Narita
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Contributions

NS, SY, and IN contributed to the conception, study design, and data interpretation. NS, SY, YO, AT, SM, and TM contributed to measurements and analyses. NS, SY, and IN drafted the manuscript. All the authors have read and approved the final version of the manuscript.

Corresponding author

Correspondence to Suguru Yamamoto.

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Conflict of interest

All authors have declared no competing interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Research involving human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of Niigata Rinko Hospital (approval no. 2303-114) and with the 1964 Helsinki declaration and its later amendments.

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The original online version of this article was revised: In the original publication, the authors have identified a typographical error in x-axis of Figure 2. The value ‘-2.2E-16’ should be replaced as ‘0’ in Figures 2a, 2b, 2c, and 2e.

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Shirai, N., Yamamoto, S., Osawa, Y. et al. Protein intake and its relationship with frailty in chronic kidney disease. Clin Exp Nephrol 28, 447–453 (2024). https://doi.org/10.1007/s10157-023-02452-9

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  • DOI: https://doi.org/10.1007/s10157-023-02452-9

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