SAN DIEGO — Dialysis patients with end-stage renal disease who consumed high quantities of dietary fiber had less inflammation and less myocardial hypertrophy and injury, according to research presented at ASN Kidney Week.
“CVD is the leading cause of death in chronic kidney disease patients,” Angela Yee Moon Wang, MD, PhD, from the University of Hong Kong, said during her presentation. “By the time patients approach stage 5, over half of them die from CVD.”
Data from the general population suggest that the risk for coronary heart disease and CVD decreases by nearly 10% with every additional gram of fiber intake, she said.
“However, in our dialysis patients, we frequently advise them to reduce their fruits, vegetables or whole grain intake for concerns of phosphates and potassium,” she said.
Wang and colleagues conducted a prospective observational study to investigate the association between dietary fiber intake and risk of major adverse cardiovascular events (MACE) in dialysis patients with end-stage renal disease (n = 219). The researchers used a 7-day validated food frequency dietary questionnaire to estimate dietary fiber intake. Participants were followed for 4 years and assessed for MACE and inflammatory biomarkers.
The researchers found that patients with higher fiber intake had less inflammation, lower serum cardiac troponin T, N-terminal pro-brain natriuretic peptide and less cardiac hypertrophy. One or more MACE was observed in most patients (n =127).
On a univariate analysis, there was an association between higher fiber intake (HR = 0.87; 95% CI, 0.8-0.94) and higher fiber intake density (HR = 0.85; 95% CI, 0.74-0.97) and a lower risk for MACE.
In the multivariable analysis, higher fiber intake was predictive of a lower risk for MACE (adjusted HR = 0.89; 95% CI, 0.81-0.97). This association was independent of other clinical, demographic, biochemical, hemodynamic, adequacy parameters, dietary protein, energy intake and inflammatory and cardiac markers.
Fiber intake density remained significantly associated with MACE as a continuous variable (aHR = 0.87; 95% CI, 0.77-0.99) and when stratified into tertiles. There was an increased risk for MACE in participants in the lower tertile (aHR = 1.78, 95% CI, 1.13-2.8) compared with the upper tertile.
“High dietary fiber intake and high fiber nutrient density were associated with less inflammation, less myocardial hypertrophy and injury and predicted a lower risk of MACE in the dialysis population,” Wang said.
“These findings form an important basis to conduct a randomized controlled trial to evaluate the effects of fiber supplementation on cardiovascular outcomes in dialysis patients,” she added. – by Alaina Tedesco
Wang AYM, et al. FR-OR126. Presented at: ASN Kidney Week; Oct. 23-28, 2018; San Diego.
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