title: Dietary Protein Intake in a Multi-ethnic Asian Population of Healthy Participants and Chronic Kidney Disease Patients.
abstract: BACKGROUND
  Clinical practice guidelines recommend different levels of dietary protein intake in predialysis chronic kidney disease (CKD) patients. It is unknown how effectively these recommendations perform in a multi-ethnic Asian population, with varied cultural beliefs and diets. We assess the profi le of protein intake in a multi-ethnic Asian population, comparing healthy participants and CKD patients.
  
  
  METHODS
  We analysed the 24-hour urine collections of the Asian Kidney Disease Study (AKDS) and the Singapore Kidney Function Study (SKFS) to estimate total protein intake (TPI; g/day). We calculated ideal body weight (IDW; kg): 22.99 × height2 (m). Standard statistical tests were applied where appropriate, and linear regression was used to assess associations of continuous variables with protein intake.
  
  
  RESULTS
  There were 232 CKD patients and 103 healthy participants with 35.5% diabetics. The mean TPI in healthy participants was 58.89 ± 18.42 and the mean TPI in CKD patients was 53.64 ± 19.39. By US National Kidney Foundation (NKF) guidelines, 29/232 (12.5%) of CKD patients with measured glomerular filtration rate (GFR) <25 (in mL/min/1.73 m2) had a TPI-IDW of <0.6 g/kg/day. By Caring for Australasians with Renal Impairment (CARI) guidelines, 76.3% (177/232) of CKD patients had TPI-IDW >0.75g/kg/ day. By American Dietetic Association (ADA) guidelines, 34.7% (44/127) of CKD patients with GFR <50 had TPI-IDW between 0.6 to 0.8 g/kg/day. Only 1/6 non-diabetic CKD patients with GFR <20 had a protein intake of between 0.3 to 0.5 g/kg/day. A total of 21.9% (25/114) of diabetic CKD patients had protein intake between 0.8 to 0.9 g/kg/day.
  
  
  CONCLUSIONS
  On average, the protein intake of most CKD patients exceeds the recommendations of guidelines. Diabetic CKD patients should aim to have higher protein intakes.
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Boon Wee
authors.initials: BW
authors.lastname: Teo
authors.forename: Qi Chun
authors.initials: QC
authors.lastname: Toh
authors.forename: Hui
authors.initials: H
authors.lastname: Xu
authors.forename: Adonsia Y T
authors.initials: AY
authors.lastname: Yang
authors.forename: Tingxuan
authors.initials: T
authors.lastname: Lin
authors.forename: Jialiang
authors.initials: J
authors.lastname: Li
authors.forename: Evan J C
authors.initials: EJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D003430:Cross-Sectional Studies; D004044:Dietary Proteins / Q000008:administration & dosage* / Q000652:urine; D005260:Female; D006306:Health Surveys; D006801:Humans; D044342:Malnutrition / Q000208:ethnology; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000208:ethnology; D012846:Singapore
chemical_list: D004044:Dietary Proteins