Potential Role of Vegetarianism on Nutritional and Cardiovascular Status in Taiwanese Dialysis Patients: A Case-Control Study.
OBJECTIVE
Cardiovascular disease remains the most common cause of death for patients on chronic dialysis. End stage renal disease patients undergoing dialysis imposed to reduce phosphorus intake, which likely contributes to development of vegetarian diet behaviors. Vegetarian diets are often lower in protein content, in contradiction to the recommendation that a high protein diet is followed by patients undergoing dialysis. The purpose of the study was to investigate the effects of a vegetarian diet on the nutritional and cardiovascular status of dialysis patients.


METHODS
A study of 21 vegetarian dialysis patients and 42 age- and sex-matched non-vegetarian dialysis patients selected as controls was conducted in the Kaohsiung Veterans General Hospital. Brachial-ankle pulse wave velocity and biochemistry data including total homocysteine levels, serum lipid profiles, high-sensitivity C-reactive protein, vitamin D levels, albumin, and normalized protein catabolic rate were measured.


RESULTS
Compared with the non-vegetarian control group, vegetarian subjects had lower body weight, body mass index, serum phosphate, blood urea nitrogen, serum creatinine, vitamin D, uric acid, albumin, and normalized protein catabolic rate (p < 0.05). The vegetarian group showed higher brachial-ankle pulse wave velocity than the non-vegetarian group (1926.95 ± 456.45 and 1684.82 ± 309.55 cm/sec, respectively, p < 0.05). After adjustment for age, albumin, pre-dialysis systolic blood pressure, and duration of dialysis, vegetarian diet remained an independent risk factor for brachial-ankle pulse wave velocity.


CONCLUSIONS
The present study revealed that patients on dialysis who follow vegetarian diets may experience subclinical protein malnutrition and vitamin D deficiency that could offset the beneficial cardiovascular effects of vegetarianism.
Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Shih-Hsiang
http://orcid.org/0000-0001-5294-3113
SH
Ou
Division of Nutrition, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Mei-Yin
MY
Chen
Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Chien-Wei
CW
Huang
Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Kaohsiung, Taiwan.
Nai-Ching
NC
Chen
Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Kaohsiung, Taiwan.
Chien-Hsing
CH
Wu
Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Chih-Yang
CY
Hsu
Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Kang-Ju
KJ
Chou
Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Po-Tsang
PT
Lee
Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Hua-Chang
HC
Fang
Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.|Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Chien-Liang
CL
Chen
D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D001835:Body Weight / Q000502:physiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D002320:Cardiovascular Physiological Phenomena; D016022:Case-Control Studies; D004032:Diet; D014676:Diet, Vegetarian / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology*; D063177:Pulse Wave Analysis; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D059289:Vascular Stiffness / Q000502:physiology