title: Red Meat Intake and Risk of ESRD.
abstract: Randomized controlled trials suggest that protein restriction may retard the progression of CKD toward ESRD. However, the effects of dietary protein intake level and the food sources of dietary protein on the risk of ESRD in the general population remain unclear. We investigated these effects in the Singapore Chinese Health Study, a prospective population-based cohort that recruited 63,257 Chinese adults aged 45-74 years from 1993 to 1998. We collected habitual diet information via a validated semiquantitative food frequency questionnaire and identified ESRD via record linkage with a nationwide registry. In all, 951 cases of ESRD occurred over a mean follow-up of 15.5 years. Regarding total protein intake, compared with the lowest quartile, the three higher quartiles combined had a hazard ratio for ESRD of 1.24 (95% confidence interval [95% CI], 1.05 to 1.46), but the dose-dependent association across the quartiles was not statistically significant (Ptrend=0.16). Red meat intake strongly associated with ESRD risk in a dose-dependent manner (hazard ratio for highest quartile versus lowest quartile,1.40 [95% CI, 1.15 to 1.71; Ptrend<0.001]). Intake of poultry, fish, eggs, or dairy products did not associate with risk of ESRD. In substitution analysis, replacing one serving of red meat with other food sources of protein associated with a maximum relative risk reduction of 62.4% (95% CI, 33.1 to 78.9; P<0.01). Our study shows that red meat intake may increase the risk of ESRD in the general population and substituting alternative sources of protein may reduce the incidence of ESRD.
authors.affiliation: Singhealth Polyclinics, Singapore.
authors.forename: Quan-Lan Jasmine
authors.initials: QJ
authors.lastname: Lew
authors.affiliation: Duke-NUS Medical School, Singapore.|Department of Renal Medicine, Singapore General Hospital, Singapore.
authors.forename: Tazeen Hasan
authors.initials: TH
authors.lastname: Jafar
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
authors.forename: Hiromi Wai Ling
authors.initials: HW
authors.lastname: Koh
authors.affiliation: National Registry of Diseases Office, Health Promotion Board, Singapore.
authors.forename: Aizhen
authors.initials: A
authors.lastname: Jin
authors.affiliation: National Registry of Diseases Office, Health Promotion Board, Singapore.
authors.forename: Khuan Yew
authors.initials: KY
authors.lastname: Chow
authors.affiliation: Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania; and.|Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Yuan
authors.affiliation: Duke-NUS Medical School, Singapore; woonpuay.koh@duke-nus.edu.sg.|Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
authors.forename: Woon-Puay
authors.initials: WP
authors.lastname: Koh
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000069466:Red Meat / Q000009:adverse effects*; D012307:Risk Factors
keywords: diet; end-stage renal disease; population-based study; protein; red meat