Table 3. Association of food sources of protein with incident chronic kidney disease, ARIC, 1987-2012.
| Quintiles of Protein Consumption a | P-value for linear trend | |||||
|---|---|---|---|---|---|---|
|
|
||||||
| Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | ||
| Red meat | ||||||
| Person-years | 51,458 | 50,381 | 46,369 | 50,169 | 47,151 | |
| Events | 524 | 520 | 515 | 528 | 545 | |
| Median, svg/d | 0.17 | 0.35 | 0.57 | 0.78 | 1.15 | |
| HR (95% CI)* | 1 (ref) | 1.05 (0.93-1.19) | 1.12 (0.99-1.27) | 1.12 (0.98-1.27) | 1.27 (1.11-1.46) | <0.001 |
| HR (95% CI)† | 1 (ref) | 1.01 (0.89-1.14) | 1.07 (0.94-1.21) | 1.06 (0.93-1.21) | 1.19 (1.03-1.36) | 0.02 |
| Processed meat | ||||||
| Person-years | 56,652 | 48,075 | 47,322 | 47,079 | 46,399 | |
| Events | 554 | 482 | 505 | 514 | 577 | |
| Median, svg/d | 0.03 | 0.14 | 0.29 | 0.53 | 1.00 | |
| HR (95% CI)* | 1 (ref) | 1.03 (0.91-1.16) | 1.07 (0.95-1.21) | 1.09 (0.96-1.24) | 1.25 (1.09-1.43) | 0.002 |
| HR (95% CI)† | 1 (ref) | 0.98 (0.87-1.11) | 1.00 (0.88-1.13) | 0.99 (0.87-1.13) | 1.12 (0.98-1.29) | 0.16 |
| Red and processed meat | ||||||
| Person-years | 50,795 | 50,096 | 49,163 | 48,670 | 46,803 | |
| Events | 495 | 510 | 521 | 540 | 566 | |
| Median, svg/d | 0.30 | 0.62 | 0.92 | 1.28 | 1.93 | |
| HR (95% CI)* | 1 (ref) | 1.09 (0.96-1.24) | 1.13 (0.99-1.28) | 1.22 (1.07-1.39) | 1.36 (1.18-1.56) | <0.001 |
| HR (95% CI)† | 1 (ref) | 1.03 (0.91-1.17) | 1.05 (0.93-1.20) | 1.11 (0.97-1.27) | 1.23 (1.06-1.42) | 0.01 |
| Poultry | ||||||
| Person-years | 60,072 | 57,204 | 59,868 | 18,964 | 49,418 | |
| Events | 699 | 606 | 624 | 179 | 524 | |
| Median, svg/d | 0.13 | 0.28 | 0.43 | 0.50 | 0.71 | |
| HR (95% CI)* | 1 (ref) | 0.88 (0.79, 0.99) | 0.88 (0.79, 0.98) | 0.83 (0.71, 0.98) | 0.93 (0.83, 1.05) | 0.12 |
| HR (95% CI)† | 1 (ref) | 0.92 (0.82, 1.02) | 0.90 (0.80, 1.00) | 0.85 (0.72, 1.01) | 0.94 (0.84, 1.06) | 0.26 |
| Fish and seafood | ||||||
| Person-years | 51,557 | 48,650 | 46,426 | 49,625 | 49,267 | |
| Events | 570 | 546 | 501 | 502 | 513 | |
| Median, svg/d | 0.07 | 0.14 | 0.23 | 0.35 | 0.64 | |
| HR (95% CI)* | 1 (ref) | 1.01 (0.89, 1.13) | 0.96 (0.85, 1.08) | 0.86 (0.76, 0.97) | 0.89 (0.78, 1.01) | 0.003 |
| HR (95% CI)† | 1 (ref) | 0.98 (0.87, 1.10) | 0.97 (0.86, 1.09) | 0.85 (0.75, 0.97) | 0.89 (0.78, 1.01) | 0.01 |
| Eggs | ||||||
| Person-years | 65,463 | 37,876 | 49,151 | 58,751 | 34,261 | |
| Events | 692 | 400 | 520 | 635 | 384 | |
| Median, svg/d | 0.03 | 0.10 | 0.14 | 0.43 | 0.72 | |
| HR (95% CI)* | 1 (ref) | 0.93 (0.82, 1.05) | 0.97 (0.86, 1.08) | 0.98 (0.88, 1.09) | 0.94 (0.83, 1.08) | 0.76 |
| HR (95% CI)† | 1 (ref) | 0.93 (0.82, 1.05) | 0.94 (0.84, 1.06) | 0.96 (0.86, 1.07) | 0.92 (0.81, 1.06) | 0.33 |
| High-fat dairy | ||||||
| Person-years | 48,866 | 52,059 | 47,937 | 50,524 | 46,064 | |
| Events | 513 | 536 | 501 | 561 | 521 | |
| Median, svg/d | 0.13 | 0.35 | 0.57 | 0.90 | 1.61 | |
| HR (95% CI)* | 1 (ref) | 0.95 (0.84, 1.08) | 0.91 (0.80, 1.03) | 0.95 (0.84, 1.07) | 0.90 (0.79, 1.03) | 0.24 |
| HR (95% CI)† | 1 (ref) | 0.96 (0.85, 1.08) | 0.93 (0.82, 1.06) | 0.96 (0.84, 1.08) | 0.93 (0.81, 1.06) | 0.32 |
| Low-fat dairy | ||||||
| Person-years | 48,236 | 47,894 | 42,299 | 50,024 | 50,048 | |
| Events | 603 | 532 | 531 | 493 | 473 | |
| Median, svg/d | 0.00 | 0.22 | 0.60 | 1.07 | 2.04 | |
| HR (95% CI)* | 1 (ref) | 0.87 (0.77, 0.98) | 0.81 (0.71, 0.91) | 0.72 (0.64, 0.82) | 0.72 (0.63, 0.82) | <0.001 |
| HR (95% CI)† | 1 (ref) | 0.88 (0.78, 0.99) | 0.81 (0.72, 0.91) | 0.74 (0.65, 0.84) | 0.75 (0.65, 0.85) | <0.001 |
| Nuts | ||||||
| Person-years | 59,643 | 39,092 | 48,463 | 48,763 | 49,541 | |
| Events | 708 | 415 | 523 | 484 | 502 | |
| Median, svg/d | 0.03 | 0.10 | 0.21 | 0.43 | 0.86 | |
| HR (95% CI)* | 1 (ref) | 0.88 (0.78, 0.99) | 0.87 (0.78, 0.98) | 0.78 (0.70, 0.88) | 0.77 (0.68, 0.87) | <0.001 |
| HR (95% CI)† | 1 (ref) | 0.89 (0.78, 1.00) | 0.88 (0.79, 0.99) | 0.82 (0.73, 0.92) | 0.81 (0.72, 0.92) | <0.001 |
| Legumes | ||||||
| Person-years | 56,812 | 42,547 | 49,648 | 53,035 | 43,485 | |
| Events | 582 | 442 | 556 | 605 | 447 | |
| Median, svg/d | 0.07 | 0.14 | 0.21 | 0.36 | 0.68 | |
| HR (95% CI)* | 1 (ref) | 0.94 (0.83-1.06) | 0.99 (0.88-1.12) | 0.96 (0.85-1.08) | 0.82 (0.72-0.94) | 0.02 |
| HR (95% CI)† | 1 (ref) | 0.95 (0.83-1.07) | 0.97 (0.86-1.10) | 0.96 (0.85-1.08) | 0.83 (0.72-0.95) | 0.03 |
ARIC indicates Atherosclerosis Risk in Communities Study; CI, confidence interval; HR, hazard ratio; and svg/d, servings/day.
Protein consumption was estimated using cumulative average intake. For those who developed kidney disease or were censored from the analysis before visit 3, food frequency questionnaire data from visit 1 was used. Otherwise, for those who developed kidney disease or were censored from the analysis after study visit 3, the average of food frequency questionnaire data from visits 1 and 3 was used.
Model 1: Adjusted for age, race-center, sex, education level, and total caloric intake.
Model 2: Adjusted for variables in Model 1 + high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, total cholesterol, lipid-lowering medication use, systolic blood pressure, anti-hypertensive medication use, alcohol intake, current smoker, physical activity index, leisure-related physical activity, total carbohydrate intake, body mass index, and waist-to-hip ratio.