| Compared to animal protein, higher plant protein intake is associated with lower production of uremic toxins and lower serum phosphorus levels. It is unclear whether plant protein has a mortality benefit in chronic kidney disease (CKD). Therefore, we hypothesized that higher plant protein intake is associated with lower risk of mortality in CKD and tested this hypothesis by examining the association of plant protein intake with all-cause mortality.;The study population consisted of 14,533 National Health and Nutrition Examination Survey III participants aged 20 years or older without missing data for plant protein, animal protein and mortality. Plant protein and animal protein intake was estimated from 24h dietary recalls. Mortality was based on the results from a probabilistic linkage with vital statistic records through 12/31/2006. Cox regression models were used to relate each 10 g increase in plant protein or animal protein with all-cause mortality in the CKD and non-CKD subpopulation.;During the follow-up period, 2141 deaths occurred. Each 10 g/day increase of plant protein intake was found to be associated with hazard ratio (HR) 0.94, 95% confidence interval (CI) 0.88-1.00 in the non-CKD subpopulation (P=0.04), and HR 0.85, 95% CI 0.75-0.96 in the CKD subpopulation (P=0.01). Each standard deviation increase in plant protein to total protein intake ratio was associated with HR 0.88, 95% CI 0.79-0.98 in the CKD subpopulation (P=0.02).;We conclude that higher plant protein intake is associated with lower all cause of mortality, and the association is stronger in the CKD subpopulation. Future studies are warranted to determine the causal role of plant protein in reducing mortality in CKD. |
