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Br J Nutr. 2019 Jul 19:1-19. doi: 10.1017/S0007114519001764. [Epub ahead of print]

Dietary fiber and mortality risk in patients on peritoneal dialysis.

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Renal Division, Department of Medicine, Peking University First Hospital;Institute of Nephrology, Peking University;Key Laboratory of Renal Disease, Ministry of Health and Key Laboratory of Renal Disease,Ministry of Education;Beijing,China.
Linyi People's Hospital,Shandong,China.


Higher fiber intake reduced all-cause and cardiovascular mortality among healthy population, but such data in dialysis patients are limited. We aimed to examine these associations in patients on peritoneal dialysis. This single-center prospective cohort study enrolled 881 incident PD patients between October 2002 and August 2014. All patients were followed until death, transfer to hemodialysis, renal transplantation or until being censored in June 2018. Demographic data were collected at baseline. Biochemical, dietary, and nutrition data were examined at baseline and thereafter at regular intervals to calculate the average values throughout the study. The outcomes were defined as all-cause and cardiovascular death. Cox proportional regression models were applied to explore the relationship between fiber intake and outcomes. Participants with higher fiber intake were more likely to be younger, male, and having better residual renal function and serum lipids at baseline. They were prone to maintain better nutrient status, higher blood pressure and lower inflammatory status at baseline and afterward. Neither baseline nor time-averaged fiber intake did show protective effects on all-cause mortality after multivariate adjustment in the whole cohort. Among non-diabetic PD patients, an independent association between fiber intake and all-cause mortality was found, in which each 1g/day of increase in time-averaged fiber intake correlated to 13% of reduction in all-cause mortality. We did not observe any benefits of fiber intake in the CVD mortality for both whole cohort and subgroups. This study revealed that higher dietary fiber intake appeared to have a protective effect on all-cause mortality in non-diabetic PD patients, which suggest that PD patients should be encouraged to eat a diet rich in fibers.


Chronic kidney disease; Dietary fiber; Dietary nutrient; Mortality; Peritoneal dialysis


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