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Low-protein diet is inversely related to the incidence of chronic kidney disease in middle-aged and older adults: results from a community-based prospective cohort study. Eur J Nutr 2022; 61:3795-3807. [PMID: 35947164 DOI: 10.1007/s00394-022-02981-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 07/29/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE Dietary protein intake can modulate renal health. However, the effect of dietary protein restriction on kidney function in the general population remains unclear. This study aimed to examine the association between total protein intake and new-onset chronic kidney disease (CKD) in Korean adults. METHODS We included 7339 participants from the Korean Genome and Epidemiology Study. Participants were divided into low-protein diet (LPD, < 0.8 g/kg/day), normal-protein diet (NPD, 0.8-1.3 g/kg/day), and high-protein diet (HPD, > 1.3 g/kg/day) groups. New-onset CKD was defined as two consecutive events of estimated glomerular filtration rate < 60 mL/min/1.73 m2. Multivariable Cox hazard regression analysis was conducted to examine the association of total protein intake with new-onset CKD. Subgroup analyses according to diabetes mellitus (DM) status were performed. We performed the same analyses by dividing participants into total protein, plant protein, and animal protein intake tertiles. RESULTS During a median follow-up of 13.7 years, 633 (8.7%) participants newly developed CKD. The fully adjusted hazard ratios (HR) with 95% confidence interval (CI) for incident CKD of the LPD and HPD groups compared with the NPD group were 1.49 (1.18-1.87) and 0.63 (0.45-0.87), respectively. The HR (95% CI) of the highest tertile group of plant protein intake for incident CKD was 0.72 (0.54-0.93), compared with that of the lowest tertile group. Similar trends were observed only in the non-DM subgroup, not in the DM subgroup. CONCLUSION Protein intake, especially plant proteins, was negatively associated with the incidence of new-onset CKD in middle-aged and older Korean adults.
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Kim H, Cho SK, Kim JW, Jung SY, Jang EJ, Bae SC, Yoo DH, Sung YK. An increased disease burden of autoimmune inflammatory rheumatic diseases in Korea. Semin Arthritis Rheum 2020; 50:526-533. [DOI: 10.1016/j.semarthrit.2019.11.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 09/26/2019] [Accepted: 11/08/2019] [Indexed: 12/17/2022]
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Medina-Solís CE, Ávila-Burgos L, Borges-Yañez SA, Irigoyen-Camacho ME, Sánchez-Pérez L, Zepeda-Zepeda MA, Lucas-Rincón SE, Medina-Solís JJ, Márquez-Corona MDL, Islas-Granillo H, Casanova-Rosado JF, Casanova-Rosado AJ, Minaya-Sánchez M, Villalobos-Rodelo JJ, Patiño-Marín N, Mendoza-Rodríguez M, Pontigo-Loyola AP, de la Rosa-Santillana R, Escoffié-Ramirez M, Fernández-Barrera MA, Maupomé G. Ecological study on needs and cost of treatment for dental caries in schoolchildren aged 6, 12, and 15 years: Data from a national survey in Mexico. Medicine (Baltimore) 2020; 99:e19092. [PMID: 32049814 PMCID: PMC7035119 DOI: 10.1097/md.0000000000019092] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
To determine the treatment needs and the care index for dental caries in the primary dentition and permanent dentition of schoolchildren and to quantify the cost of care that would represent the treatment of dental caries in Mexico.A secondary analysis of data from the First National Caries Survey was conducted, which was a cross-sectional study conducted in the 32 states of Mexico. Based on dmft (average number of decayed, extracted, and filled teeth in the primary dentition) and DMFT (average number of decayed, extracted, and filled teeth in permanent dentition) information, a treatment needs index (TNI) and a caries care index (CI) were calculated.At age 6, the TNI for the primary dentition ranged from 81.7% to 99.5% and the CI ranged from 0.5% to 17.6%. In the permanent dentition, the TNI ranged from 58.8% to 100%, and the CI ranged from 0.0% to 41.2%. At age 12, the TNI ranged from 55.4% to 93.4%, and the CI ranged from 6.5% to 43.4%. At age 15, the TNI ranged from 50.4% to 98.4%, and the CI ranged from 1.4% to 48.3%. The total cost of treatment at 6 years of age was estimated to range from a purchasing power parity (PPP) of USD $49.1 to 287.7 million in the primary dentition, and from a PPP of USD $3.7 to 24 million in the permanent dentition. For the treatment of the permanent dentition of 12-year-olds, the PPP ranged from USD $13.3 to 85.4 million. The estimated cost of treatment of the permanent dentition of the 15-year-olds ranged from a PPP of USD $10.9 to 70.3 million. The total estimated cost of caries treatment ranged from a PPP of USD $77.1 to 499.6 million, depending on the type of treatment and provider (public or private).High percentages of TNI for dental caries and low CI values were observed. The estimated costs associated with the treatment for caries have an impact because they represent a considerable percentage of the total health expenditure in Mexico.
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Affiliation(s)
- Carlo E. Medina-Solís
- Academic Area of Dentistry of Institute of Health Sciences at Autonomous University of Hidalgo State, Pachuca
- Advanced Studies and Research Center in Dentistry “Dr. Keisaburo Miyata” of School of Dentistry at Autonomous University State of Mexico, Toluca
| | - Leticia Ávila-Burgos
- Health Systems Research Centre at National Institute of Public Health, Cuernavaca
| | | | | | - Leonor Sánchez-Pérez
- Health Care Department, Metropolitan Autonomous University-Xochimilco, Mexico City
| | | | - Salvador E. Lucas-Rincón
- Academic Area of Dentistry of Institute of Health Sciences at Autonomous University of Hidalgo State, Pachuca
- Clinic of Dental Specialties of the General Hospital of Pachuca, campus Arista of the Ministry of Health of Hidalgo, Pachuca
| | - June J. Medina-Solís
- Ministry of Education of Campeche, Sub-secretary of Educational Coordination, Direction of Coordination and Budgetary Management, Campeche
| | - María de L. Márquez-Corona
- Academic Area of Dentistry of Institute of Health Sciences at Autonomous University of Hidalgo State, Pachuca
| | - Horacio Islas-Granillo
- Academic Area of Dentistry of Institute of Health Sciences at Autonomous University of Hidalgo State, Pachuca
| | | | | | | | - Juan J. Villalobos-Rodelo
- Department of Epidemiology at Institute of Social Security and Services for Government Workers (ISSSTE), Culiacan
| | - Nuria Patiño-Marín
- Clinical Research Laboratory, Program of Doctorate in Dental Sciences at Autonomous University of San Luis Potosi, San Luis Potosi
| | - Martha Mendoza-Rodríguez
- Academic Area of Dentistry of Institute of Health Sciences at Autonomous University of Hidalgo State, Pachuca
| | - América P. Pontigo-Loyola
- Academic Area of Dentistry of Institute of Health Sciences at Autonomous University of Hidalgo State, Pachuca
| | - Rubén de la Rosa-Santillana
- Academic Area of Dentistry of Institute of Health Sciences at Autonomous University of Hidalgo State, Pachuca
- Clinic of Dental Specialties of the General Hospital of Pachuca, campus Arista of the Ministry of Health of Hidalgo, Pachuca
| | | | - Miguel A. Fernández-Barrera
- Academic Area of Dentistry of Institute of Health Sciences at Autonomous University of Hidalgo State, Pachuca
| | - Gerardo Maupomé
- Richard M. Fairbanks School of Public Health, Indiana University/Purdue University, Indianapolis
- Indiana University Network Science Institute, Bloomington, IN, USA
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Łabuś A, Niemczyk M, Czyżewski Ł, Fliszkiewicz M, Kulesza A, Mucha K, Pączek L. Costs of Long-Term Post-Transplantation Care in Kidney Transplant Recipients. Ann Transplant 2019; 24:252-259. [PMID: 31061380 PMCID: PMC6524555 DOI: 10.12659/aot.914661] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Solid organ transplantations lead to improvements in patient survival and patient quality of life, as well as health care system economic benefits. However, over time, health problems can accumulate post-transplantation. Therefore, we hypothesized that in the late post-transplantation period, the costs of patient care increase. Material/Methods We retrospectively calculated costs of patient care in 306 randomly selected kidney transplant recipients who had different follow-up time periods after kidney transplantation (between 1 year and 25 years). Direct costs of inpatient care as well as outpatient care, from the perspective of a transplant center, were considered. Results The mean costs, as well as median costs of post-transplantation care were the highest in the first post-transplantation year. Afterwards, the mean costs and median costs decreased, without an increase in costs of care in the late post-transplantation periods. Conclusions From the perspective of a transplant center, costs of long-term post-kidney transplantation care did not increase in the late period, even as long as 25 years after transplantation. Our results confirmed that kidney transplantation is a modality of renal replacement therapy that can be associated with economic benefits even when considering long-term post-transplantation care.
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Affiliation(s)
- Anna Łabuś
- Department of Immunology, Transplant Medicine and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Niemczyk
- Department of Immunology, Transplant Medicine and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Łukasz Czyżewski
- Department of Nephrology Nursing, Medical University of Warsaw, Warsaw, Poland
| | - Magda Fliszkiewicz
- Department of Immunology, Transplant Medicine and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Kulesza
- Department of Immunology, Transplant Medicine and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Mucha
- Department of Immunology, Transplant Medicine and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Leszek Pączek
- Department of Immunology, Transplant Medicine and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
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Niemczyk M. Increasing economic burden caused by nephro-geriatric patients. J Med Econ 2018; 21:271-272. [PMID: 29124993 DOI: 10.1080/13696998.2017.1403923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mariusz Niemczyk
- a Department of Immunology, Transplant Medicine, and Internal Diseases , Medical University of Warsaw , Poland
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