#2107 Dietary fiber intake and frailty in patients with and without chronic kidney disease: a nationally representative analysis

Abstract Background and Aims Higher dietary fiber intake (DFI) is linked to lower risk of frailty in older population. However, people with chronic kidney disease (CKD) often eat less fiber due to concerns about fiber and potassium-rich foods causing hyperkalemia. It remains unclear if the link between DFI and frailty applies to people with and without CKD. Method This cross-sectional study analysed data from the National Health and Nutrition Examination Survey (NHANES 2003–2018). DFI was calculated based on average of two days dietary recall. Frailty was evaluated by the 36-item frailty index. CKD was defined as estimated glomerular filtration rate < 60 mL/min/1.73 m2 and/or urinary albumin creatinine ratio ≥30 mg/g. The association of DFI with frailty were analysed using weighted multivariate logistic regression and restricted cubic splines (RCS). Results A total of 15304 adults (median age 63 years, 55% female) were included in this analysis. The prevalence of frailty was 30% in 4037 CKD patients and 9.5% in 11267 non-CKD population. Each SD (3.95 g/1000 kcal/day) increase of DFI was associated with 41% reduced odds of frailty in whole population {adjusted odds ratio (aOR) 0.59 [95% confidence interval (CI) 0.46–0.76]} and 44% in non-CKD population (aOR: 0.56, 95% CI: 0.41–0.77), but not in the CKD population (aOR: 0.67, 95% CI: 0.44–1.03). RCS analysis in whole population reveal linear association between DFI and frailty (P for nonlinearity =0.88, Fig. 1 ). The results of subgroup analysis in those with and without cardiovascular diseases (CVD), hypertension, drinking habit were consistent. Conclusion DFI is associated with frailty in the non-CKD population but not in the CKD population. Other factors instead of DFI might contribute more on frailty in patients with CKD.