Prognostic Value of Snack Intake Patterns in Patients on Maintenance Hemodialysis

Background: To explore the predictive value of snack intake patterns for hyperphosphatemia and major adverse cardiovascular events (MACE) in maintenance hemodialysis (MHD) patients. Methods: Snack questionnaire data was collected from 99 MHD patients at Shanghai Geriatric Medical Center. Patients were classified into low-(<5 times), medium-(<10 times), and high-frequency(>10 times) snack intake groups based on their weekly snacking habits. The most important variables were screened by randomized survival forest (RSF) which were included in the Cox regression model. The primary endpoint was the composite endpoint of hyperphosphatemia and MACE. Results: (1) Kaplan- Meier curves revealed a lower risk of composite endpoint events in the low-frequency group. (2)The RSF analysis screened out the six most important variables. Conclusion: Snack intake more than 10 times weekly represents an independent risk factor for the development of hyperphosphatemia and MACE in MHD patients. Funding: Private Foundation SupportCox proportional hazards regression modeling of composite endpoints - Model Crude model Model 1 Model 2 Model 3 HR(95%CI) p HR(95%CI) p HR(95%CI) p HR(95%CI) p Medium- 2.1 (1.2,3.6) 0.01 1.85(3.02,3.4) 0.04 2.22(0.68,7.3) 0.18 2.31 (0.71,7.5) 0.17 High- 5.6 (2,16) 0 4.49(1.5,13.4) 0.01 5.57(1.17,26.6) 0.03 5.45 (1.17,25.4) 0.03 The low frequency group was used as a reference. Crude model: uncorrected. Model 1: corrected for age, sex, BMI; Model 2: corrected for age, sex, BMI, snack type; Model 3: corrected for age, sex, BMI, snack type, phosphorus binding agent.