#676 Correlation between dietary live microbe intake and all-cause mortality based on baseline characteristics: results from NHANES 2011-2018

Background and Aims The gut microbiome plays a beneficial role in human health, including kidney function and chronic kidney disease progression. Potential therapeutic strategies for CKD and hypertension that target the gut microbiota include dietary interventions, mainly probiotic, prebiotic, synbiotic modulation. In addition to probiotic foods, live micro-organisms are also found in other food products, such as raw vegetables and fruits. In this study, we evaluated the potential impact of dietary live microbiome intake on all-cause mortality in different baseline characteristics, including kidney function status. Method A total of 20 627 subjects were included in the study. We used data from the US National Health and Nutrition Examination Survey 2011-2018. Based on a 2-day 24-hour dietary recall, the dietary intake of the live microbiome was adjusted and the participants were categorized into three groups: low (<104 CFU/g), medium (104–107 CFU/g), or high (>107 CFU/g) dietary intake of live microbes, according to the classification system for the dietary intake of live microbes and participants’ 24-hour dietary recall data. Low intake was used as a reference. Baseline characteristics included kidney function by estimated glomerular filtration rate (GFR-EPI <60 mL/min/1.73 m2) and urinary albumin-to-creatinine ratio (uACR >30 mg/g). We used a multivariate Cox proportional hazards model to identify the impact of dietary live microbiome intake on all-cause mortality. In subgroups, we adjusted the Hazard Ratio (aHR) of the additional factors in the models. Results The risk for all-cause mortality was significantly decreased in subjects included in the medium dietary live microbiome intake (HR: 0.82, 95% Cl: 0.73-0.93, p < 0.004). In subgroup analysis (N = 3302), medium dietary intake of the live microbiome decreased mortality in subjects with eGFR <60 mL/min/1.73 m2 or uACR >30 mg/g and BMI >25 (aHR: 0.86, 95% CI: 0.75-0.99, p<0.05) as compared to low dietary intake of the live microbiome group after adjustment for hypertension, diabetes, BMI, total calorie intake, laboratory results (hemoglobin, creatinine, total cholesterol, estimated glomerular filtration rate). However, there was no significance to the risk for all-cause mortality in the subgroup with CKD between the high and low dietary live microbiome intake groups. Conclusion In this study, low dietary live microbial intake significantly increased all-cause mortality in the population. The medium dietary intake of live microbiome significantly decreased all-cause mortality in overweight or obese patients with CKD or microalbuminuria.