A Healthy Diet Reduces the Risk of Chronic Kidney Disease


In an extensive review of 18 cohort studies, investigators connect dietary patterns with chronic kidney disease incidence rates.

A healthy dietary pattern could help prevent chronic kidney disease (CKD) and albuminuria.

In a systematic review and meta-analysis, a team led by Katrina E. Bach, Bond University, evaluated the link between dietary patterns and the incidence of chronic kidney disease.

The investigators extracted data from 18 prospective cohort studies that included 630,108 adults with evidence certainty that was moderate for CKD incidence and low for estimated glomerular filtration rate (eGFR) decline (percentage drop from baseline or reduced by at least 3 ml/min per 1.73 m2 per year) and incident albuminuria.

The primary outcome was the incidence of CKD, defined as eGFR<60 ml/min per 1.73 m2.

The secondary outcomes were end-stage kidney disease (ESKD)—requiring dialysis or kidney transplantation or eGFR<15 ml/min per 1.73 m2, eGFR decline, progression of albuminuria (normal or mildly increased to moderately or severely increased), eGFR or creatinine clearance at the end of study follow-up, and doubling of serum creatinine.

“In a meta-analysis including 8 studies from the 8 eligible cohort datasets (31,410 participants; mean, 7.1 years follow-up), adherence to a healthy dietary pattern was associated with lower odds of incident CKD (OR, .70; 95% CI, .60-.82) with moderate certainty of evidence,” the authors wrote. “This finding was consistent across different dietary subtypes (P =.65).”

They also found 5 studies with 9179 participants that show a decline in eGFR across 4 datasets.

A meta-analysis of 4 studies from 4 eligible datasets with 7377 participants showed a healthy dietary pattern was nonsignficiantly linked with lower odds of eGFR decline (OR, .70; 95% CI, .49-1.01), consistent across dietary subtypes (P =.57).

The investigators performed a sensitivity analysis for both findings, repeating the analysis by rotating each study reporting associations to incident CKD from the same cohort of data and did not find a change to the primary finding.

Healthy dietary patterns typically encouraged higher intakes of vegetables, fruit, legumes, nuts, whole grains, fish and low-fat diary, and lower intakes of red and processed meats, sodium, and sugar-sweetened beverages.

“A healthy dietary pattern was associated with a lower incidence of CKD (OR, .70; 95% CI, .60-.82), and incidence of albuminuria (OR, .77; 95% CI, .59-.99),” the authors wrote. “There appeared to be no significant association between healthy dietary patterns and eGFR decline (OR, .70; 95% CI, .49-1.01).”

The investigators said the study should lead to future research confirming how diet impacts the incidence of CKD and albuminuria.

The prevalence of CKD is growing globally, increasing the risk of death from cardiovascular disease and raising healthcare costs.

The associations of dietary patterns on health outcomes, including cardiovascular disease, have been associated with reduced inflammation from higher consumption of whole grains and reduced oxidative stress through increased consumption of fruits and vegetables.

Dietary patterns are also tied to decreased circulating concentrations of inflammatory markers through a higher consumption of unsaturated fats including nuts and seeds and a reduced dietary acid load associated with CKD progression.

The study, “Healthy Dietary Patterns and Incidence of CKD,” was published in the Clinical Journal of American Society of Nephrology.

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