Association Between Dietary Diabetes Risk Reduction Score and Risk of Chronic Kidney Disease in Adults: Tehran Lipid and Glucose Study

Mirmiran, Parvin; Ramezan, Marjan; Farhadnejad, Hossein; Asghari, Golaleh; Tahmasebinejad, Zhaleh; Azizi, Fereidoun

doi:10.21203/rs.3.rs-48108/v1

Cited by 3 publications

(3 citation statements)

References 9 publications

(13 reference statements)

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“…However, to the best of our knowledge, there are only four cross-sectional studies and one longitudinal study investigating the potential relationship of dietary acid load with renal function defined by eGFR and/or CKD in older adults without CKD. These cross-sectional studies conducted in different cohorts of adults reported that higher dietary acid load was associated with higher odds of CKD and/or impaired kidney function as indicated by low eGFR after adjusting for multiple confounders (14,16,17,33). Our observations are in accordance with these crosssectional studies since we observed a greater eGFR decline at 1 year with higher PRAL and NEAP scores, even after adjusting for baseline eGFR and other essential confounding factors.…”

Section: Discussionsupporting

confidence: 91%

Longitudinal association of dietary acid load with kidney function decline in an older adult population with metabolic syndrome

et al. 2022

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BackgroundDiets high in acid load may contribute to kidney function impairment. This study aimed to investigate the association between dietary acid load and 1-year changes in glomerular filtration rate (eGFR) and urine albumin/creatinine ratio (UACR).MethodsOlder adults with overweight/obesity and metabolic syndrome (mean age 65 ± 5 years, 48% women) from the PREDIMED-Plus study who had available data on eGFR (n = 5,874) or UACR (n = 3,639) at baseline and after 1 year of follow-up were included in this prospective analysis. Dietary acid load was estimated as potential renal acid load (PRAL) and net endogenous acid production (NEAP) at baseline from a food frequency questionnaire. Linear and logistic regression models were fitted to evaluate the associations between baseline tertiles of dietary acid load and kidney function outcomes. One year-changes in eGFR and UACR were set as the primary outcomes. We secondarily assessed ≥ 10% eGFR decline or ≥10% UACR increase.ResultsAfter multiple adjustments, individuals in the highest tertile of PRAL or NEAP showed higher one-year changes in eGFR (PRAL, β: –0.64 ml/min/1.73 m2; 95% CI: –1.21 to –0.08 and NEAP, β: –0.56 ml/min/1.73 m2; 95% CI: –1.13 to 0.01) compared to those in the lowest category. No associations with changes in UACR were found. Participants with higher levels of PRAL and NEAP had significantly higher odds of developing ≥10% eGFR decline (PRAL, OR: 1.28; 95% CI: 1.07–1.54 and NEAP, OR: 1.24; 95% CI: 1.03–1.50) and ≥10 % UACR increase (PRAL, OR: 1.23; 95% CI: 1.04–1.46) compared to individuals with lower dietary acid load.ConclusionsHigher PRAL and NEAP were associated with worse kidney function after 1 year of follow-up as measured by eGFR and UACR markers in an older Spanish population with overweight/obesity and metabolic syndrome.

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Section: Discussionsupporting

confidence: 91%

Longitudinal association of dietary acid load with kidney function decline in an older adult population with metabolic syndrome

et al. 2022

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“…The different amino acid composition of plant protein compared to animal protein (higher proportions of glutamic acid, phenylalanine, proline, cysteine, and serine) can also play an effective role in kidney function and its related risk factors, such as BP (37). A diet with high plant-based protein is also rich in antioxidant nutrients such as vitamin C, potassium, calcium, and magnesium, and phytochemicals that can be linked to lower dietary acid load and improved renal function (38,39).…”

Section: Discussionmentioning

confidence: 99%

Dietary protein score and carbohydrate quality index with the risk of chronic kidney disease: Findings from a prospective cohort study

et al. 2022

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Background/AimThis study aimed to examine the associations between dietary protein score and carbohydrate quality index (CQI) and the risk of chronic kidney disease (CKD) in Iranian adults.MethodsThis population-based cohort study was performed within the Tehran Lipid and Glucose Study framework on 6,044 subjects aged ≥18 years old, who were followed up for a mean of 7.7 years. Dietary protein score and CQI were determined using a food frequency questionnaire. CKD was defined as an estimated glomerular filtration rate <60 ml/min/1.73 m2. A multivariate Cox proportional hazard regression model was used to estimate the risk of CKD across tertiles of protein score and CQI.ResultsThe mean (standard deviation) of age and body mass index of participants were 37.9 (12.8) years and 26.8 (4.7) kg/m2, respectively. During the 7.7 ± 2.7 years of follow-up, 1,216 cases (20.1%) of CKD were ascertained. In the final adjusted model, individuals in the highest tertile of protein score had decreased risk of CKD (HR: 0.85, 95% CI: 0.74–0.98, Ptrend = 0.033). Also, there is a significant association between total carbohydrate score (HR: 0.85, 95% CI: 0.73–0.99, Ptrend = 0.016), the ratio of whole grain/total grains (HR: 0.81, 95% CI: 0.70–0.94, Ptrend = 0.004), and glycemic index (HR: 1.30, 95% CI: 1.12–1.51, Ptrend < 0.001) and risk of CKD. However, no significant association was found between total protein intakes, plant-to-animal ratio, and solid carbohydrate/total carbohydrate with the risk of CKD.ConclusionOur results revealed a diet with a high protein score and high quality of carbohydrates, characterized by higher intakes of plant proteins, low glycaemic index (GI) carbohydrates, whole grain, fibers, and lower intakes of animal proteins, can be related to reduced CKD risk.

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“…The ethics research committee approved the study protocol of the Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. A preprint of this manuscript has previously been published [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

High Dietary Diabetes Risk Reduction Score Is Associated with Decreased Risk of Chronic Kidney Disease in Tehranian Adults

Mirmiran

Ramezan

Farhadnejad

et al. 2022

International Journal of Clinical Practice

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Aim. In the current study, we examined the association of dietary diabetes risk reduction score (DDRRS) with chronic kidney disease (CKD) among an Iranian adult population. Methods. We followed up 2076 ≥20-year-old participants of the Tehran Lipid and Glucose Study (2006–2008), who were initially free of CKD for 5.98 years. The dietary diabetes risk reduction score was calculated based on scoring eight components, including cereal fiber, nuts, coffee, polyunsaturated fatty acids-to-saturated fatty acids ratio, glycemic index, sugar-sweetened beverages, trans fatty acids, and red and processed meat using a valid and reliable 168-item food frequency questionnaire. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. A Cox proportional hazard regression model was used to assess the association between the quartiles of DDRRS and CKD incidence. Results. Mean ± SD age of the study population (53% women) was 37.6 ± 12.61 years. During 5.98 years of follow-up, 357 incident cases of CKD were reported. The median (25–75 interquartile range) of DDRRS was 20 (18–22). After adjustment for age, sex, smoking status, total energy intake, body mass index, hypertension, diabetes, eGFR, and physical activity, individuals in the highest versus lowest quartile of DDRRS were 33% less likely to have CKD (HR: 0.67; 95% CI: 0.48–0.96, P for trend: 0.043). Conclusion. The present study’s findings suggest that greater adherence to a dietary pattern with a higher score of DDRRS may be associated with a lower risk of CKD incident.

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Association Between Dietary Diabetes Risk Reduction Score and Risk of Chronic Kidney Disease in Adults: Tehran Lipid and Glucose Study

Cited by 3 publications

References 9 publications

Longitudinal association of dietary acid load with kidney function decline in an older adult population with metabolic syndrome

Longitudinal association of dietary acid load with kidney function decline in an older adult population with metabolic syndrome

Dietary protein score and carbohydrate quality index with the risk of chronic kidney disease: Findings from a prospective cohort study

High Dietary Diabetes Risk Reduction Score Is Associated with Decreased Risk of Chronic Kidney Disease in Tehranian Adults

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