Diet and Major Renal Outcomes: A Prospective Cohort Study. The NIH-AARP Diet and Health Study

Smyth, Andrew; Griffin, Matthew D.; Yusuf, Salim; Mann, Johannes F.E.; Reddan, Donal; Canavan, Michelle; Newell, John; O’Donnell, Martin

doi:10.1053/j.jrn.2016.01.016

Cited by 71 publications

(52 citation statements)

References 51 publications

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“…Therefore, it seems that the implementation of healthy dietary patterns could be an efficient tool to reduce mortality in people with kidney disease [82]. Also a large prospective cohort study [83] of 544,635 community-dwelling adults demonstrated that the highest quintiles of the Alternate Healthy Eating Index (AHEI) (subdistribution hazard ratio—sHR 0.71; 95% confidence interval (CI) 0.65–0.79), Healthy Eating Index (HEI) (sHR 0.82; 95% CI 0.74–0.91), Mediterranean Diet Score (MDS) (sHR 0.84; 95% CI 0.74–0.95), and Dietary Approaches to Stop Hypertension (DASH) (sHR 0.85; 95% CI 0.77–0.94) were associated with a reduced composite risk of major renal outcomes in comparison to the lowest score quintile. Moreover, the highest sodium quintile (sHR 1.17; 95% CI 1.02–1.33 for sodium intake > 3.6 g/day) was shown to have an increase in hazard, whereas the highest potassium quintile (sHR 0.83 (0.73–0.95)) showed a decrease in this hazard [83].…”

Section: Various Types Of Dietmentioning

confidence: 99%

The Effect of Diet on the Survival of Patients with Chronic Kidney Disease

et al. 2017

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The prevalence of chronic kidney disease (CKD) is high and it is gradually increasing. Individuals with CKD should introduce appropriate measures to hamper the progression of kidney function deterioration as well as prevent the development or progression of CKD-related diseases. A kidney-friendly diet may help to protect kidneys from further damage. Patients with kidney damage should limit the intake of certain foods to reduce the accumulation of unexcreted metabolic products and also to protect against hypertension, proteinuria and other heart and bone health problems. Despite the fact that the influence of certain types of nutrients has been widely studied in relation to kidney function and overall health in CKD patients, there are few studies on the impact of a specific diet on their survival. Animal studies demonstrated prolonged survival of rats with CKD fed with protein-restricted diets. In humans, the results of studies are conflicting. Some of them indicate slowing down of the progression of kidney disease and reduction in proteinuria, but other underline significant worsening of patients’ nutritional state, which can be dangerous. A recent systemic study revealed that a healthy diet comprising many fruits and vegetables, fish, legumes, whole grains, and fibers and also the cutting down on red meat, sodium, and refined sugar intake was associated with lower mortality in people with kidney disease. The aim of this paper is to review the results of studies concerning the impact of diet on the survival of CKD patients.

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Section: Various Types Of Dietmentioning

confidence: 99%

The Effect of Diet on the Survival of Patients with Chronic Kidney Disease

et al. 2017

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“…Although current guidelines recommend treatment of metabolic acidosis in CKD with sodium (Na + )-based alkali [9], base-producing fruits and vegetables (F + V) that are generally low in diets of US adults overall [10] and are even lower in those with CKD [11], comparably improve CKD-related metabolic acidosis [12,13]. A diet high in F + V is associated with reduced CVD mortality in the general population [14] and in patients with CKD [15,16]. Such a diet is also associated with reduced lowdensity lipoprotein cholesterol (LDL-c) [17], and decreased LDL-c predicts a reduction in major CVD events in CKD [18].…”

Section: Introductionmentioning

confidence: 99%

Fruit and Vegetable Treatment of Chronic Kidney Disease-Related Metabolic Acidosis Reduces Cardiovascular Risk Better than Sodium Bicarbonate

et al. 2019

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Background: Current guidelines recommend treatment of metabolic acidosis in chronic kidney disease (CKD) with sodium-based alkali. We tested the hypothesis that treatment with base-producing fruits and vegetables (F + V) better improves cardiovascular disease (CVD) risk indicators than oral sodium bicarbonate (NaHCO₃). Methods: We randomized 108 macroalbuminuric, matched, nondiabetic CKD patients with metabolic acidosis to F + V (n = 36) in amounts to reduce dietary acid by half, oral NaHCO₃ (HCO₃, n = 36) 0.3 mEq/kg bw/day, or to Usual Care (UC, n = 36) to assess the 5-year effect of these interventions on estimated glomerular filtration rate (eGFR) course as the primary analysis and on indicators of CVD risk as the secondary analysis. Results: Five-year plasma total CO₂ was higher in HCO₃ and F + V than UC but was not different between HCO₃ and F + V (difference p value < 0.01). Five-year net eGFR decrease was less in HCO₃ (mean –12.3, 95% CI –12.9 to –11.7 mL/min/1.73 m²) and F + V (–10.0, 95% CI –10.6 to –9.4 mL/min/1.73 m²) than UC (–18.8, 95% CI –19.5 to –18.2 mL/min/1.73 m²; p value < 0.01) but was not different between HCO₃ and F + V. Five-year systolic blood pressure was lower in F + V than UC and HCO₃ (p value < 0.01). Despite similar baseline values, F + V had lower low-density lipoprotein, Lp(a), and higher serum vitamin K1 (low serum K1 is associated with coronary artery calcification) than HCO₃ and UC at 5 years. Conclusion: Metabolic acidosis improvement and eGFR preservation were comparable in CKD patients treated with F + V or oral NaHCO₃ but F + V better improved CVD risk indicators, making it a potentially better treatment option for reducing CVD risk.

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“…Therefore, the evidence for such strategies is still incipient to establish the most appropriate therapeutic approach for CKD. Until high-quality evidence is obtained in this field, a healthy dietary pattern that includes larger amounts of whole grains, fruits, and vegetables should be encouraged among CKD patients since there are additional benefits other than the decrease in uremic toxin production [147,148].…”

Section: Gut Ecosystem In Ckd and Immunitymentioning

confidence: 99%

The cross-talk between the kidney and the gut: implications for chronic kidney disease

Andrade

Ramos

Cuppari

2017

Nutrire

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In recent decades, special attention has been given to the potential association between the gut ecosystem and chronic diseases. Several features and complications of chronic kidney disease (CKD) may induce an unbalanced gut environment, leading to unfavorable consequences for a patient's health. The first section of this review is dedicated to a description of some aspects of gut microbiota and intestinal barrier physiology. The following section explores the impact of CKD on the gut ecosystem and intestinal barrier, particularly the association with uremic toxins, inflammation, and immunodeficiency. Finally, the review describes the state of the art of potential therapies with prebiotics, probiotics, and synbiotics employed to modulate the gut environment and to reduce the generation of colon-derived uremic toxins in CKD.

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Diet and Major Renal Outcomes: A Prospective Cohort Study. The NIH-AARP Diet and Health Study

Cited by 71 publications

References 51 publications

The Effect of Diet on the Survival of Patients with Chronic Kidney Disease

The Effect of Diet on the Survival of Patients with Chronic Kidney Disease

Fruit and Vegetable Treatment of Chronic Kidney Disease-Related Metabolic Acidosis Reduces Cardiovascular Risk Better than Sodium Bicarbonate

The cross-talk between the kidney and the gut: implications for chronic kidney disease

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