Energy-Adjusted Dietary Inflammatory Index Is Associated With 5-Year All Cause and Cardiovascular Mortality Among Chronic Kidney Disease Patients

Abstract

BackgroundDiet management is a pivotal intervention for chronic kidney disease (CKD) patients. Dietary inflammation index (DII) is developed to evaluate the integral inflammatory potential of a diet pattern. However, research about the association between DII and mortality in CKD is limited.ObjectiveWe conducted a cohort study to investigate the relationship between energy-adjusted DII (E-DII) and the 5-year all-cause and cardiovascular mortality in CKD population.Materials and MethodsCKD participants with complete E-DII data and death status from National Health and Nutrition Examination Survey (1999–2014) were involved in this study. E-DII was calculated based on dietary recall interviews. Smooth curve fitting, Kaplan–Meier survival analysis, and Cox proportional hazards models were used to evaluate the association between E-DII and the 5-year all cause and cardiovascular mortality. Subgroup analysis was also performed.ResultsA total of 7,207 participants were included (55.46% elderly and 46.54% male) in this study. The 5-year all-cause and cardiovascular mortality were 16.86 and 4.32%, respectively. Smooth curve fitting showed a “J” shape and near linear relationship between the E-DII score and the 5-year all-cause and cardiovascular mortality, respectively. In multivariate Cox proportional hazards models, the hazard ratios (95% confidence intervals [CI]) for the highest tertile of the E-DII were 1.33 (1.15, 1.54) for all-cause mortality, and 1.54 (1.15, 2.07) for cardiovascular mortality when compared with the lowest tertile of the E-DII. The subgroup analyses revealed relatively stronger associations between the E-DII and the mortality among CKD patients with other death risk factors.ConclusionsEnergy-adjusted dietary inflammatory index is independently related with the 5-year all-cause and cardiovascular mortality among CKD patients. Therefore, anti-inflammatory diet patterns should be recommended for CKD patients.

Association between dietary inflammatory index and chronic kidney disease in middle-aged and elderly populations

“…It has also been suggested that treatments using an anti-inflammatory diet might lower rates to get hyperparathyroidism in patients with CKD ( 24 ). Moreover, Ying Huang et al found that the association of elevated energy-adjusted dietary inflammatory index (E-DII) with increased risk of 5-year all-cause and cardiovascular mortality in individuals with CKD was not modified by other factors, while subgroup analyses showed that individuals with worsening renal function were more vulnerable to the effects of E-DII ( 25 ). With the aging of populations worldwide, researchers are increasingly concentrating on middle-aged and older populations, including DII-related studies.…”

Association between Dietary Inflammatory Index and Risk of Colorectal Adenomatous Polyps in Kashgar Prefecture of Xinjiang, China

“…DII was calculated using the approach reported by Shivappa et al [ 13 , 27 ]. The food intake data for each patient were converted into nutrient data based on the China Food Composition Table, Standard Edition, Sixth Version.…”

“…Additionally, standard values and standard deviations from the global database were converted accordingly, with all units expressed per 1000 kilocalorie energy intake [ 15 , 28 , 29 ]. Referring to previous studies related to the E-DII, prior to the analysis, three quartiles of the E-DII were created based on continuous E-DII scores, which served as the classification criteria for the E-DII as a categorical variable [ 21 , 22 , 27 ]. Tertiles 1, 2, and 3 represented patients with the lowest, intermediate, and highest potential for dietary inflammation, respectively.…”

Association between systemic immune-inflammation index and low muscle mass in US adults: a cross-sectional study

“…Current medical conditions were also included in our study based on self-reported forms or relevant laboratory or imaging findings: diabetes mellitus (yes/no), hypertension (yes/no), congestive heart failure(yes/no), stroke(yes/no), osteoarthritis(yes/no), osteoporosis(yes/no), cancer(yes/no), chronic kidney disease(CKD)(yes/no), and chronic obstructive pulmonary disease(COPD)(yes/no). The diagnosis of CKD was based on the estimated glomerular filtration rate [eGFR] < 60 ml/min per 1.73 m2 or urine albumin-to creatinine ratio (ACR) ≥ 30 mg/g [ 29 , 30 ]. The diagnosis of osteoporosis was based on bone mineral density, which was evaluated by evaluated by dual-energy X-ray absorptiometry scans with Hologic QDR-4500 A fan-beam densitometers (Hologic, Inc., Bedford, Massachusetts).…”