Healthy Dietary Patterns and Incidence of CKD

Abstract

Background and objectives Whether a healthy dietary pattern may prevent the incidence of developing CKD is unknown. This study evaluated the associations between dietary patterns and the incidence of CKD in adults and children. Design, setting, participants, & measurements This systematic review and meta-analysis identified potential studies through a systematic search of MEDLINE, Embase and references from eligible studies from database inception to February 2019. Eligible studies were prospective and retrospective cohort studies including adults and children without CKD, where the primary exposure was dietary patterns. To be eligible, studies had to report on the primary outcome, incidence of CKD (eGFR,60 ml/min per 1.73 m 2). Two authors independently extracted data, assessed risk of bias and evidence certainty using the Newcastle-Ottawa scale and GRADE. Results Eighteen prospective cohort studies involving 630,108 adults (no children) with a mean follow-up of 10.467.4 years were eligible for analysis. Included studies had an overall low risk of bias. The evidence certainty was moderate for CKD incidence and low for eGFR decline (percentage drop from baseline or reduced by at least 3 ml/min per 1.73 m 2 per year) and incident albuminuria. Healthy dietary patterns typically encouraged higher intakes of vegetables, fruit, legumes, nuts, whole grains, fish and low-fat dairy, 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 (odds ratio [OR] 0.70 (95% confidence interval [95% CI], 0.60 to 0.82); I 2 =51%; eight studies), and incidence of albuminuria (OR 0.77, [95% CI, 0.59 to 0.99]; I 2 =37%); four studies). There appeared to be no significant association between healthy dietary patterns and eGFR decline (OR 0.70 [95% CI, 0.49 to 1.01], I 2 =49%; four studies). Conclusions A healthy dietary pattern may prevent CKD and albuminuria.

Dietary Patterns Based on Estimated Glomerular Filtration Rate and Kidney Function Decline in the General Population: The Lifelines Cohort Study

“…Lin et al identified dietary patterns using principal component analysis (PCA), and concluded that a Western diet was associated with rapid eGFR decline while a DASH diet was associated with slower eGFR decline in older white women [6]. Of note, a meta-analysis of cohort studies suggested that a healthy dietary pattern rich in fruits and vegetables, fish, legumes, whole grain, and fiber intake and low in red meat, sodium, and refined sugar intake was associated with a lower risk of incident CKD and albuminuria, but not with eGFR decline [8]. In the present study, we could identify sex-specific eGFR-DPs that, in contrast with the MDS in our cohort, were independently associated with kidney function decline.…”

“…However, a dietary pattern-based approach may be more informative, as it provides a broader picture of food and nutrient intake [5]. Although some individual studies have shown that the Mediterranean diet (higher intake of fruit, vegetables, legumes, cereals, and fish) or the Dietary Approach to Stop Hypertension (DASH) diet (higher intake of fruits, vegetables, and whole grain) have been associated with a lower risk of estimated glomerular filtration rate (eGFR) decline [6,7], a recent meta-analysis did not confirm associations of these dietary patterns with eGFR decline overall [8]. These findings raise questions about whether kidney-specific healthy dietary patterns exist, whether their composition differs from more general healthy dietary patterns, and whether these are consistently associated with eGFR decline and CKD incidence.…”

Meal Frequency and Skipping Breakfast Are Associated with Chronic Kidney Disease

“…To prevent CKD and its progression, previous studies have suggested healthy nutritional approaches, such as the DASH (Dietary Approaches to Stop Hypertension), the Mediterranean, or vegetarian diet [27][28][29][30][31][32]. Nevertheless, research on the association among meal frequency, breakfast skipping, and CKD prevalence is scarce.…”

Diet and Kidney Function: a Literature Review

“…Lifestyle factors, including smoking [12], alcohol use [13], and physical inactivity [14], could promote CKD. Apart from that, there is increasing scientific interest in the potential role of diet [15,16]. High salt intake is an established risk factor for kidney function decline [17,18], mainly through its adverse effect on blood pressure and vascular health [19][20][21].…”