Healthy eating tied to 30% lower risk for CKD

  • Bach KE & al.
  • Clin J Am Soc Nephrol
  • 24 Sep 2019

  • International Clinical Digest
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Takeaway

  • Adherence to a healthy dietary pattern is associated with lower odds of incident chronic kidney disease (CKD) and albuminuria.

Why this matters

  • Findings add to evidence for diet as a modifiable risk factor for CKD progression.

Study design

  • Meta-analysis of 15 prospective cohort studies involving 85,473 adults (age range, 27-71 years); mean estimated glomerular filtration rate (eGFR) was 87.2±13 mL/minute/1.73 m2.
  • Healthy diet consisted of higher consumption of vegetables, fruits, legumes, nuts, whole grains, fish, and low-fat dairy with limited intake of red/processed meats, sodium, and sugary drinks.
  • Mean follow-up was 10.4±7.4 years.
  • Funding: None disclosed.

Key results

  • 15 studies (n=79,998): moderate-certainty evidence supported 30% lower odds of CKD with healthy dietary patterns (OR, 0.70; 95% CI, 0.60-0.82; I2=51%).
    • Finding was consistent across dietary subtypes (P=.65).
  • 4 studies (n=8135) linked healthy dietary patterns to 23% reduced odds of albuminuria (OR, 0.77; 95% CI, 0.59-0.99; I2=37%).
  • In subgroup analysis, reduced odds of incident CKD were observed with:
    • Mediterranean diets (OR, 0.61; 95% CI, 0.40-0.93), and
    • Guideline-adherent diets (OR, 0.64; 95% CI, 0.50-0.84), but not
    • Dietary Approaches to Stop Hypertension (DASH) diets (OR, 0.81; 95% CI, 0.47-1.39).
  • No significant association was observed between healthy dietary patterns and eGFR decline.
  • Low overall risk for bias.

Limitations

  • Observational design.
  • Heterogeneous definitions of healthy eating.

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