Plant-based diet tied to lower risk for kidney disease

  • Kim H & al.
  • Clin J Am Soc Nephrol
  • 25 Apr 2019

  • International Clinical Digest
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Takeaway

  • Following a plant-based diet—high in fruits, vegetables, whole grains, nuts, and legumes—appears to reduce the risk for incident chronic kidney disease (CKD) and slows renal function decline.

Why this matters

  • This is the first study to report an association in the general population.
  • A small but statistically significant proportion of CKD cases could be avoided through diet alone.

Study design

  • Data for 14,686 middle-aged respondents to a modified semiquantitative Willett food frequency questionnaire in the Atherosclerosis Risk in Communities (ARIC) study.
  • Researchers constructed indices for 4 diets: overall plant-based, healthy plant-based, less healthy plant-based, and provegetarian; all negatively scored animal foods.
  • Funding: None disclosed.       

Key results

  • 4343 incident CKD cases were diagnosed over a median 24-year follow-up.
  • Comparing fifth vs first quintile of adherence on CKD risk:
    • Healthy plant-based diet: 14% reduction (HR=0.86; P=.001).
    • Provegetarian diet: 10% reduction (HR=0.90; P=.03).
    • Less healthy plant-based diet: 11% increase (HR=1.11; P=.04).
  • Higher adherence was associated with lower annual decline in estimated glomerular filtration rate (eGFR, in mL/minute/1.73 m2) for fifth vs first quintile of adherence to:
    • Overall plant-based diet: −1.54 vs −1.68; P<.001.>
    • Healthy plant-based diet: −1.55 vs −1.62; P=.01.
  • 4.1% of CKD cases (95% CI, 0.1%-8.2%) were attributable to low overall plant-based dietary adherence.

Limitations

  • Self-reported dietary information, questionnaire limitations.