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Proinflammatory diet associated with greater risk of kidney disease progression

Issue: December 2018

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SAN DIEGO — Patients with chronic kidney disease who consumed greater amounts of proinflammatory foods were more likely to progress to ESRD, according to data presented at ASN Kidney Week 2018.

“CKD is characterized by a state of chronic low-grade inflammation,” Tanushree Banerjee, PhD, associate researcher at the University of California, San Francisco, said during her presentation. “Diet may play a pivotal role in this inflammation.”

Banerjee and colleagues analyzed data from the 1988 to1994 National Health and Nutrition Examination Survey linked with the U.S. Renal Data System to investigate whether a proinflammatory diet increases the risk of kidney disease progression. A total of 1,084 adults with CKD, defined as having an eGFR between 15 ml/min/1.73 m² and 59 ml/min/1.73 m², and aged 20 years or older were included in the analysis. Researchers calculated patients’ adapted dietary inflammatory index at baseline, based on a 24-hour dietary recall. Data were adjusted for demographics, BMI, physical activity, HbA1C, systolic BP, total cholesterol, eGFR and urinary albumin–to-creatinine ratio (ACR). Patients were followed for 14 years.

Proinflammatory diets included those containing foods with concentrations of inflammatory markers, such as tomatoes, carbonated beverages, vegetables other than green leafy and dark yellow vegetables, and processed meat, red meat, organ meat and fish other than dark-meat fish.

Approximately 11% of patients with CKD developed ESRD. Patients with increases in adapted dietary inflammatory index were more likely to have a higher inflammatory score, which was associated with ESRD (relative hazard = 1.12; 95% CI, 1.02-1.25).

Inflammatory score explained a quarter of the total effect of adapted dietary inflammatory index on ESRD.

In interaction tests, each standard deviation increase in the adapted dietary inflammatory index was associated with a greater risk of ESRD in adults with an ACR 30 mg/g or greater (relative hazard = 1.55; 95% CI, 1.12-1.96) compared with those with an ACR of less than 30 mg/g (relative hazard = 0.96; 95% CI, 0.55-1.38).

“Our data suggests that a proinflammatory diet was associated with systemic inflammation, as well as risk of ESRD,” Banerjee said. “Our data suggests that systemic inflammation may be one of the potential pathways through which a proinflammatory diet is linked to ESRD. Based on our findings, we suggest that an anti-inflammatory diet should be tested as to whether they can reduce the risk of ESRD.” – by Alaina Tedesco

Reference:

Banerjee T, et al. Abstract FR-OR124. Presented at: ASN Kidney Week; Oct. 23-28, 2018; San Diego.

Disclosure: Healio Nephrology was unable to confirm relevant financial disclosures at the time of publication.