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Healthy dietary pattern may reduce CKD risk by 30%
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A recently published study found adherence to a healthy dietary pattern was associated with a lower incidence of both chronic kidney disease and albuminuria.
“Dietary modification is considered one of the key modifiable risk factors for the progression of CKD,” Katrina E. Bach, of Bond University in Australia, and colleagues wrote. “Dietary patterns are defined as the consumption of foods that reflect habitual dietary intake [and] can be classified as ‘healthy’ or ‘unhealthy’... Observational evidence supports the association between healthy dietary patterns and the primary prevention of major health conditions, including type 2 diabetes, cardiovascular disease, hypertension and metabolic syndrome; however, it is unclear whether a healthy dietary pattern may prevent CKD.”
To determine the association between dietary pattern and CKD, researchers conducted a systematic review and meta-analysis of 15 prospective cohort studies that included 630,108 adults without CKD at baseline (average eGFR, 87.2 mL/min/1.73m2). Dietary pattern was the primary exposure of the study and was defined as healthy (consisting of higher intake of vegetables, fruit, legumes, whole grains, fish and low-fat dairy) or unhealthy (also known as the “Western” dietary pattern, which included higher intakes of red and processed meats, sodium and sugar-sweetened beverages). Subgroup analyses were conducted considering the specific type of healthy dietary pattern (eg, Mediterranean or Dietary Approaches to Stop Hypertension). Patients were followed for a mean of 10.4 years.
Researchers found a healthy dietary pattern was associated with a 30% lower odds of CKD (odds ratio = 0.70), as well as a 23% lower odds of albuminuria (OR = 0.77). No significant association between healthy dietary patterns and eGFR decline was observed. It was also noted that, due to the high heterogeneity across the studies, which type of “healthy” dietary pattern may be most beneficial remains undecided.
Despite this area of uncertainty, researchers concluded: “Previous findings of a meta-analysis have supported the role of healthy dietary patterns in the prevention of CKD progression. Our results add to this evidence base and suggest that following healthy dietary patterns may play a protective role in the primary prevention of CKD.”
In a related editorial, Emily A. Hu and Casey M. Rebholz, PhD, both of Johns Hopkins Bloomberg School of Public Health, suggested further research be done to determine if the associations between dietary patterns and incident CKD vary between racial/ethnic groups. They also contended that beverages should be considered, as many dietary scores do not assess these drinks.
Still, they wrote the study has “many notable strengths,” and concluded that “the timing of a healthy dietary intervention may be critical, as diet modification may be more effective in preventing CKD in a healthy population than preventing ESKD among individuals already diagnosed with CKD.”
In a patient voice that also accompanied the study, Michael J. Lennon argued that more data related to children and adolescents are necessary.
“It is particularly challenging to accept that important findings like those in the meta-analysis are not inclusive of children because of the life-long effect CKD and other chronic illnesses have on children and adolescents diagnosed with the disease,” he wrote. “We grow up and many times experience more of the symptoms of our disease and are stratified into higher-risk categories for other diseases and comorbidities later in life ... Findings that a healthy diet pattern can prevent CKD in this patient population, with key considerations for dietary needs in growing children, would be welcomed information so that patients and their caregivers might be better informed and choose to establish healthy eating habits earlier for their children.” – by Melissa J. Webb
Disclosures: The authors report no relevant financial disclosures.
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Bach KE, et al. Clin J Am Soc Nephrol. 2019;doi:10.2215/CJN.00530119.
Hu EA and Rebholz CM. Clin J Am Soc Nephrol. 2019;doi:10.2215/CJN.09440819.
Lennon MJ. Clin J Am Soc Nephrol. 2019;doi:10.2215/CJN.09660819.
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