Researchers identify modifiable lifestyle factors to prevent CKD, including diet changes
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Researchers from Australia have identified several modifiable factors associated with the likelihood of study participants developing chronic kidney disease.
According to Jaimon T. Kelly, MD, of the Menzies Health Institute Queensland at Griffith University in Australia, and colleagues, these findings can be used to provide recommendations to patients regarding lifestyle changes.
“Because prevention is more effective than cure, avoiding exposures to hazards that may cause CKD in the community is a key priority,” the researchers wrote. “This is particularly important because the management of patients with established CKD may require dietary adaptations that diametrically differ from those that are needed for primary prevention.”
They added that there are currently no evidence-based lifestyle recommendations for the primary prevention of CKD; rather, they wrote, current recommendations are “drawn from literature concerning cardiovascular disease, hypertension, and diabetes.”
To examine the association between lifestyle factors and incident CKD, Kelly and colleagues reviewed 104 cohort studies of adults without CKD at baseline, who had reported lifestyle exposures (totaling 2,755,719 participants). The exposures considered for the study included diet, physical activity, alcohol consumption and tobacco smoking. All the studies reviewed had a generally low risk of bias, according to the researchers.
Findings revealed that higher dietary potassium intake and higher vegetable intake were both associated with a significantly decreased odds of CKD (odds ratios [OR] of 0.78 and 0.79, respectively). Participants who were physically active also had a lower likelihood for developing CKD (OR = 0.82) than those who were sedentary. Further findings indicated that compared with no consumption, moderate consumption of alcohol was associated with a reduced risk for CKD (relative risk = 0.86).
On the other hand, the researchers found the odds of developing CKD were significantly increased with higher salt intake (OR = 1.21) and that current or former smokers had significantly increased odds of CKD compared with never smokers (OR = 1.81).
Based on these findings, Kelly and colleagues argued that “it is not trivial to ask patients to change their lifestyle.”
“Diet, in particular, is a highly social and cultural issue,” they wrote. “[F]urthermore, many patients are constrained by external factors, including economic factors, in their decisions. For these reasons, we believe that lifestyle intervention studies to address unanswered questions examining the whole range of clinically important outcomes, including the incidence and progression of CKD, continue to be justified.”
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