Decline in fruit, vegetable intake linked to progressive CKD
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Key takeaways:
- Vegetable and fruit intake frequency decreased as chronic kidney disease worsened.
- There were 561 patient deaths during a median follow-up of 5.7 years.
Intake levels of fruit and vegetables are associated with worsening chronic kidney disease, according to recently published findings.
“Patients with advanced chronic kidney disease (CKD) are generally discouraged from consuming high amounts of vegetables and fruits given the potential risk of hyperkalemia,” Minako Wakasugi, MD, MPH, of the department of inter-organ communication research at Niigata University Graduate School of Medical and Dental Sciences in Japan, and colleagues wrote.
The study, published in the Journal of Renal Nutrition, explored the link between vegetable and fruit intake frequency and all-cause mortality, “and whether this association is modified by the presence of CKD.”
Researchers reviewed a hospital-based cohort study that included 2,006 patients who visited the outpatient department of a general hospital between June 2008 and December 2016. Of the participants, 902 were non-dialysis-dependent patients with CKD and 131 were patients on hemodialysis. Participants self-reported vegetable and fruit intake frequency using a scale of “never or rarely,” “sometimes” or “every day.”
Vegetable and fruit intake frequency decreased as CKD stage worsened. However, baseline serum potassium levels stratified by CKD stage were similar across the three intake frequency groups. There were 561 patient deaths during a median follow-up of 5.7 years, resulting in a mortality rate of 47.1 per 1,000 person-years,
After adjusting for demographic factors, comorbidities and CKD status, researchers found the adjusted HRs for mortality relative to the “every day” intake group were 1.25 for the “sometimes” group and 1.60 for the “never or rarely” group. They also observed a similar dose-dependent relationship between vegetable and fruit intake frequency and all-cause mortality when stratified by status.
“The frequency of vegetable and fruit intake decreases with worsening CKD stage,” the researchers wrote. Based on the evidence, “consuming both vegetables and fruits every day may reduce all-cause mortality in patients with CKD as well as in non-CKD individuals.”
Future work should build around current study limitations, the researchers wrote, such as self-reporting food intake limited data. More research may explore mechanisms and potential interventions to improve vegetable and fruit intake in patients with CKD.
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