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Dietary patterns associated with renal impairment in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA). Eur J Nutr 2021; 60:4045-4054. [PMID: 33959803 PMCID: PMC8437851 DOI: 10.1007/s00394-021-02579-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 04/27/2021] [Indexed: 12/19/2022]
Abstract
Background Dietary-based primary prevention guidelines for chronic kidney disease (CKD) treatment are lacking due to limited evidence. Single nutrient intake studies do not account for complex dietary interactions. We assessed associations between dietary patterns and renal function in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA). Design A cross-sectional observational study used NICOLA baseline dietary data collected between February 2014 and March 2016 via a food frequency questionnaire for 2590 participants aged ≥ 50 years. Principal component analysis identified a posteriori dietary patterns. Renal function was characterised by estimated glomerular filtration rate (eGFR) using serum creatinine and cystatin-C. Associations were assessed according to quintiles of dietary pattern adherence and multivariable regression analysis examined associations with eGFR. Results Variation in three dietary patterns was significantly associated with eGFR. After adjustment for potential confounders, participants with least adherence to the ‘healthy’ dietary pattern 1 had a mean eGFR 3.4 ml/min/1.73m2 (95% confidence interval, [CI] − 5.0, − 1.7, p < 0.001) lower than the most adherent. Those with lowest adherence to the ‘unhealthy’ dietary pattern 2 had a mean eGFR 1.9 ml/min/1.73m2 (CI 0.2, 3.5, p = 0.03) higher than those with highest adherence. Participants with lowest adherence to dietary pattern 3, characterised by a high consumption of alcohol and coffee, had a mean eGFR 1.8 ml/min/1.73m2 (− 3.5, − 0.01, p = 0.05) lower than those with greatest adherence. Conclusions Our findings identify independent associations between dietary patterns and eGFR. These findings can inform the development of diet-related primary prevention advice for CKD. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02579-z.
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Lee J, Oh KH, Park SK. Dietary Micronutrients and Risk of Chronic Kidney Disease: A Cohort Study with 12 Year Follow-Up. Nutrients 2021; 13:nu13051517. [PMID: 33946331 PMCID: PMC8145051 DOI: 10.3390/nu13051517] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/21/2021] [Accepted: 04/27/2021] [Indexed: 12/14/2022] Open
Abstract
We investigated the association between dietary micronutrient intakes and the risk of chronic kidney disease (CKD) in the Ansan-Ansung study of the Korean Genome and Epidemiologic Study (KoGES), a population-based prospective cohort study. Of 9079 cohort participants with a baseline estimate glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 and a urine albumin to creatinine ratio (UACR) <300 mg/g and who were not diagnosed with CKD, we ascertained 1392 new CKD cases over 12 year follow-up periods. The risk of CKD according to dietary micronutrient intakes was presented using hazard ratios (HRs) and 95% confidence intervals (95% CIs) in a full multivariable Cox proportional hazard models, adjusted for multiple micronutrients and important clinico-epidemiological risk factors. Low dietary intakes of phosphorus (<400 mg/day), vitamin B2 (<0.7 mg/day) and high dietary intake of vitamin B6 (≥1.6 mg/day) and C (≥100 mg/day) were associated with an increased risk of CKD stage 3B and over, compared with the intake at recommended levels (HR = 6.78 [95%CI = 2.18–21.11]; HR = 2.90 [95%CI = 1.01–8.33]; HR = 2.71 [95%CI = 1.26–5.81]; HR = 1.83 [95%CI = 1.00–3.33], respectively). In the restricted population, excluding new CKD cases defined within 2 years, an additional association with low folate levels (<100 µg/day) in higher risk of CKD stage 3B and over was observed (HR = 6.72 [95%CI = 1.40–32.16]). None of the micronutrients showed a significant association with the risk of developing CKD stage 3A. Adequate intake of micronutrients may lower the risk of CKD stage 3B and over, suggesting that dietary guidelines are needed in the general population to prevent CKD.
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Affiliation(s)
- Juyeon Lee
- Department of Preventive Medicine, College of Medicine, Seoul National University, 103 Daehakro, Jongnogu, Seoul 03080, Korea;
- Department of Biomedical Science, College of Medicine, Seoul National University, 103 Daehakro, Jongnogu, Seoul 03080, Korea
- Department Cancer Institution, Seoul National University, 103 Daehakro, Jongnogu, Seoul 03080, Korea
| | - Kook-Hwan Oh
- Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, 103 Daehakro, Jongnogu, Seoul 03080, Korea;
| | - Sue-Kyung Park
- Department of Preventive Medicine, College of Medicine, Seoul National University, 103 Daehakro, Jongnogu, Seoul 03080, Korea;
- Department Cancer Institution, Seoul National University, 103 Daehakro, Jongnogu, Seoul 03080, Korea
- Integrated Major in Innovative Medical Science, College of Medicine, Seoul National University, 103 Daehakro, Jongnogu, Seoul 03080, Korea
- Correspondence: ; Tel.: +82-2-740-8338
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Quintela BCSF, Carioca AAF, de Oliveira JGR, Fraser SDS, da Silva Junior GB. Dietary patterns and chronic kidney disease outcomes: A systematic review. Nephrology (Carlton) 2021; 26:603-612. [PMID: 33864650 DOI: 10.1111/nep.13883] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 07/09/2020] [Accepted: 04/14/2021] [Indexed: 01/11/2023]
Abstract
Chronic kidney disease (CKD) is a serious public health problem and its prevalence is growing in many countries, often related to issues resulting from the lifestyle in growing economies and the population's life expectancy. Nutritional therapy is a beneficial but still neglected strategy for preventing CKD and delaying disease progression. The aim of this study was to assess the association of dietary patterns with CKD development and progression. Observational studies conducted in adult humans and the correlation between the adopted dietary pattern and prevalent and incident cases of CKD were assessed. A significant association was observed between unhealthy dietary patterns and an increased risk of developing or worsening CKD, as well as an adverse effect. Whereas healthy eating patterns characterized by the consumption of fruit, vegetables and dietary fibre showed nephroprotective outcomes.
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Affiliation(s)
| | | | | | - Simon D S Fraser
- Academic Unit of Primary Care and Population Science, Faculty of Medicine, University of Southampton, Southampton, Hampshire, United Kingdom
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Di Marco F, Trevisani F, Vignolini P, Urciuoli S, Salonia A, Montorsi F, Romani A, Vago R, Bettiga A. Preliminary Study on Pasta Samples Characterized in Antioxidant Compounds and Their Biological Activity on Kidney Cells. Nutrients 2021; 13:1131. [PMID: 33808117 PMCID: PMC8067028 DOI: 10.3390/nu13041131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 02/06/2023] Open
Abstract
Pasta is one of the basic foods of the Mediterranean diet and for this reason it was chosen for this study to evaluate its antioxidant properties. Three types of pasta were selected: buckwheat, rye and egg pasta. Qualitative-quantitative characterization analyses were carried out by HPLC-DAD to identify antioxidant compounds. The data showed the presence of carotenoids such as lutein and polyphenols such as indoleacetic acid, (carotenoids from 0.08 to 0.16 mg/100 g, polyphenols from 3.7 to 7.4 mg/100 g). To assess the effect of the detected metabolites, in vitro experimentation was carried out on kidney cells models: HEK-293 and MDCK. Standards of β-carotene, indoleacetic acid and caffeic acid, hydroalcoholic and carotenoid-enriched extracts from samples of pasta were tested in presence of antioxidant agent to determine viability variations. β-carotene and indoleacetic acid standards exerted a protective effect on HEK-293 cells while no effect was detected on MDCK. The concentrations tested are likely in the range of those reached in body after the consumption of a standard pasta meal. Carotenoid-enriched extracts and hydroalcoholic extracts showed different effects, observing rescues for rye pasta hydroalcoholic extract and buckwheat pasta carotenoid-enriched extract, while egg pasta showed milder dose depending effects assuming pro-oxidant behavior at high concentrations. The preliminary results suggest behaviors to be traced back to the whole phytocomplexes respect to single molecules and need further investigations.
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Affiliation(s)
- Federico Di Marco
- Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (F.D.M.); (F.T.); (A.S.); (F.M.)
| | - Francesco Trevisani
- Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (F.D.M.); (F.T.); (A.S.); (F.M.)
| | - Pamela Vignolini
- PHYTOLAB (Pharmaceutical, Cosmetic, Food Supplement, Technology and Analysis), DiSIA, University of Florence, 50019 Sesto Fiorentino, Italy; (P.V.); (S.U.); (A.R.)
| | - Silvia Urciuoli
- PHYTOLAB (Pharmaceutical, Cosmetic, Food Supplement, Technology and Analysis), DiSIA, University of Florence, 50019 Sesto Fiorentino, Italy; (P.V.); (S.U.); (A.R.)
| | - Andrea Salonia
- Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (F.D.M.); (F.T.); (A.S.); (F.M.)
- Department of Urology, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (F.D.M.); (F.T.); (A.S.); (F.M.)
- Department of Urology, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Annalisa Romani
- PHYTOLAB (Pharmaceutical, Cosmetic, Food Supplement, Technology and Analysis), DiSIA, University of Florence, 50019 Sesto Fiorentino, Italy; (P.V.); (S.U.); (A.R.)
| | - Riccardo Vago
- Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (F.D.M.); (F.T.); (A.S.); (F.M.)
- Department of Urology, Università Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Arianna Bettiga
- Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (F.D.M.); (F.T.); (A.S.); (F.M.)
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Apetrii M, Timofte D, Voroneanu L, Covic A. Nutrition in Chronic Kidney Disease-The Role of Proteins and Specific Diets. Nutrients 2021; 13:956. [PMID: 33809492 PMCID: PMC7999704 DOI: 10.3390/nu13030956] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/04/2021] [Accepted: 03/12/2021] [Indexed: 12/18/2022] Open
Abstract
Chronic kidney disease (CKD) is a global public health burden, needing comprehensive management for preventing and delaying the progression to advanced CKD. The role of nutritional therapy as a strategy to slow CKD progression and uremia has been recommended for more than a century. Although a consistent body of evidence suggest a benefit of protein restriction therapy, patients' adherence and compliance have to be considered when prescribing nutritional therapy in advanced CKD patients. Therefore, these prescriptions need to be individualized since some patients may prefer to enjoy their food without restriction, despite knowing the potential importance of dietary therapy in reducing uremic manifestations, maintaining protein-energy status.
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Affiliation(s)
- Mugurel Apetrii
- Department of Nephrology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (M.A.); (L.V.); (A.C.)
| | - Daniel Timofte
- Surgical Department I, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Luminita Voroneanu
- Department of Nephrology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (M.A.); (L.V.); (A.C.)
| | - Adrian Covic
- Department of Nephrology, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania; (M.A.); (L.V.); (A.C.)
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Joshi S, McMacken M, Kalantar-Zadeh K. Plant-Based Diets for Kidney Disease: A Guide for Clinicians. Am J Kidney Dis 2021; 77:287-296. [DOI: 10.1053/j.ajkd.2020.10.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 10/07/2020] [Indexed: 12/12/2022]
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Hu EA, Coresh J, Anderson CAM, Appel LJ, Grams ME, Crews DC, Mills KT, He J, Scialla J, Rahman M, Navaneethan SD, Lash JP, Ricardo AC, Feldman HI, Weir MR, Shou H, Rebholz CM. Adherence to Healthy Dietary Patterns and Risk of CKD Progression and All-Cause Mortality: Findings From the CRIC (Chronic Renal Insufficiency Cohort) Study. Am J Kidney Dis 2021; 77:235-244. [PMID: 32768632 PMCID: PMC7855760 DOI: 10.1053/j.ajkd.2020.04.019] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 04/23/2020] [Indexed: 02/07/2023]
Abstract
RATIONALE & OBJECTIVE Current dietary guidelines recommend that patients with chronic kidney disease (CKD) restrict individual nutrients, such as sodium, potassium, phosphorus, and protein. This approach can be difficult for patients to implement and ignores important nutrient interactions. Dietary patterns are an alternative method to intervene on diet. Our objective was to define the associations of 4 healthy dietary patterns with risk for CKD progression and all-cause mortality among people with CKD. STUDY DESIGN Prospective cohort study. SETTING & PARTICIPANTS 2,403 participants aged 21 to 74 years with estimated glomerular filtration rates of 20 to 70mL/min/1.73m2 and dietary data in the Chronic Renal Insufficiency Cohort (CRIC) Study. EXPOSURES Healthy Eating Index-2015, Alternative Healthy Eating Index-2010, alternate Mediterranean diet (aMed), and Dietary Approaches to Stop Hypertension (DASH) diet scores were calculated from food frequency questionnaires. OUTCOMES (1) CKD progression defined as≥50% estimated glomerular filtration rate decline, kidney transplantation, or dialysis and (2) all-cause mortality. ANALYTICAL APPROACH Cox proportional hazards regression models adjusted for demographic, lifestyle, and clinical covariates to estimate hazard ratios (HRs) and 95% CIs. RESULTS There were 855 cases of CKD progression and 773 deaths during a maximum of 14 years. Compared with participants with the lowest adherence, the most highly adherent tertile of Alternative Healthy Eating Index-2010, aMed, and DASH had lower adjusted risk for CKD progression, with the strongest results for aMed (HR, 0.75; 95% CI, 0.62-0.90). Compared with participants with the lowest adherence, the highest adherence tertiles for all scores had lower adjusted risk for all-cause mortality for each index (24%-31% lower risk). LIMITATIONS Self-reported dietary intake. CONCLUSIONS Greater adherence to several healthy dietary patterns is associated with lower risk for CKD progression and all-cause mortality among people with CKD. Guidance to adopt healthy dietary patterns can be considered as a strategy for managing CKD.
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Affiliation(s)
- Emily A Hu
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Josef Coresh
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Cheryl A M Anderson
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Morgan E Grams
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD; Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Deidra C Crews
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD; Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Katherine T Mills
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Julia Scialla
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA; Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA
| | - Mahboob Rahman
- Division of Nephrology, University Hospitals Cleveland Medical Center, Cleveland, OH
| | | | - James P Lash
- Department of Medicine, University of Illinois, Chicago, IL
| | - Ana C Ricardo
- Department of Medicine, University of Illinois, Chicago, IL
| | - Harold I Feldman
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Renal Electrolyte and Hypertension Division, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Matthew R Weir
- Division of Nephrology, University of Maryland School of Medicine, Baltimore, MD
| | - Haochang Shou
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Casey M Rebholz
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
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Sugar- and artificially-sweetened beverages and the risks of chronic kidney disease: a systematic review and dose-response meta-analysis. J Nephrol 2021; 34:1791-1804. [PMID: 33502726 DOI: 10.1007/s40620-020-00957-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/27/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Consumption of sugar or artificially-sweetened beverages (SASBs) has been linked to albuminuria, decline in kidney function, and risk of chronic kidney disease (CKD). However, the results are controversial. We therefore aim to evaluate the effects of sugar or artificially-sweetened beverage consumption on CKD risk. METHODS Original observational studies reporting relative risks (RRs) with 95% confidence intervals (CIs) for the association between sugar or artificially-sweetened beverage consumption and impaired renal function or CKD risk in adults were identified using a systematic search of PubMed and EMBASE from inception to 20 February, 2019. Random effects model was applied to derive summary RRs and 95% CIs. Linear and non-linear dose-response relationships were estimated using data from sugar or artificially-sweetened beverage consumption categories in each study. RESULTS The summary RR of CKD for high versus low sugar-sweetened beverage consumption was 1.30 (95% CI 0.88-1.94) according to six included studies with a total of 25,455 participants, while the pooled RR of CKD for high versus low artificially sweetened beverage consumption was 1.40 (95% CI 0.65-3.02) according to three studies with a total of 19,995 participants. For dose-response analysis, a significant, increased risk of CKD was observed with the sugar or artificially-sweetened beverage consumption above seven servings per week (P < 0.001). CONCLUSION Our study found a positive association between consumption of sugar or artificially-sweetened beverage consumption and CKD, though it did not reach statistical significance. However, the dose-response results suggest that more than seven servings per week should be avoided.
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Dietary patterns and chronic kidney disease risk: a systematic review and updated meta-analysis of observational studies. Nutr J 2021; 20:4. [PMID: 33419440 PMCID: PMC7796538 DOI: 10.1186/s12937-020-00661-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 12/22/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND A number of studies have reported the association between dietary patterns and the risk of chronic kidney disease (CKD), however a consistent perspective hasn't been established to date. Herein, we conducted this systematic review and meta-analysis of observational studies to assess the association between dietary patterns and CKD. METHODS MEDLINE, EBSCO and references from eligible studies were searched for relevant articles published up to 9 May 2020 that examined the association of common dietary patterns and CKD. The heterogeneity among studies was assessed by Cochran's Q test and I2 methods. RESULTS Seventeen eligible studies, involving 149,958 participants, were included in our systematic review and meta-analysis. The highest compared with the lowest category of healthy dietary pattern was significantly associated with a lower risk of CKD (OR=0.69; CI: 0.57, 0.84; P=0.0001). A higher risk of CKD was shown for the highest compared with the lowest categories of Western-type dietary pattern (OR=1.86; CI: 1.21, 2.86; P=0.005). There were evidence of a lower risk of CKD in the highest compared with the lowest categories of light-moderate drinking pattern (OR=0.76; CI: 0.71, 0.81; P< 0.0001) and heavy drinking pattern (OR=0.67; CI: 0.56, 0.80; P< 0.0001). CONCLUSIONS The results of this systematic review and meta-analysis show that a healthy dietary pattern and alcohol drinking were associated with lower risk of CKD, whereas a Western-type dietary pattern was associated with higher risk of CKD.
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Ma E, Ohira T, Yasumura S, Nakano H, Eguchi E, Miyazaki M, Hosoya M, Sakai A, Takahashi A, Ohira H, Kazama J, Shimabukuro M, Yabe H, Maeda M, Ohto H, Kamiya K. Dietary Patterns and Progression of Impaired Kidney Function in Japanese Adults: A Longitudinal Analysis for the Fukushima Health Management Survey, 2011-2015. Nutrients 2021; 13:nu13010168. [PMID: 33430501 PMCID: PMC7827845 DOI: 10.3390/nu13010168] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 12/31/2020] [Accepted: 01/05/2021] [Indexed: 02/07/2023] Open
Abstract
To investigate associations between dietary patterns and the risk of impaired kidney function, we analyzed data from 14,732 participants (40–89 years) who completed the baseline diet questionnaire of The Fukushima Health Management Survey in 2011. The incidence of chronic kidney disease (CKD) (estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or proteinuria (≥1+ by dipstick test)) and annual changes in eGFR were assessed from 2012 to 2015. Three major dietary patterns were identified. The adjusted cumulative incidence ratio of the highest vs. lowest tertile of a vegetable diet scores was 0.90 (95% confidence interval (CI): 0.82, 1.00) for eGFR < 60 mL/min/1.73 m2, 0.68 (95% CI: 0.52, 0.90) for proteinuria, and 0.88 (95% CI: 0.80, 0.97) for CKD (P for trend = 0.031, 0.007, and 0.005, respectively). The incident risk of CKD in the highest tertile of juice diet scores was 18% higher than the lowest tertile. The odds ratio of the highest vs. lowest tertile of vegetable diet scores was 0.85 (95% CI: 0.75, 0.98) in the rapidly decreasing eGFR group (P for trend = 0.009). We did not observe significant associations for the meat dietary pattern. A Japanese vegetable diet could reduce the risk of developing impaired kidney function and CKD.
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Affiliation(s)
- Enbo Ma
- Health Promotion Centre, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (M.M.); (M.H.)
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan; (H.N.); (E.E.)
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Correspondence: ; Tel.: +81-24-547-1788; Fax: +81-24-547-1789
| | - Tetsuya Ohira
- Health Promotion Centre, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (M.M.); (M.H.)
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan; (H.N.); (E.E.)
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
| | - Seiji Yasumura
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Hironori Nakano
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan; (H.N.); (E.E.)
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
| | - Eri Eguchi
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan; (H.N.); (E.E.)
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
| | - Makoto Miyazaki
- Health Promotion Centre, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (M.M.); (M.H.)
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
| | - Mitsuaki Hosoya
- Health Promotion Centre, Fukushima Medical University, Fukushima 960-1295, Japan; (T.O.); (M.M.); (M.H.)
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Department of Paediatrician, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Akira Sakai
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Atsushi Takahashi
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan;
| | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan;
| | - Junichiro Kazama
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Michio Shimabukuro
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Department of Diabetes, Endocrinology, and Metabolism, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Hirooki Yabe
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Masaharu Maeda
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan
| | - Hitoshi Ohto
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
| | - Kenji Kamiya
- Radiation Medical Science Centre for Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan; (S.Y.); (A.S.); (A.T.); (J.K.); (M.S.); (H.Y.); (M.M.); (H.O.); (K.K.)
- Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima 734-8553, Japan
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Abstract
Evolutionary processes, including mutation, migration and natural selection, have influenced the prevalence and distribution of various disorders in humans. However, despite a few well-known examples, such as the APOL1 variants - which have undergone positive genetic selection for their ability to confer resistance to Trypanosoma brucei infection but confer a higher risk of chronic kidney disease - little is known about the effects of evolutionary processes that have shaped genetic variation on kidney disease. An understanding of basic concepts in evolutionary genetics provides an opportunity to consider how findings from ancient and archaic genomes could inform our knowledge of evolution and provide insights into how population migration and genetic admixture have shaped the current distribution and landscape of human kidney-associated diseases. Differences in exposures to infectious agents, environmental toxins, dietary components and climate also have the potential to influence the evolutionary genetics of kidneys. Of note, selective pressure on loci associated with kidney disease is often from non-kidney diseases, and thus it is important to understand how the link between genome-wide selected loci and kidney disease occurs in relation to secondary nephropathies.
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62
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Geng TT, Jafar TH, Neelakantan N, Yuan JM, van Dam RM, Koh WP. Healthful dietary patterns and risk of end-stage kidney disease: the Singapore Chinese Health Study. Am J Clin Nutr 2020; 113:675-683. [PMID: 33381807 PMCID: PMC7948892 DOI: 10.1093/ajcn/nqaa348] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/27/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Although adherence to healthful dietary patterns has been associated with a lower risk of kidney function decline in Western populations, evidence in Asian populations remains scanty. OBJECTIVES We examined predefined dietary patterns, namely, the Alternate Healthy Eating Index-2010 (AHEI-2010), the Dietary Approaches to Stop Hypertension (DASH), and the alternate Mediterranean diet (aMED), in relation to risk of end-stage kidney disease (ESKD). METHODS We included 56,985 Chinese adults (aged 45-74 y) in the Singapore Chinese Health Study who were free of cancer, stroke, coronary artery disease, and ESKD at recruitment (1993-1998). Dietary pattern scores were calculated based on a validated 165-item FFQ. AHEI-2010 and aMED scores were modified by excluding the alcohol intake component because daily drinking has been associated with a higher risk of ESKD in our study population. We identified 1026 ESKD cases over a median follow-up of 17.5 y via linkage with the nationwide Singapore Renal Registry. Multivariable Cox regression models were used to compute HRs and their 95% CIs. RESULTS Higher scores of all 3 dietary patterns were associated with lower ESKD risk in a dose-dependent manner. Compared with the lowest quintiles, the multivariable-adjusted HRs (95% CIs) of ESKD were 0.75 (0.61, 0.92) for the highest quintile of AHEI-2010, 0.67 (0.54, 0.84) for DASH, and 0.73 (0.59, 0.91) for aMED (all P-trend ≤ 0.004). These inverse associations were stronger with increasing BMI (in kg/m2), and the HRs for the diet-ESKD association were lowest in the obese (BMI ≥ 27.5), followed by the overweight (BMI = 25 to <27.5) participants, compared with those in lower BMI categories; the P-interaction values between BMI and diet scores were 0.03 for AHEI-2010, 0.004 for aMED, and 0.06 for DASH. CONCLUSIONS Adherence to healthful dietary patterns was associated with a lower ESKD risk in an Asian population, especially in overweight or obese individuals.
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Affiliation(s)
- Ting-Ting Geng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Tazeen H Jafar
- Health Services and Systems Research, Duke-NUS Medical School, Singapore,Department of Renal Medicine, Singapore General Hospital, Singapore
| | - Nithya Neelakantan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA,Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
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63
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Syauqy A, Hsu CY, Lee HA, Rau HH, Chao JCJ. Association between Dietary Patterns and Kidney Function Parameters in Adults with Metabolic Syndrome: A Cross-Sectional Study. Nutrients 2020; 13:nu13010040. [PMID: 33374257 PMCID: PMC7823384 DOI: 10.3390/nu13010040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 12/14/2022] Open
Abstract
This study explored the association between dietary patterns and kidney function parameters in adults with metabolic syndrome in Taiwan. This cross-sectional study was undertaken in 56,476 adults from the health screening centers in Taiwan from 2001 to 2010. Dietary intake and dietary patterns were assessed using a food frequency questionnaire and principal component analysis, respectively. Blood urea nitrogen (BUN), creatinine, estimated glomerular filtration rate (eGFR), and uric acid were measured as clinical parameters of kidney function. Multivariate linear regression was conducted to explore the relationship between dietary patterns and kidney function parameters. After adjusting for confounders, the highest tertiles of the processed food–sweets dietary pattern and the meat–seafood–eggs dietary pattern were associated with increased BUN, creatinine, and uric acid but decreased eGFR (all adjusted p < 0.05). Meanwhile, the highest tertiles of the veggie–fruit–grains dietary pattern and the milk–dairy dietary pattern were associated with decreased BUN, creatinine, and uric acid but increased eGFR (all adjusted p < 0.05). A processed food–sweets dietary pattern or a meat–seafood–eggs dietary pattern is associated with worse kidney function parameters in adults with metabolic syndrome. In contrast, a veggie–fruit–grains dietary pattern or a milk–dairy dietary pattern is associated with better kidney function parameters.
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Affiliation(s)
- Ahmad Syauqy
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei 11031, Taiwan;
- Department of Nutrition Science, Faculty of Medicine, Diponegoro University, Jl. Prof. H. Soedarto, SH., Tembalang, Semarang 50275, Indonesia
| | - Chien-Yeh Hsu
- Department of Information Management, National Taipei University of Nursing and Health Sciences, 365 Ming-Te Road, Peitou District, Taipei 11219, Taiwan;
- Master Program in Global Health and Development, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei 11031, Taiwan
| | - Hsiu-An Lee
- Department of Computer Science and Information Engineering, Tamkang University, 151 Yingzhuan Road, Tamsui District, New Taipei City 25137, Taiwan;
| | - Hsiao-Hsien Rau
- Joint Commission of Taiwan, 5F, 31, Section 2, Sanmin Road, Banqiao District, New Taipei City 22069, Taiwan;
| | - Jane C.-J. Chao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei 11031, Taiwan;
- Master Program in Global Health and Development, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei 11031, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei 11031, Taiwan
- Correspondence: ; Tel.: +886-2-2736-1661 (ext. 6548); Fax: +886-2-2736-3112
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64
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Ghorbaninejad P, Mohammadpour S, Djafari F, Tajik S, Shab-Bidar S. Dietary Total Antioxidant Capacity and Its Association with Renal Function and Progression of Chronic Kidney Disease in Older Adults: a Report from a Developing Country. Clin Nutr Res 2020; 9:296-306. [PMID: 33204669 PMCID: PMC7644366 DOI: 10.7762/cnr.2020.9.4.296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 01/15/2023] Open
Abstract
While evidence exists for an association between the dietary total antioxidant capacity (DTAC), mortality, metabolic syndrome, and cardiovascular diseases, data about DTAC and renal function, and progression of chronic kidney disease (CKD) are scarce. This study aimed to determine the associations between DTAC, renal function, and progression of CKD in older adults. The present cross-sectional study consisted of 226 older adults aged ≥ 60 years old from five districts of Tehran, Iran. DTAC was estimated using the oxygen radical absorbance capacity (ORAC) method. Dietary intake, socio-demographic data, medical history, and anthropometric measurements were collected using a validated questionnaire. The estimated glomerular filtration rate (eGFR) was assessed from serum creatinine. Albumin to creatinine ratio (ACR) was calculated by dividing albumin concentration by creatinine concentration and reported as mg/g. The DTAC ranged from 112.8 to 2,553.9. Analyses indicated that DTAC was not associated with eGFR (p = 0.35) and ACR (p = 0.91) even after controlling for confounding variables. Additionally, in logistic regression, no association between eGFR < 60 mL/min/1.73 m2 (p = 0.32) and ACR ≥ 30 mg/g (p = 0.32) with DTAC was observed, which was independent of confounding variables. We observed that more compliance with DTAC is not associated with renal function and CKD progression. Further studies are needed to confirm the findings of the present study in larger samples on different populations.
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Affiliation(s)
- Parivash Ghorbaninejad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14167-53955, Iran
| | - Saba Mohammadpour
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14167-53955, Iran
| | - Farhang Djafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14167-53955, Iran
| | - Somayeh Tajik
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14167-53955, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran 14167-53955, Iran
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65
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Silva Junior GB, Fraser SDS, Néri AKM, Xavier RMF, Mota RMS, Lopes AA, Mill JG, Barreto SM, Luft VC, Chor D, Santos CAST, Lotufo PA, Matos SMA. Association between dietary patterns and renal function in a cross-sectional study using baseline data from the ELSA-Brasil cohort. ACTA ACUST UNITED AC 2020; 53:e10230. [PMID: 33146283 PMCID: PMC7643924 DOI: 10.1590/1414-431x202010230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/24/2020] [Indexed: 01/16/2023]
Abstract
Previous analyses of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) identified four main dietary patterns (DP). The aim of this study was to explore the association between the previously defined DP and renal function (RF). A cross-sectional study using the ELSA-Brasil baseline data was carried out. DP (“traditional”, “fruits and vegetables”, “bakery”, and “low sugar/low fat), metabolic syndrome (MS) using the Joint Interim Statement criteria, microalbuminuria (MA), and glomerular filtration rate (eGFR) through the CKD-EPI equation were evaluated. Abnormal RF was defined as eGFR<60 mL·min-1·(1.73 m2)-1 and MA≥3.0 mg/dL. Factors associated with RF were determined and mediation analysis was performed to investigate the association between DP, MS, and RF. A total of 15,105 participants were recruited, with a mean age of 52±9 years; 8,134 participants (54%) were females. The mediation analysis identified indirect associations between “bakery” and “fruits and vegetables”, and both were associated with decreased eGFR and albuminuria in both genders, compared with “traditional” and “low sugar/low fat” patterns in the general population. There was a direct association of the “bakery” pattern with MA in men (OR: 1.17, 95%CI: 1.92-1.48). The “fruits and vegetables” pattern also showed a direct association with reduced eGFR in women (OR: 1.65, 95%CI: 1.28-2.12), although there was no significance after adjustment. The “fruits and vegetables” and “bakery” DPs were associated with renal dysfunction. The only independent, direct association was between “bakery” DP and MA in men, raising concerns about DP and renal damage in men.
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Affiliation(s)
- G B Silva Junior
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brasil.,Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, CE, Brasil
| | - S D S Fraser
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - A K M Néri
- Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, CE, Brasil
| | - R M F Xavier
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brasil.,Programa de Pós-Graduação em Saúde Coletiva, Centro de Ciências da Saúde, Universidade de Fortaleza, Fortaleza, CE, Brasil
| | - R M S Mota
- Departamento de Estatística e Matemática Aplicada, Centro de Ciências, Universidade Federal do Ceará, Fortaleza, CE, Brasil
| | - A A Lopes
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brasil
| | - J G Mill
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - S M Barreto
- Departamento de Medicina Preventiva e Social, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - V C Luft
- Programa de Pós-Graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - D Chor
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | - C A S T Santos
- Laboratório de Epidemiologia Molecular e Bioestatísticas, Centro de Pesquisa Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brasil
| | - P A Lotufo
- Divisão de Medicina Interna, Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Universidade de São Paulo, São Paulo, SP, Brasil
| | - S M A Matos
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brasil
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66
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Suri S, Kumar V, Kumar S, Goyal A, Tanwar B, Kaur J, Kaur J. DASH Dietary Pattern: A Treatment for Non-communicable Diseases. Curr Hypertens Rev 2020; 16:108-114. [PMID: 31589127 PMCID: PMC7499347 DOI: 10.2174/1573402115666191007144608] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/23/2019] [Accepted: 08/26/2019] [Indexed: 02/07/2023]
Abstract
Non-communicable diseases are the major inducer of mortality and morbidity in the Western world. In terms of nutrition, a diet high in fat (particularly saturated fat), salt and sugars have shown to be associated with innumerable incidence of diet- associated health diseases. Dietary modification is a central part of any treatment strategy. The Dietary Approach to Stop Hypertension (DASH) diet is one among such healthy dietary patterns, which emphasizes on the consumption of fruits, vegetables and low-fat dairy foods, including whole grains, poultry, fish, and small quantities of red meat, sweets and drinks containing sugar. This study provides certain practical evidence that prolonged adoption of DASH diet which can be a useful treatment for numerous non-communicable diseases with a sustained effect on the health that involves both accessibility and proximity to healthy eating choices. Long-term studies are required to assess whether these effects are maintained over time.
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Affiliation(s)
- Sheenam Suri
- Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab-144411, India
| | - Vikas Kumar
- Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab-144411, India
| | - Satish Kumar
- Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab-144411, India
| | - Ankit Goyal
- Department of Dairy Chemistry, Mansinhbhai Institute of Dairy and Food Technology, Mehsana, Gujarat- 384002, India
| | - Beenu Tanwar
- Department of Dairy Technology, Mansinhbhai Institute of Dairy and Food Technology, Mehsana, Gujarat-384002, India
| | - Jasleen Kaur
- Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab-144411, India
| | - Jaspreet Kaur
- Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab-144411, India
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67
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Yazdi F, Morreale P, Reisin E. First Course DASH, Second Course Mediterranean: Comparing Renal Outcomes for Two “Heart-Healthy” Diets. Curr Hypertens Rep 2020; 22:54. [DOI: 10.1007/s11906-020-01054-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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68
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Ko GJ, Rhee CM, Kalantar-Zadeh K, Joshi S. The Effects of High-Protein Diets on Kidney Health and Longevity. J Am Soc Nephrol 2020; 31:1667-1679. [PMID: 32669325 PMCID: PMC7460905 DOI: 10.1681/asn.2020010028] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Although high-protein diets continue to be popular for weight loss and type 2 diabetes, evidence suggests that worsening renal function may occur in individuals with-and perhaps without-impaired kidney function. High dietary protein intake can cause intraglomerular hypertension, which may result in kidney hyperfiltration, glomerular injury, and proteinuria. It is possible that long-term high protein intake may lead to de novo CKD. The quality of dietary protein may also play a role in kidney health. Compared with protein from plant sources, animal protein has been associated with an increased risk of ESKD in several observational studies, including the Singapore Chinese Health Study. Potential mediators of kidney damage from animal protein include dietary acid load, phosphate content, gut microbiome dysbiosis, and resultant inflammation. In light of such findings, adopting current dietary approaches that include a high proportion of protein for weight reduction or glycemic control should be considered with care in those at high risk for kidney disease. Given the possibility of residual confounding within some observational studies and the conflicting evidence from previous trials, long-term studies including those with large sample sizes are warranted to better ascertain the effects of high protein intake on kidney health.
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Affiliation(s)
- Gang-Jee Ko
- Harold Simmons Center for Kidney Disease Research and Epidemiology, School of Medicine, University of California Irvine, Orange, California
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Connie M Rhee
- Harold Simmons Center for Kidney Disease Research and Epidemiology, School of Medicine, University of California Irvine, Orange, California
| | - Kamyar Kalantar-Zadeh
- Harold Simmons Center for Kidney Disease Research and Epidemiology, School of Medicine, University of California Irvine, Orange, California
- Department of Medicine, Long Beach Veteran Affairs Health System, Long Beach, California
- Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles, Torrance, California
| | - Shivam Joshi
- Division of General Internal Medicine, Department of Medicine, New York University School of Medicine, New York, New York
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69
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Raphael KL. The Dietary Approaches to Stop Hypertension (DASH) diet in chronic kidney disease: should we embrace it? Kidney Int 2020; 95:1296-1298. [PMID: 31122706 DOI: 10.1016/j.kint.2019.01.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 01/29/2019] [Indexed: 01/16/2023]
Abstract
The Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure and cardiovascular disease risk. In this issue, Banerjee et al. report that the DASH diet is associated with lower risk of end-stage kidney disease in individuals with stage 3 chronic kidney disease and hypertension. This association was particulary strong among those with diabetes. The DASH diet may have an important role in preventing end-stage kidney disease in select individuals with chronic kidney disease.
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Affiliation(s)
- Kalani L Raphael
- Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah, USA; Department of Internal Medicine, University of Utah Health, Salt Lake City, Utah, USA.
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70
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Bernier-Jean A, Prince RL, Lewis JR, Craig JC, Hodgson JM, Lim WH, Teixeira-Pinto A, Wong G. Dietary plant and animal protein intake and decline in estimated glomerular filtration rate among elderly women: a 10-year longitudinal cohort study. Nephrol Dial Transplant 2020; 36:1640-1647. [DOI: 10.1093/ndt/gfaa081] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Indexed: 01/06/2023] Open
Abstract
Abstract
Background
Many older women demonstrate an age-related accelerating rate of renal decline that is associated with increased rates of bone disease, cardiovascular disease and mortality. Population-based protein restriction has been studied principally in patients with reduced renal function. In this investigation, we examined the hypothesis of a differential effect of plant-derived protein compared with animal-derived protein on renal function in older women.
Methods
We assessed dietary intake from a validated food frequency questionnaire and the estimated glomerular filtration rate (eGFR) (using the Chronic Kidney Disease Epidemiology Collaboration creatinine and cystatin C equation) at baseline, 5 and 10 years in the Longitudinal Study of Aging Women cohort. We tested the association between plant- and animal-sourced protein intake and kidney function using linear mixed modeling.
Results
A total of 1374 Caucasian women [mean (standard deviation, SD) age = 75 years (2.7) and mean (SD) baseline eGFR = 65.6 mL/min/1.73 m2 (13.1)] contributed to the analysis. The average decline in eGFR was 0.64 mL/min/1.73 m2/year [95% confidence interval (CI) 0.56–0.72]. Higher intakes of plant-sourced protein were associated with slower declines in eGFR after adjusting for covariates including animal protein and energy intake (P = 0.03). For each 10 g of plant protein, the yearly decline in eGFR was reduced by 0.12 mL/min/1.73 m2 (95% CI 0.01–0.23), principally associated with fruit-, vegetable- and nut-derived protein. The intake of animal protein was not associated with eGFR decline (P = 0.84).
Conclusions
Older women consuming a diet that is richer in plant-sourced protein have a slower decline in kidney function. These data extend support for the health benefits of plant-rich diets in the general population to maintain kidney health.
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Affiliation(s)
- Amélie Bernier-Jean
- Centre for Kidney Research, Children’s Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Richard L Prince
- Medical School, University of Western Australia, Perth, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia
| | - Joshua R Lewis
- Centre for Kidney Research, Children’s Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
- Medical School, University of Western Australia, Perth, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Jonathan M Hodgson
- Medical School, University of Western Australia, Perth, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Wai H Lim
- Medical School, University of Western Australia, Perth, Australia
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Armando Teixeira-Pinto
- Centre for Kidney Research, Children’s Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Germaine Wong
- Centre for Kidney Research, Children’s Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
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71
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Ebrahim Z, Esau N, Cilliers L. Keeping the Diet Simple and Natural in Chronic Kidney Disease: A South African-Based Dietary Infographic. J Ren Nutr 2020; 30:e58-e65. [PMID: 32303412 DOI: 10.1053/j.jrn.2019.11.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/23/2019] [Accepted: 11/11/2019] [Indexed: 01/15/2023] Open
Affiliation(s)
- Zarina Ebrahim
- Department of Human Nutrition, Stellenbosch University, Stellenbosch, South Africa.
| | - Nazeema Esau
- Department of Dietetics, Tygerberg Hospital, Cape Town, South Africa
| | - Lynette Cilliers
- Department of Dietetics, Groote Schuur Hospital, Cape Town, South Africa
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72
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Cai Q, Dekker LH, Bakker SJL, de Borst MH, Navis GJ. Dietary Patterns Based on Estimated Glomerular Filtration Rate and Kidney Function Decline in the General Population: The Lifelines Cohort Study. Nutrients 2020; 12:nu12041099. [PMID: 32316088 PMCID: PMC7230954 DOI: 10.3390/nu12041099] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/10/2020] [Accepted: 04/13/2020] [Indexed: 02/07/2023] Open
Abstract
No specific dietary patterns have been established that are linked with loss of kidney function. We aimed to identify an estimated glomerular filtration rate-based dietary pattern (eGFR-DP) and to evaluate its association with eGFR decline and chronic kidney disease (CKD) incidence in the general population. We included 78,335 participants from the Lifelines cohort in the Northern Netherlands. All participants had an eGFR >60 mL/min/1.73 m2 at baseline and completed a second visit five years later. The eGFR-DP was constructed at baseline using a 110-item food frequency questionnaire by reduced rank regression, stratified by sex. Logistic regression was performed to evaluated the association between the eGFR-DP score and either a ≥20% eGFR decline or incident CKD. Among women, eGFR-DP were characterized by high consumption of egg, cheese, and legumes and low consumption of sweets, white meat, and commercially prepared dishes. In men, eGFR-DP were characterized by high consumption of cheese, bread, milk, fruits, vegetables, and beer and low consumption of white and red meat. A higher eGFR-DP score was associated with a lower risk of a ≥20% eGFR decline (OR 4th vs. 1st quartile, women: 0.79 [95% CI: 0.73-0.87]; men: 0.67 [0.59-0.76]). The association between the eGFR-DP score and CKD incidence was lost upon adjustment for baseline eGFR. Our results provide support for dietary interventions to prevent kidney function decline in the general population.
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Affiliation(s)
- Qingqing Cai
- Department of Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (L.H.D.); (S.J.L.B.); (M.H.d.B.); (G.J.N.)
- Correspondence:
| | - Louise H. Dekker
- Department of Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (L.H.D.); (S.J.L.B.); (M.H.d.B.); (G.J.N.)
- Aletta Jacobs School of Public Health, 9747 AD Groningen, The Netherlands
| | - Stephan J. L. Bakker
- Department of Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (L.H.D.); (S.J.L.B.); (M.H.d.B.); (G.J.N.)
| | - Martin H. de Borst
- Department of Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (L.H.D.); (S.J.L.B.); (M.H.d.B.); (G.J.N.)
| | - Gerjan J. Navis
- Department of Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; (L.H.D.); (S.J.L.B.); (M.H.d.B.); (G.J.N.)
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73
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Soltani S, Jayedi A. Adherence to healthy dietary pattern and risk of kidney disease: a systematic review and meta-analysis of observational studies. INT J VITAM NUTR RES 2020; 92:267-279. [PMID: 32138628 DOI: 10.1024/0300-9831/a000647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Epidemiological studies show that adherence to healthy dietary patterns may be associated with a lower risk of decline in kidney function. However, existing evidence has not been quantitatively gathered. Pertinent observational studies investigating the association of adherence to a healthy dietary pattern, either priori-defined dietary pattern/indices or data-driven dietary patterns, with risk of kidney disease in the general population were identified by searching Medline and Scopus databases to May 28, 2018. A random-effects meta-analysis was applied. The analysis included eight prospective cohorts (5734 cases among 569,688 participants) and five cross-sectional studies (1955 cases among 16,614 participants). Higher adherence to a healthy dietary pattern (either priori-defined or data-driven dietary patterns) was associated with a 28% lower risk of kidney disease in the analysis of prospective cohort studies (RR = 0.72, 95 % CI = 0.58, 0.86; I2 = %71, n = 8). A subgroup analysis based on definition of healthy dietary pattern resulted in significant inverse association only in the subgroup of Dietary Approaches to Stop Hypertension dietary pattern (RR: 0.74, 95 % CI: 0.54, 0.93; I2 = 73%, n = 5). A dose-response analysis indicated a monotonic inverse association between adherence to the Dietary Approaches to Stop Hypertension dietary pattern with risk of kidney disease. A 32% lower risk was observed in the analysis of cross-sectional studies (OR: 0.68, 95 %CI: 0.53, 0.83, I2 = 0%, n = 5). The findings suggest that higher adherence to a healthy dietary pattern is associated with a lower risk of kidney disease.
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Affiliation(s)
- Sepideh Soltani
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ahmad Jayedi
- Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran.,Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Ma E, Ohira T, Sakai A, Yasumura S, Takahashi A, Kazama J, Shimabukuro M, Nakano H, Okazaki K, Maeda M, Yabe H, Suzuki Y, Kamiya K. Associations between Dietary Patterns and Cardiometabolic Risks in Japan: A Cross-Sectional Study from the Fukushima Health Management Survey, 2011-2015. Nutrients 2020; 12:nu12010129. [PMID: 31906499 PMCID: PMC7019971 DOI: 10.3390/nu12010129] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/27/2019] [Accepted: 12/30/2019] [Indexed: 12/17/2022] Open
Abstract
Cardiometabolic risks were increasing in Fukushima residents after the Great East Japan Earthquake. We examined the association between dietary patterns and cardiometabolic risks in those aged ≥16 years. Dietary patterns were derived by principal component analysis for participants who underwent at least one diet assessment using a short-form food frequency questionnaire during 2011–2013 and a health checkup in 2014 and 2015 (n = 15,409 and 14,999, respectively). In 2014, the adjusted prevalence ratio (PR) and 95% confidence interval (CI) in the highest versus lowest quartile of accumulative mean scores were 0.97 (0.96–0.99) for overweight/obesity, 0.96 (0.95–0.97) for total cholesterol (TC) ≥ 220 mg/dL, 0.96 (0.95–0.98) for low-density lipoprotein cholesterol (LDL-C) ≥ 140 mg/dL, and 0.97 (0.96–0.99) for triglycerides ≥ 150 mg/dL for a vegetable diet and 1.03 (1.01–1.04) for TC ≥ 220 mg/dL and 1.02 (1.01–1.04) for LDL-C ≥ 140 mg/dL for a juice/milk diet. In 2015, we found consistently significant associations for the vegetable and juice/milk diets, and the PR and 95% CI were 0.99 (0.98–1.00) for HDL-C < 40 mg/dL for a meat diet. The continuous promotion of the vegetable pattern diet is necessary to reduce cardiometabolic risks, particularly dyslipidemia, in Japan.
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Affiliation(s)
- Enbo Ma
- Health Promotion Center, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan;
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan; (H.N.); (K.O.)
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Correspondence: ; Tel.: +81-24-547-1788
| | - Tetsuya Ohira
- Health Promotion Center, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan;
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan; (H.N.); (K.O.)
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
| | - Akira Sakai
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Public Health, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Atsushi Takahashi
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Junichiro Kazama
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Michio Shimabukuro
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Diabetes, Endocrinology and Metabolism School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Hironori Nakano
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan; (H.N.); (K.O.)
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
| | - Kanako Okazaki
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan; (H.N.); (K.O.)
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
| | - Masaharu Maeda
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan;
| | - Yuriko Suzuki
- Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8553, Japan;
| | - Kenji Kamiya
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
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75
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Gomes-Neto AW, Osté MCJ, Sotomayor CG, van den Berg E, Geleijnse JM, Berger SP, Gans ROB, Bakker SJL, Navis GJ. Mediterranean Style Diet and Kidney Function Loss in Kidney Transplant Recipients. Clin J Am Soc Nephrol 2020; 15:238-246. [PMID: 31896540 PMCID: PMC7015079 DOI: 10.2215/cjn.06710619] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 11/22/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Despite improvement of short-term graft survival over recent years, long-term graft survival after kidney transplantation has not improved. Studies in the general population suggest the Mediterranean diet benefits kidney function preservation. We investigated whether adherence to the Mediterranean diet is associated with kidney outcomes in kidney transplant recipients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We included 632 adult kidney transplant recipients with a functioning graft for ≥1 year. Dietary intake was inquired using a 177-item validated food frequency questionnaire. Adherence to the Mediterranean diet was assessed using a nine-point Mediterranean Diet Score. Primary end point of the study was graft failure and secondary end points included kidney function decline (doubling of serum creatinine or graft failure) and graft loss (graft failure or death with a functioning graft). Cox regression analyses were used to prospectively study the associations of the Mediterranean Diet Score with study end points. RESULTS During median follow-up of 5.4 (interquartile range, 4.9-6.0) years, 76 participants developed graft failure, 119 developed kidney function decline, and 181 developed graft loss. The Mediterranean Diet Score was inversely associated with all study end points (graft failure: hazard ratio [HR], 0.68; 95% confidence interval [95% CI], 0.50 to 0.91; kidney function decline: HR, 0.68; 95% CI, 0.55 to 0.85; and graft loss: HR, 0.74; 95% CI, 0.63 to 0.88 per two-point increase in Mediterranean Diet Score) independent of potential confounders. We identified 24-hour urinary protein excretion and time since transplantation to be an effect modifier, with stronger inverse associations between the Mediterranean Diet Score and kidney outcomes observed in participants with higher urinary protein excretion and participants transplanted more recently. CONCLUSIONS Adherence to the Mediterranean diet is associated with better kidney function outcomes in kidney transplant recipients.
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Affiliation(s)
- António W Gomes-Neto
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; and
| | - Maryse C J Osté
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; and
| | - Camilo G Sotomayor
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; and
| | - Else van den Berg
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; and
| | | | - Stefan P Berger
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; and
| | - Reinold O B Gans
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; and
| | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; and
| | - Gerjan J Navis
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; and
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76
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Naderinejad N, Ejtahed HS, Asghari G, Mirmiran P, Azizi F. Dietary Patterns and Risk of Chronic Kidney Disease Among Tehranian Adults with High Blood Pressure. Int J Endocrinol Metab 2020; 18:e89709. [PMID: 32308695 PMCID: PMC7144243 DOI: 10.5812/ijem.89709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 11/14/2019] [Accepted: 01/07/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Although high blood pressure is an important risk factor for chronic kidney disease (CKD), it remains unclear whether diet can still influence the risk of CKD in adults with high blood pressure. OBJECTIVES This study aimed at investigating the association between major dietary patterns and the incidence of CKD in adults with high blood pressure. METHODS In this cross-sectional study, we recruited 1,521 subjects aged ≥ 27 years with high blood pressure and with preserved estimated glomerular filtration rate at baseline, who participated in the fourth examination survey of the Tehran Lipid and Glucose Study. The principal component analysis was performed to derive dietary patterns. High blood pressure was defined as systolic blood pressure ≥ 120, diastolic blood pressure ≥ 80, or the current use of antihypertensive drugs. Multiple logistic regression analysis was applied to investigate the association between the dietary pattern scores and CKD risk. RESULTS After 3.6 years of follow-up, the incidence of CKD was 16.8%. Three dietary patterns were produced by using factor analysis, including the Western, the healthy, and the traditional Iranian dietary patterns. The healthy and the traditional Iranian dietary patterns were not related to the risk of CKD, but scoring on the Western dietary pattern was associated with enhanced odds of CKD, after being adjusted for relevant confounders (odds ratio: 2.12; 95% confidence interval: 1.19 - 3.76). CONCLUSIONS Results of this study provided evidence that a high score on the Western dietary pattern was associated with an increased risk of CKD in adults with high blood pressure.
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Affiliation(s)
- Niloofar Naderinejad
- Department of Clinical Nutrition and Dietetics, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Golaleh Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding Author: Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Shahid Arabi St., Yemen Blvd., Chamran Exp., Tehran, Iran. Tel: +98-2122432500, Fax: +98-2122416264,
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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77
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Plant-based diets for prevention and management of chronic kidney disease. Curr Opin Nephrol Hypertens 2020; 29:16-21. [DOI: 10.1097/mnh.0000000000000574] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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78
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Dietary inflammatory index and the aging kidney in older women: a 10-year prospective cohort study. Eur J Nutr 2019; 59:3201-3211. [PMID: 31828473 DOI: 10.1007/s00394-019-02160-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 12/04/2019] [Indexed: 01/20/2023]
Abstract
PURPOSE Chronic inflammation plays a role in the pathogenesis of age-related renal disease and the diet can moderate systemic inflammation. The primary objective of this study was to examine the associations between a dietary inflammatory index (DII®) score and renal function, the trajectory of renal function decline, and renal disease-related hospitalizations and/or mortality over 10 years. METHODS The study was conducted in 1422 Western Australian women without prevalent chronic kidney disease and aged ≥ 70 years. Baseline dietary data, obtained from a validated food frequency questionnaire, were used to calculate a DII score for each individual. RESULTS In this cohort, the mean [range] DII score was 0.19 [- 6.14 to 6.39]. A higher DII score was associated with poorer renal function at baseline and a greater renal function decline over 10 years; after multivariable adjustments, a one-unit higher DII score was associated with a 0.55 mL/min/1.73 m2 lower eGFR at baseline (p = 0.01) and a 0.06 mL/min/1.73 m2 greater annual decline in eGFR over 10 years (p = 0.05). Restricted cubic splines provide evidence of a non-linear association between baseline DII score and risk of a renal disease-related event. Compared to participants in the lowest quintile, those in the highest quintile of DII score were at a higher risk of experiencing a renal disease-related event (adjusted HR 2.06, 95% CI 0.97, 4.37). CONCLUSION Recommending an increased consumption of foods with a higher anti-inflammatory potential could form part of a multifaceted approach to reduce the risk of renal disease through diet and lifestyle changes.
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79
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Shi Z, Zhang M, Liu J. Chili Intake Is Inversely Associated with Chronic Kidney Disease among Adults: A Population-Based Study. Nutrients 2019; 11:nu11122949. [PMID: 31817083 PMCID: PMC6949978 DOI: 10.3390/nu11122949] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/10/2019] [Accepted: 11/26/2019] [Indexed: 01/02/2023] Open
Abstract
We aimed to assess the association between chili consumption and kidney function and chronic kidney disease (CKD). Data from 8429 adults attending the China Health and Nutrition Survey were used. Chili intake was assessed using a 3 day, 24 h food record in combination with household food inventory between 1991 and 2009. CKD was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2, as measured in 2009. Logistic regression was used to assess the association. Of the 8429 participants, 1008 (12.0%) fit the definition of CKD. The prevalence of CKD was 13.1% in non-consumers of chili and 7.4% among those with chili intake above 50 g/day. After adjusting for demographics, lifestyle factors (i.e., smoking, alcohol drinking, physical activity), dietary patterns, and chronic conditions, the odds ratio (OR) (95% CI) for CKD across chili consumption levels of none, 1–20 g/day, 20.1–50 g/day, ≥50.1 g/day were 1.00 (reference), 0.82 (0.67–1.01), 0.83 (0.65–1.05), and 0.51 (0.35–0.75), respectively (p for trend 0.001). There was no interaction between chili intake with gender, income, urbanization, hypertension, obesity, or diabetes. This longitudinal large population-based study suggests that chili consumption is inversely associated with CKD, independent of lifestyle, hypertension, obesity, and overall dietary patterns.
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Affiliation(s)
- Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar
- Correspondence: ; Tel.: +974-4403-6037
| | - Ming Zhang
- Department of Nutrition, Peking University Shenzhen Hospital, Shenzhen 518036, China;
| | - Jianghong Liu
- University of Pennsylvania School of Nursing, Philadelphia, PA 19104, USA;
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Heindel J, Baid-Agrawal S, Rebholz CM, Nadal J, Schmid M, Schaeffner E, Schneider MP, Meiselbach H, Kaesler N, Bergmann M, Ernst S, Krane V, Eckardt KU, Floege J, Schlieper G, Saritas T. Association Between Dietary Patterns and Kidney Function in Patients With Chronic Kidney Disease: A Cross-Sectional Analysis of the German Chronic Kidney Disease Study. J Ren Nutr 2019; 30:296-304. [PMID: 31761711 DOI: 10.1053/j.jrn.2019.09.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/02/2019] [Accepted: 09/15/2019] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE In the general population, "healthy" dietary patterns are associated with improved health outcomes, but data on associations between observance of specific dietary patterns and kidney function in patients with chronic kidney disease (CKD) are sparse. METHODS Dietary intake was evaluated using food frequency questionnaires in patients with moderately severe CKD under nephrology care enrolled into the observational multicenter German CKD study. The Dietary Approaches to Stop Hypertension (DASH) diet score, Mediterranean diet score, and German Food Pyramid Index (GFPI) were calculated and their association with estimated glomerular filtration rate (eGFR) and albuminuria was assessed by multivariable linear regression analysis, adjusted for gender, age, body mass index, energy intake, smoking status, alcohol intake, education, high-density lipoprotein-cholesterol (HDL- cholesterol), low-density lipoprotein-cholesterol (LDL-cholesterol), hypertension, and diabetes mellitus. RESULTS A total of 2,813 patients (41% women; age 60.1 ± 11.6 years) were included in the analysis. High DASH diet score and GFPI were associated with lower systolic blood pressure and lower intake of antihypertensive medication, higher HDL, and lower uric acid levels. Mediterranean-style diet was associated with lower prevalence of diabetes mellitus. Higher DASH and Mediterranean diet scores were associated with higher eGFR (β-coefficient = 1.226, P < .001; β-coefficient = 0.932, P = .007, respectively). In contrast, GFPI was not associated with eGFR. For the individual components of the dietary patterns, higher intake of nuts and legumes, cereals, fish, and polyunsaturated fats was associated with higher eGFR and higher intake of dairy, composed of low- and whole-fat dairy, was associated with lower eGFR. No association was found between dietary patterns and albuminuria. CONCLUSION Higher observance of the DASH or Mediterranean diet, but not German food pyramid recommendations, was associated with higher eGFR among patients with CKD. Improving dietary habits may offer an opportunity to better control comorbidities and kidney function decline in patients with CKD.
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Affiliation(s)
- Judith Heindel
- Division of Nephrology and Clinical Immunology, University Hospital RWTH Aachen, Aachen, Germany
| | - Seema Baid-Agrawal
- Department of Nephrology and Transplant Center, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Casey M Rebholz
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jennifer Nadal
- Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Matthias Schmid
- Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Elke Schaeffner
- Department of Nephrology and Medical Intensive Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Markus P Schneider
- Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Department of Nephrology and Hypertension, Klinikum Nürnberg, Paracelsus Private Medical University, Nürnberg, Germany
| | - Heike Meiselbach
- Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Nadine Kaesler
- Division of Nephrology and Clinical Immunology, University Hospital RWTH Aachen, Aachen, Germany
| | - Manuela Bergmann
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Sabine Ernst
- Division of Nephrology and Clinical Immunology, University Hospital RWTH Aachen, Aachen, Germany
| | - Vera Krane
- Division of Nephrology, Department of Internal Medicine I, University of Würzburg, Würzburg, Germany
| | - Kai-Uwe Eckardt
- Department of Nephrology and Medical Intensive Care Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany; Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Jürgen Floege
- Division of Nephrology and Clinical Immunology, University Hospital RWTH Aachen, Aachen, Germany
| | - Georg Schlieper
- Division of Nephrology and Clinical Immunology, University Hospital RWTH Aachen, Aachen, Germany
| | - Turgay Saritas
- Division of Nephrology and Clinical Immunology, University Hospital RWTH Aachen, Aachen, Germany.
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Ji A, Pan C, Wang H, Jin Z, Lee JH, Wu Q, Jiang Q, Cui L. Prevalence and Associated Risk Factors of Chronic Kidney Disease in an Elderly Population from Eastern China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224383. [PMID: 31717585 PMCID: PMC6888049 DOI: 10.3390/ijerph16224383] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 11/03/2019] [Accepted: 11/04/2019] [Indexed: 12/11/2022]
Abstract
Chronic kidney disease (CKD) is a global major public health problem. Almost all of previous studies evaluating the prevalence of CKD focused on adults, while studies among the elderly were relatively rare, especially in China. The aim of this study was to investigate the prevalence and associated risk factors of CKD among the elderly in Qingdao, China. This was a cross-sectional study with 38,038 inhabitants (aged 60-109) randomly recruited in Qingdao, China. All participants were required to complete a questionnaire for their demographic characteristics. Blood and urine samples of participants were collected, and the albumin and creatinine levels were measured for albuminuria and estimated glomerular filtration rate (eGFR) assessment. The associations between risk factors and indicators of kidney damage were analyzed by logistic regression. A total of 34,588 inhabitants completed the survey. The overall prevalence of CKD was 11.41% (95% confidence interval (CI): 11.07-11.74%) in the elders from Qingdao in 2016. The prevalence of albuminuria and low eGFR (<60 mL/min per 1·73 m²) were 8.47% (95% CI: 8.17-8.76%) and 3.98% (95% CI: 3.78-4.19%), respectively. Older age, hypertension, diabetes, anemia, hyperuricemia, hyperhomocysteinemia, hypertriglyceridemia, obesity, and LDL-C ≥ 4.1 mmol/L were independently associated with the presence of CKD. In conclusion, common chronic non-communicable diseases, including hypertension, diabetes, obesity, hyperhomocysteinemia, hyperuricemia, and hypertriglyceridemia, were associated with greater prevalence of CKD.
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Affiliation(s)
- Andong Ji
- School of Public Health, Medical College of Qingdao University, Qingdao 266021, Shandong Province, China; (A.J.); (Q.J.); (Q.W.)
| | - Chunlei Pan
- Health Center of Liuting Street, Chengyang District, Qingdao 266108, Shandong Province, China; (C.P.); (H.W.)
| | - Hongxia Wang
- Health Center of Liuting Street, Chengyang District, Qingdao 266108, Shandong Province, China; (C.P.); (H.W.)
| | - Zhezhen Jin
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
| | - Joseph H. Lee
- Sergievsky Center, Taub Institute, and Department of Epidemiology, Mailman School of Public Health, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA;
| | - Qincheng Wu
- School of Public Health, Medical College of Qingdao University, Qingdao 266021, Shandong Province, China; (A.J.); (Q.J.); (Q.W.)
| | - Qixiao Jiang
- School of Public Health, Medical College of Qingdao University, Qingdao 266021, Shandong Province, China; (A.J.); (Q.J.); (Q.W.)
| | - Lianhua Cui
- School of Public Health, Medical College of Qingdao University, Qingdao 266021, Shandong Province, China; (A.J.); (Q.J.); (Q.W.)
- Correspondence: ; Tel.: +86-532-8299-1503
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82
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Kramer H. Diet and Chronic Kidney Disease. Adv Nutr 2019; 10:S367-S379. [PMID: 31728497 PMCID: PMC6855949 DOI: 10.1093/advances/nmz011] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 12/04/2018] [Accepted: 01/07/2019] [Indexed: 02/07/2023] Open
Abstract
Kidney disease affects almost 15% of the US population, and prevalence is anticipated to grow as the population ages and the obesity epidemic continues due to Western dietary practices. The densely caloric Western diet, characterized by high animal protein and low fruit and vegetable content, has fueled the growth of chronic diseases, including chronic kidney disease. The glomerulus or filtering unit of the kidney is very susceptible to barotrauma, and diets high in animal protein impede the glomerulus' ability to protect itself from hemodynamic injury. High animal protein intake combined with low intake of fruits and vegetables also leads to a high net endogenous acid production requiring augmentation of ammonium excretion in order to prevent acidosis. This higher workload of the kidney to maintain a normal serum bicarbonate level may further exacerbate kidney disease progression. This article reviews the potential mechanisms whereby several key characteristics of the typical Western diet may impact kidney disease incidence and progression. Reducing animal protein intake and egg yolk and increasing intake of fruits and vegetables and fiber may prevent or delay end-stage renal disease, but few clinical trials have examined vegetarian diets for management of chronic kidney disease. More research is needed to determine optimal dietary patterns for the prevention of kidney disease and its progression.
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Affiliation(s)
- Holly Kramer
- Department of Public Health Sciences and Medicine
- Division of Nephrology and Hypertension, Loyola University, Chicago, IL
- Address correspondence to HK (e-mail: )
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Taghavi M, Sadeghi A, Maleki V, Nasiri M, Khodadost M, Pirouzi A, Rashid-Beigi E, Sadeghi O, Swann O. Adherence to the dietary approaches to stop hypertension-style diet is inversely associated with chronic kidney disease: a systematic review and meta-analysis of prospective cohort studies. Nutr Res 2019; 72:46-56. [PMID: 31740009 DOI: 10.1016/j.nutres.2019.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 10/01/2019] [Accepted: 10/16/2019] [Indexed: 12/27/2022]
Abstract
No conclusive information is available about the association between the Dietary Approaches to Stop Hypertension (DASH)-style diet and chronic kidney disease (CKD). Hence, we aimed to summarize the findings of prospective cohort studies on the relationship between adherence to the DASH-style diet and risk of CKD. A systematic search was done using relevant keywords in the online databases for relevant publications up through July 2018. In total, we included 6 studies in the current systematic review and meta-analysis, with a total sample size of 568 156 individuals and 9249 cases of CKD. Combining 6 effect sizes from 6 studies revealed a significant inverse association between adherence to the DASH diet and risk of CKD (Combined effect size: 0.72, 95% CI: 0.61-0.85, P < .001). In addition, adherence to a DASH-style diet was inversely associated with a risk of rapid decline in estimated glomerular filtration rate (eGFR) (Combined effect size: 0.74, 95% CI: 0.54-0.99, P = .04) and microalbuminuria (Combined effect size: 0.61, 95% CI: 0.43-0.88, P = .009), but not with low eGFR. Adherence to the DASH-style diet, as a healthy dietary pattern, might be beneficial for the prevention of CKD.
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Affiliation(s)
- Mohsen Taghavi
- Department of Nutrition, Islamic Azad University Olum Tahghighat, Tehran, Iran.
| | - Alireza Sadeghi
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| | - Vahid Maleki
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Morteza Nasiri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Operating Room Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mahmoud Khodadost
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
| | | | - Elaheh Rashid-Beigi
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| | - Omid Sadeghi
- Gerash University of Medical Sciences, Gerash, Iran; Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| | - Olivia Swann
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
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84
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Mozaffari H, Ajabshir S, Alizadeh S. Dietary Approaches to Stop Hypertension and risk of chronic kidney disease: A systematic review and meta-analysis of observational studies. Clin Nutr 2019; 39:2035-2044. [PMID: 31669002 DOI: 10.1016/j.clnu.2019.10.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 08/16/2019] [Accepted: 10/02/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND & AIMS Dietary Approaches to Stop Hypertension (DASH) diet has been favorably linked to important risk factors associated with development of chronic kidney disease (CKD), such as insulin resistance, hypertension, and dyslipidemia. However, the protective role of DASH dietary patterns in development of CKD, as measured by estimated glomerular filtration rate (eGFR), remains inconsistent in the literature. The aim of the current systematic review was to summarize the findings of previous observational studies and quantify the potential association between DASH dietary patterns and the risk of CKD using meta-analysis. METHODS A comprehensive search was done with the use of MEDLINE, EMBASE, Web of Sciences, and Scopus databases to find relevant articles published prior to June 2019. Search terms included: ([Dietary Approaches to Stop Hypertension] OR [DASH]) AND ([Kidney Failure, Chronic] OR [Renal Insufficiency, Chronic] OR [Chronic Kidney Disease], OR [CKD] OR [End-Stage Renal Disease] OR [ESRD] OR [Kidney] OR [Renal]). To pool the risk estimates, fixed-effects and random-effects models were applied. Cochrane Q test was performed to detect sources of heterogeneity among the included studies. RESULTS Out of the seven studies included in the systematic review, six were eligible for inclusion in the meta-analysis. The total sample size was 568,213 participants including 16,694 cases of CKD. Combined risk estimates for 2 cross-sectional and 4 prospective cohort studies showed an inverse association between DASH dietary patterns and risk of CKD (Pooled risk estimate: 0.77, 95% CI 0.63-0.94; p = 0.01). Stratified analysis showed a marginally significant relationship between DASH dietary patterns and risk of CKD in prospective cohort studies (Pooled risk estimate: 0.79, 95% CI 0.61-1.01; p = 0.05), and no significant association in cross-sectional studies (Pooled risk estimate: 0.71, 95% CI 0.38-1.34; p = 0.29), respectively. A significant association was observed between DASH dietary patterns and risk of CKD in the studies extracted DASH based on nutrients (Pooled risk estimate: 0.78, 95% CI 0.63-0.97; p = 0.02), compared to the studies extracted DASH based on food groups (Pooled risk estimate: 0.66, 95% CI 0.28-1.58; p = 0.35). CONCLUSIONS The results of the present study showed a significant inverse association between DASH dietary patterns and the risk of developing CKD. Adherence to DASH dietary patterns might have protective effects against CKD development and progression. Further research is required to confirm the certainty of estimates.
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Affiliation(s)
- Hadis Mozaffari
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, Canada; Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sahar Ajabshir
- Department of Cellular Biology and Pharmacology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.
| | - Shahab Alizadeh
- Department of Clinical Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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85
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Bach KE, Kelly JT, Palmer SC, Khalesi S, Strippoli GFM, Campbell KL. Healthy Dietary Patterns and Incidence of CKD: A Meta-Analysis of Cohort Studies. Clin J Am Soc Nephrol 2019; 14:1441-1449. [PMID: 31551237 PMCID: PMC6777603 DOI: 10.2215/cjn.00530119] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 07/05/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVES Whether a healthy dietary pattern may prevent the incidence of developing CKD is unknown. This study evaluated the associations between dietary patterns and the incidence of CKD in adults and children. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS This systematic review and meta-analysis identified potential studies through a systematic search of MEDLINE, Embase and references from eligible studies from database inception to February 2019. Eligible studies were prospective and retrospective cohort studies including adults and children without CKD, where the primary exposure was dietary patterns. To be eligible, studies had to report on the primary outcome, incidence of CKD (eGFR<60 ml/min per 1.73 m2). Two authors independently extracted data, assessed risk of bias and evidence certainty using the Newcastle-Ottawa scale and GRADE. RESULTS Eighteen prospective cohort studies involving 630,108 adults (no children) with a mean follow-up of 10.4±7.4 years were eligible for analysis. Included studies had an overall low risk of bias. The evidence certainty was moderate for CKD incidence and low for eGFR decline (percentage drop from baseline or reduced by at least 3 ml/min per 1.73 m2 per year) and incident albuminuria. Healthy dietary patterns typically encouraged higher intakes of vegetables, fruit, legumes, nuts, whole grains, fish and low-fat dairy, and lower intakes of red and processed meats, sodium, and sugar-sweetened beverages. A healthy dietary pattern was associated with a lower incidence of CKD (odds ratio [OR] 0.70 (95% confidence interval [95% CI], 0.60 to 0.82); I2=51%; eight studies), and incidence of albuminuria (OR 0.77, [95% CI, 0.59 to 0.99]; I2=37%); four studies). There appeared to be no significant association between healthy dietary patterns and eGFR decline (OR 0.70 [95% CI, 0.49 to 1.01], I2=49%; four studies). CONCLUSIONS A healthy dietary pattern may prevent CKD and albuminuria.
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Affiliation(s)
- Katrina E. Bach
- Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
| | - Jaimon T. Kelly
- Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
| | | | - Saman Khalesi
- Physical Activity Research Group, Appleton Institute and School of Health, Medical and Applied Sciences, Central Queensland University, Queensland, Australia
| | - Giovanni F. M. Strippoli
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy;,Diaverum Academy, Lund, Sweden; and,Faculty of Medicine and Health, School of Public Health, University of Sydney, Camperdown, Australia
| | - Katrina L. Campbell
- Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
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86
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Association between dietary patterns and chronic kidney disease in a middle-aged Chinese population. Public Health Nutr 2019; 23:1058-1066. [PMID: 31576799 PMCID: PMC7282855 DOI: 10.1017/s1368980019002805] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To explore the relationship between dietary patterns and risk of chronic kidney disease (CKD) in Chinese adults aged 45-59 years. DESIGN Dietary data were collected using a semi-quantitative FFQ. Factor analysis was used to identify the major dietary patterns. Logistic regression models were applied to clarify the association between dietary patterns and the risk of CKD. SETTING The present study population was a part of the population-based Nutrition and Health Study performed in the city of Hangzhou, Zhejiang Province, eastern China. PARTICIPANTS A total of 2437 eligible participants (45-59 years) were enrolled in the present cross-sectional study from June 2015 to December 2016. RESULTS Three major dietary patterns were identified: 'traditional southern Chinese', 'Western' and 'grains-vegetables' patterns, collectively accounting for 25·6 % of variance in the diet. After adjustment for potential confounders, participants in the highest quartile of the Western pattern had greater odds for CKD (OR = 1·83, 95 % CI 1·21, 2·81; P < 0·05) than those in the lowest quartile. Compared with the lowest quartile of the grains-vegetables pattern, the highest quartile had lower odds for CKD (OR = 0·84, 95 % CI 0·77, 0·93; P < 0·05). In addition, there was no significant association between the traditional southern Chinese pattern and risk of CKD (P > 0·05). CONCLUSIONS Our results suggest that the Western pattern is associated with an increased risk, whereas the grains-vegetables pattern is associated with a reduced risk for CKD. These findings can guide dietary interventions for the prevention of CKD in a middle-aged Chinese population.
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87
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Yuzbashian E, Asghari G, Mirmiran P, Amouzegar-Bahambari P, Azizi F. Adherence to low-sodium Dietary Approaches to Stop Hypertension-style diet may decrease the risk of incident chronic kidney disease among high-risk patients: a secondary prevention in prospective cohort study. Nephrol Dial Transplant 2019; 33:1159-1168. [PMID: 29361057 DOI: 10.1093/ndt/gfx352] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 10/30/2017] [Indexed: 02/03/2023] Open
Abstract
Background Considering the fact that subjects with dysglycemia, dyslipidemia or high blood pressure are at high risk for chronic kidney disease (CKD), long-term adherence to the Dietary Approaches to Stop Hypertension (DASH)-style diet may contribute to the prevention of CKD. This study, examined the association between adherence to the low-sodium DASH-style diet and incident CKD among high-risk adults over 3 years of follow-up. Methods In this prospective cohort study (followed up for 3 years, 2012-15), we selected 1100 subjects with dysglycemia, 2715 with dyslipidemia and 2089 with high blood pressure, all of whom were free of CKD at baseline (2009-11) in a subgroup of the Tehran Lipid and Glucose Study. The low-sodium DASH-style diet was designed based on eight foods and nutrients using a food frequency questionnaire. Estimated glomerular filtration rate (eGFR) was calculated and CKD was defined as eGFR <60 mL/min/1.73 m2. Results After 3 years of follow-up, among subjects with dysglycemia, dyslipidemia or high blood pressure, the rate of incident CKD was ∼16%. In multivariable-adjusted analyses for participants in the highest compared with the lowest quartile of the low-sodium DASH-style diet score, the odds ratio was 0.58 [95% confidence interval (CI) 0.36-0.92] for subjects with dysglycemia, 0.64 (95% CI 0.48-0.87) for subjects with dyslipidemia and 0.62 (95% CI 0.44-0.87) for subjects with high blood pressure. Conclusions Higher adherence to the low-sodium DASH-style diet might be associated with a lower risk of incident CKD among high-risk adults, highlighting the importance of adherence to the low-sodium DASH-style diet in substantially reducing both the occurrence of CKD and the burden imposed by it in the future.
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Affiliation(s)
- Emad Yuzbashian
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Golaleh Asghari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pegah Amouzegar-Bahambari
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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88
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Olivo RE, Davenport CA, Diamantidis CJ, Bhavsar NA, Tyson CC, Hall R, Bidulescu A, Young B, Mwasongwe SE, Pendergast J, Boulware LE, Scialla JJ. Obesity and synergistic risk factors for chronic kidney disease in African American adults: the Jackson Heart Study. Nephrol Dial Transplant 2019; 33:992-1001. [PMID: 28992354 DOI: 10.1093/ndt/gfx230] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 06/01/2017] [Indexed: 01/08/2023] Open
Abstract
Background African Americans are at high risk for chronic kidney disease (CKD). Obesity may increase the risk for CKD by exacerbating features of the metabolic syndrome and promoting glomerular hyperfiltration. Whether other factors also affecting these pathways may amplify or mitigate obesity-CKD associations has not been investigated. Methods We studied interactions between obesity and these candidate factors in 2043 African Americans without baseline kidney disease enrolled in the Jackson Heart Study. We quantified obesity as body mass index (BMI), sex-normalized waist circumference and visceral adipose volume measured by abdominal computed tomography at an interim study visit. Interactions were hypothesized with (i) metabolic risk factors (dietary quality and physical activity, both quantified by concordance with American Heart Association guidelines) and (ii) factors exacerbating or mitigating hyperfiltration (dietary protein intake, APOL1 risk status and use of renin-angiotensin system blocking medications). Using multivariable regression, we evaluated associations between obesity measures and incident CKD over the follow-up period, as well as interactions with metabolic and hyperfiltration factors. Results Assessed after a median of 8 years (range 6-11 years), baseline BMI and waist circumference were not associated with incident CKD. Higher visceral adipose volume was independently associated with incident CKD (P = 0.008) in a nonlinear fashion, but this effect was limited to those with lower dietary quality (P = 0.001; P-interaction = 0.04). In additional interaction models, higher waist circumference was associated with greater risk of incident CKD among those with the low-risk APOL1 genotype (P = 0.04) but not those with a high-risk genotype (P-interaction = 0.02). Other proposed factors did not modify obesity-CKD associations. Conclusions. Higher risks associated with metabolically active visceral adipose volume and interactions with dietary quality suggest that metabolic factors may be key determinants of obesity-associated CKD risk. Interactions between obesity and APOL1 genotype should be considered in studies of African Americans.
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Affiliation(s)
- Robert E Olivo
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA.,Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
| | - Clemontina A Davenport
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | | | - Nrupen A Bhavsar
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Crystal C Tyson
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Rasheeda Hall
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | | | - Bessie Young
- Veterans Affairs Puget Sound Health Care System, Kidney Research Institute and Division of Nephrology and Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - Jane Pendergast
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - L Ebony Boulware
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Julia J Scialla
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA.,Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
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89
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Greater Dietary Inflammatory Index score is associated with higher likelihood of chronic kidney disease. Br J Nutr 2019; 120:204-209. [PMID: 29947319 DOI: 10.1017/s0007114518001071] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Chronic kidney disease (CKD) is described as a progressive alteration of kidney function, resulting from multiple factors, including behaviours. We investigated the association of the Dietary Inflammatory Index (DII®) with prevalent CKD in adult Americans. National Health and Nutrition Examination Survey participants with measured data on kidney function markers from 2005 to 2012 were included in this study. Prevalent CKD was based on an estimated glomerular filtration rate (eGFR) <60 ml/min per 1·73 m2 or urinary albumin/creatinine≥30 mg/g. Energy-adjusted DII (E-DIITM) scores were calculated from 24-h dietary recalls. Statistical analyses accounted for the survey design and sample weights. We included 21 649 participants, with 1634 (6·8 %) having prevalent CKD. Participants with high E-DII scores had greater BMI, fasting blood glucose and systolic blood pressure, and were more likely to be diabetic or hypertensive (all P<0·001) compared with those with lower E-DII scores. In regression models adjusted for age, sex, race, fasting blood glucose, blood pressure, BMI, hypertension and diabetes status, mean eGFR significantly decreased across increasing quartiles of E-DII, whereas serum uric acid level and log urinary albumin:creatinine ratio significantly increased (all P<0·001). Prevalent CKD increased from 5·3 % in the lowest to 9·3 % in the highest E-DII quartile (P=0·02). In multivariable-adjusted logistic regression models, the odds of prevalent CKD were 29 % higher in the highest compared with the lowest E-DII quartile. Pro-inflammatory diet is associated with declining kidney function and high prevalence of CKD. Dietary changes that reduce inflammation have a potential to prevent CKD.
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90
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Inflammatory Dietary Pattern Predicts Dyslipidemia and Anemia in Middle-Aged and Older Taiwanese Adults with Declined Kidney Function: A Cross-Sectional Population Study from 2008 to 2010. Nutrients 2019; 11:nu11092052. [PMID: 31480674 PMCID: PMC6770658 DOI: 10.3390/nu11092052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 08/17/2019] [Accepted: 08/25/2019] [Indexed: 02/06/2023] Open
Abstract
Dyslipidemia, anemia, and inflammation are associated with declined kidney function. This study investigated the association of inflammatory dietary pattern with dyslipidemia, anemia, and kidney function biomarkers among middle-aged and older Taiwanese adults with declined kidney function. Biochemical data and food frequency questionnaire were obtained from 41,128 participants with estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m2 and positive urinary protein. Inflammatory dietary pattern was identified by reduced rank regression with C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (N/L) as response variables. Males had higher prevalence of dyslipidemia and higher inflammatory markers, but lower prevalence of anemia and lower eGFR levels compared to females. Inflammatory dietary pattern characterized with low intakes of seafood, grains, vegetables, and fruits but high intakes of meat, eggs, preserved/processed foods, and sugary drinks was associated with an increased risk of dyslipidemia by 21% in males and an increased risk of anemia by 28–47% in both genders. Furthermore, high consumption of inflammatory dietary pattern was associated with reduced eGFR (males β = −0.85, 95% CI −1.26 to −0.43, females β = −0.53, 95% CI −0.98 to −0.08) and increased N/L and/or CRP in both genders. In conclusion, inflammatory dietary pattern is positively associated with dyslipidemia, anemia, and decreased kidney function in middle-aged and older adults with declined kidney function.
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91
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Ahola AJ, Forsblom C, Harjutsalo V, Groop PH. Dietary intake in type 1 diabetes at different stages of diabetic kidney disease. Diabetes Res Clin Pract 2019; 155:107775. [PMID: 31271811 DOI: 10.1016/j.diabres.2019.06.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/27/2019] [Accepted: 06/25/2019] [Indexed: 12/20/2022]
Abstract
AIM Diet plays an important role in the kidney health of individuals with type 1 diabetes. However, not much is known about dietary practices at different stages of diabetic nephropathy. We aimed at investigating food intake, dietary patterns, and nutrient intakes in individuals with type 1 diabetes differing in renal status. METHODS Data were available from 1874 individuals with type 1 diabetes (45% men, age 48 ± 13 years). Diet was assessed at the levels of food items and diet patterns (diet questionnaire), and energy and nutrient intakes (food record). Six groups were formed based on the eGFR or dialysis and transplantation status. RESULTS Reductions in liquid-milk product and salt consumption, and increase in special diet adherence were observed at the early stages of eGFR decline. Reduced coffee consumption was observed after eGFR was <30 ml/min/1.73 m2. With advancing kidney failure, rye bread consumption decreased, but that of wheat bread increased. Compared to those with intact kidney function (the index group), the Fish and vegetable diet pattern scores were higher in individuals with mildly-to-severely decreased eGFR. Instead, the Sweet pattern scores were lower than in the index group in all other groups. Energy intake was lower in all groups compared to those with intact kidney function. Advancing kidney failure was associated with reductions in protein intake per body weight, and in the intakes of sodium, potassium, calcium, and phosphorus. CONCLUSIONS Differences in the dietary intake are seen already at the early stages of kidney function decline.
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Affiliation(s)
- Aila J Ahola
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland
| | - Carol Forsblom
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland
| | - Valma Harjutsalo
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland; Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Per-Henrik Groop
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland; Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland; Department of Diabetes, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
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92
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Hu EA, Steffen LM, Grams ME, Crews DC, Coresh J, Appel LJ, Rebholz CM. Dietary patterns and risk of incident chronic kidney disease: the Atherosclerosis Risk in Communities study. Am J Clin Nutr 2019; 110:713-721. [PMID: 31386145 PMCID: PMC6736122 DOI: 10.1093/ajcn/nqz146] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/19/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Adherence to healthy dietary patterns, measured by the Healthy Eating Index (HEI), Alternative Healthy Eating Index (AHEI), and alternate Mediterranean diet (aMed) scores, is associated with a reduced risk of cardiovascular disease. The association between these scores and chronic kidney disease (CKD) is undetermined. OBJECTIVE We aimed to estimate the association between the HEI, AHEI, and aMed scores and risk of incident CKD. METHODS We conducted a prospective analysis in 12,155 participants aged 45-64 y from the Atherosclerosis Risk in Communities (ARIC) Study. We calculated HEI-2015, AHEI-2010, and aMed scores for each participant and categorized them into quintiles of each dietary score. Incident CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2 accompanied by ≥25% decline in estimated glomerular filtration rate, a kidney disease-related hospitalization or death, or end-stage renal disease. We used cause-specific hazard models to estimate risk of CKD from the quintile of the dietary score through to 31 December 2017. RESULTS There were 3980 cases of incident CKD over a median follow-up of 24 y. Participants who had higher adherence to the HEI-2015, AHEI-2010, and aMed scores were more likely to be female, have higher educational attainment, higher income level, be nonsmokers, more physically active, and diabetic compared with participants who scored lower. All 3 dietary scores were associated with lower CKD risk (P-trend < 0.001). Participants who were in the highest quintile of HEI-2015 score had a 17% lower risk of CKD (HR: 0.83; 95% CI: 0.74, 0.92) compared with participants in the lowest quintile. Those in quintile 5 of AHEI-2010 and aMed scores, respectively, had a 20% and 13% lower risk of CKD compared with those in quintile 1. CONCLUSION Higher adherence to healthy dietary patterns during middle age was associated with lower risk of CKD.
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Affiliation(s)
- Emily A Hu
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Morgan E Grams
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Deidra C Crews
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Josef Coresh
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Casey M Rebholz
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Address correspondence to CMR (E-mail: )
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93
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Wei J, Zhang J, Jiang S, Wang L, Persson AEG, Liu R. High-Protein Diet-Induced Glomerular Hyperfiltration Is Dependent on Neuronal Nitric Oxide Synthase β in the Macula Densa via Tubuloglomerular Feedback Response. Hypertension 2019; 74:864-871. [PMID: 31422689 DOI: 10.1161/hypertensionaha.119.13077] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
It is well known that high protein intake increases glomerular filtration rate. Evidence from several studies indicated that NO and tubuloglomerular feedback (TGF) mediate the effect. However, a recent study with a neuronal NO synthase-α knockout model refuted this mechanism and concluded that neither neuronal NO synthase nor TGF response is involved in the protein-induced hyperfiltration. To examine the discrepancy, this study tested a hypothesis that neuronal NO synthase-β in the macula densa mediates the high-protein diet-induced glomerular hyperfiltration via TGF mechanism. We examined the effects of high protein intake on NO generation at the macula densa, TGF response, and glomerular filtration rate in wild-type and macula densa-specific neuronal NO synthase KO mice. In wild-type mice, high-protein diet increased kidney weight, glomerular filtration rate, and renal blood flow, while reduced renal vascular resistance. TGF response in vivo and in vitro was blunted, and NO generation in the macula densa was increased following high-protein diet, associated with upregulations of neuronal NO synthase-β expression and phosphorylation at Ser1417. In contrast, these high-protein diet-induced changes in NO generation at the macula densa, TGF response, renal blood flow, and glomerular filtration rate in wild-type mice were largely attenuated in macula densa-specific neuronal NO synthase KO mice. In conclusion, we demonstrated that high-protein diet-induced glomerular hyperfiltration is dependent on neuronal NO synthase β in the macula densa via TGF response.
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Affiliation(s)
- Jin Wei
- From the Department of Molecular Pharmacology and Physiology, College of Medicine, University of South Florida, Tampa (J.W., J.Z., S.J., L.W., R.L.)
| | - Jie Zhang
- From the Department of Molecular Pharmacology and Physiology, College of Medicine, University of South Florida, Tampa (J.W., J.Z., S.J., L.W., R.L.)
| | - Shan Jiang
- From the Department of Molecular Pharmacology and Physiology, College of Medicine, University of South Florida, Tampa (J.W., J.Z., S.J., L.W., R.L.)
| | - Lei Wang
- From the Department of Molecular Pharmacology and Physiology, College of Medicine, University of South Florida, Tampa (J.W., J.Z., S.J., L.W., R.L.)
| | - A Erik G Persson
- Department of Medical Cell Biology, Division of Integrative Physiology, Uppsala University, Sweden (A.E.G.P.)
| | - Ruisheng Liu
- From the Department of Molecular Pharmacology and Physiology, College of Medicine, University of South Florida, Tampa (J.W., J.Z., S.J., L.W., R.L.)
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94
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Ajjarapu AS, Hinkle SN, Li M, Francis EC, Zhang C. Dietary Patterns and Renal Health Outcomes in the General Population: A Review Focusing on Prospective Studies. Nutrients 2019; 11:E1877. [PMID: 31412575 PMCID: PMC6723758 DOI: 10.3390/nu11081877] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/07/2019] [Accepted: 08/09/2019] [Indexed: 12/14/2022] Open
Abstract
Healthy dietary patterns may promote kidney health and prevent adverse renal outcomes. Although reviews have summarized the findings from studies on dietary patterns for chronic kidney disease (CKD) management, less is known about dietary patterns for maintaining kidney health prior to CKD development. The current review summarized the results from observational studies from March 2009 to March 2019 investigating associations between dietary patterns and renal outcomes in the general population. The main renal outcome assessed was CKD (estimated glomerular filtration rate < 60 mL/min/1.73 m2). A total of twenty-six research articles met the inclusion criteria. Adherence to the Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets were significantly associated with a decreased risk of CKD in the majority of the studies. Furthermore, a posteriori "unhealthy" dietary patterns were associated with an increased risk of CKD. In conclusion, the findings from this review suggest that adherence to DASH and Mediterranean dietary patterns may be useful in promoting kidney health and preventing CKD in the general population. More studies, in particular among minorities, are warranted to investigate the role of diet, a potentially modifiable factor, in promoting kidney health.
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Affiliation(s)
- Aparna S Ajjarapu
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA
| | - Stefanie N Hinkle
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA
| | - Mengying Li
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA
| | - Ellen C Francis
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA
- National Institutes of Health Graduate Partnerships Program, Bethesda, MD 20817, USA
- Department of Public Health Sciences, Clemson University, Clemson, SC 29634, USA
| | - Cuilin Zhang
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA.
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95
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Dietary patterns in relation to testosterone levels and severity of impaired kidney function among middle-aged and elderly men in Taiwan: a cross-sectional study. Nutr J 2019; 18:42. [PMID: 31351493 PMCID: PMC6660671 DOI: 10.1186/s12937-019-0467-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 07/17/2019] [Indexed: 12/17/2022] Open
Abstract
Background Chronic Kidney Disease (CKD), characterized by an impaired kidney function, is associated with low testosterone levels. This study investigated the association between dietary patterns, testosterone levels, and severity of impaired kidney function among middle-aged and elderly men. Methods This cross-sectional study used the database from a private health-screening institute in Taiwan between 2008 and 2010. Men aged 40 years old and older (n = 21,376) with estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m2 and proteinuria were selected. Among 21,376 men, 256 men had available measurements of testosterone levels. Dietary assessment was conducted using a food frequency questionnaire and three dietary patterns (fried-processed, vege-seafood, and dairy-grain dietary patterns) were identified using principal component analysis. Results Men in the lower tertiles (T1 and T2) of eGFR had significantly decreased testosterone levels by 0.8 (95% CI: − 1.40, − 0.20) and 0.9 nmol/L (95% CI: − 1.43, − 0.33). Furthermore, serum triglycerides (TG) levels were inversely associated with testosterone levels (β = − 0.51, 95% CI: − 0.77, − 0.24). Men in the higher tertile of fried-processed dietary pattern scores were associated with decreased testosterone levels by 0.8 nmol/L (95% CI: − 1.40, − 0.16), reduced testosterone-to-TG (T/TG) ratio by 1.8 units (95% CI: − 2.99, − 0.53), and increased risk of moderate/severe impaired kidney function (eGFR < 60 mL/min/1.73 m2) and proteinuria severity by 1.35 (95% CI: 1.15, 1.58) and 1.18 (95% CI: 1.02, 1.37) times respectively. In contrast, the vege-seafood dietary pattern was negatively associated with severity of impaired kidney function and proteinuria after multivariable adjustment, but had no association with testosterone levels and T/TG ratio. Conclusions The fried-processed dietary pattern is negatively associated with testosterone levels but positively associated with the severity of impaired kidney function. However, the vege-seafood and dairy-grain dietary patterns appear to have beneficial effects. Electronic supplementary material The online version of this article (10.1186/s12937-019-0467-x) contains supplementary material, which is available to authorized users.
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96
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Dietary approaches to stop hypertension, mediterranean dietary pattern, and diabetic nephropathy in women with type 2 diabetes: A case-control study. Clin Nutr ESPEN 2019; 33:164-170. [PMID: 31451255 DOI: 10.1016/j.clnesp.2019.05.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 05/22/2019] [Accepted: 05/28/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS The association between dietary habits and kidney function in patients with type 2 diabetes (T2D) has been poorly investigated. We aimed to test the relationship between adherences to the Dietary Approaches to Stop Hypertension (DASH) diet and the Mediterranean dietary pattern (Med diet) and likelihood of diabetic nephropathy (DN) in women with T2D. METHODS In a case-control study, 105 women with T2D and DN (albumin-creatinine ratio ≥ 30 mg/g, mean age: 55.3 ± 7.0 years; diabetes duration: 7.6 ± 2.2 years), and 105 controls with T2D and without DN (mean age: 55.4 ± 7.1 years; diabetes duration: 7.6 ± 2.1 years) who attended at Kowsar diabetes clinic in Semnan, Iran were matched for age and diabetes duration. Dietary intakes were assessed using a validated 147-item semiquantitative food frequency questionnaire. The DASH and Med diet scores were calculated using the methods developed by Fung and Trichopoulou, respectively. A generalized estimating equation model was used to examine the relationship between dietary scores and odds of DN across tertiles of dietary patterns scores. RESULTS Type 2 diabetic women with moderate and high Med diet scores had 62% and 86% lower odds of DN in comparison with low adherent (ORs: 0.38, 95%CI: 0.20, 0.73; and 0.14, 95%CI: 0.06, 0.33; respectively). A moderate adherence to the DASH diet was not associated with risk of DN, but a significant inverse relationship was found in those with high adherence (OR: 0.71, 95%CI: 0.57, 0.90). CONCLUSIONS Adherence to the DASH and Med diets was inversely and dose-dependently associated with risk of DN. Further observational studies are needed to confirm the present results.
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97
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Cases A, Cigarrán-Guldrís S, Mas S, Gonzalez-Parra E. Vegetable-Based Diets for Chronic Kidney Disease? It Is Time to Reconsider. Nutrients 2019; 11:E1263. [PMID: 31167346 PMCID: PMC6627351 DOI: 10.3390/nu11061263] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/23/2019] [Accepted: 05/30/2019] [Indexed: 12/12/2022] Open
Abstract
Traditional dietary recommendations to renal patients limited the intake of fruits and vegetables because of their high potassium content. However, this paradigm is rapidly changing due to the multiple benefits derived from a fundamentally vegetarian diet such as, improvement in gut dysbiosis, reducing the number of pathobionts and protein-fermenting species leading to a decreased production of the most harmful uremic toxins, while the high fiber content of these diets enhances intestinal motility and short-chain fatty acid production. Metabolic acidosis in chronic kidney disease (CKD) is aggravated by the high consumption of meat and refined cereals, increasing the dietary acid load, while the intake of fruit and vegetables is able to neutralize the acidosis and its deleterious consequences. Phosphorus absorption and bioavailability is also lower in a vegetarian diet, reducing hyperphosphatemia, a known cause of cardiovascular mortality in CKD. The richness of multiple plants in magnesium and vitamin K avoids their deficiency, which is common in these patients. These beneficial effects, together with the reduction of inflammation and oxidative stress observed with these diets, may explain the reduction in renal patients' complications and mortality, and may slow CKD progression. Finally, although hyperkalemia is the main concern of these diets, the use of adequate cooking techniques can minimize the amount absorbed.
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Affiliation(s)
- Aleix Cases
- Medicine Department, Universitat de Barcelona, Institut d'Investigacions Biomèqiques August Pi i Sunyer, 08036 Barcelona, Spain.
| | | | - Sebastián Mas
- Servicio de Nefrología, Fundación Jiménez Díaz, 28040 Madrid, Spain.
- Centro de investigación en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain.
| | - Emilio Gonzalez-Parra
- Servicio de Nefrología, Fundación Jiménez Díaz, 28040 Madrid, Spain.
- Red de Investigación Renal (RedinRen), 28029 Madrid, Spain.
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98
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Chang AR, Bailey-Davis L, Hetherington V, Ziegler A, Yule C, Kwiecen S, Graboski E, Melough MM, Collins C, Anderson C. Remote Dietary Counseling Using Smartphone Applications in Patients With Stages 1-3a Chronic Kidney Disease: A Mixed Methods Feasibility Study. J Ren Nutr 2019; 30:53-60. [PMID: 31078403 DOI: 10.1053/j.jrn.2019.03.080] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 02/08/2019] [Accepted: 03/12/2019] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE(S) Although healthy dietary patterns are associated with decreased mortality in patients with chronic kidney disease (CKD), few patients receive dietitian counseling due to concerns such as dietitian availability, travel distance, and cost. Our objective was to determine the feasibility of dietary smartphone application-supported telecounseling to reduce sodium intake and improve dietary quality in patients with early CKD. METHODS This was a pre-post, mixed methods feasibility study of 16 patients with Stage 1-3a CKD in central/northeast Pennsylvania. Patients recorded and shared dietary data via smartphone applications with registered dietitians, who used motivational interviewing to provide telephone counseling weekly for 8 weeks. Seven patients were assigned to a customized study-specific application and nine patients to a commercially available, free application (MyFitnessPal). Participant satisfaction was assessed via survey, and participants were invited to complete a semistructured interview. Outcomes assessed included sodium intake, Healthy Eating Index 2015 score, weight, and 24-hour blood pressure (BP). RESULTS Mean age was 64.7 years, 31% were female, 100% were white, 13% had income <$25,000. Adherence was excellent with 14 (88%) entering dietary data at least 75% of total days. Patients reported high satisfaction with the intervention and dietitian telecounseling. Use of dietary apps was viewed positively for allowing tracking of sodium and energy intake although some participants experienced functionality issues with the customized application that were not generally experienced by those using the commercially available free application. Sodium intake (-604 mg/day, 95% confidence interval [CI]: -1,104 to -104), Healthy Eating Index 2015 score (3.97, 95% CI: 0.03-7.91), weight (-3.4, 95% CI: -6.6 to -0.1), daytime systolic BP (-5.8, 95% CI: -12.1 to 0.6), and daytime diastolic BP (-4.1, 95% CI: -7.9 to -0.2) improved after the intervention. CONCLUSIONS An application-supported telecounseling program with a registered dietitian appears to be a feasible and well-accepted strategy to improve dietary quality and improve cardiovascular risk factors in patients with early kidney disease.
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Affiliation(s)
- Alex R Chang
- Geisinger Health System, Kidney Health Research Institute, Danville, PA; Geisinger Health System, Medicine Institute, Danville, PA.
| | | | | | - Anna Ziegler
- Geisinger Health System, Medicine Institute, Danville, PA
| | - Christina Yule
- Geisinger Health System, Kidney Health Research Institute, Danville, PA
| | - Sara Kwiecen
- Geisinger Health System, Kidney Health Research Institute, Danville, PA
| | | | - Melissa M Melough
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT
| | | | - Cheryl Anderson
- Department of Family Medicine and Public Health, Division of Preventive Medicine, University of California San Diego, San Diego, CA
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Kim H, Caulfield LE, Garcia-Larsen V, Steffen LM, Grams ME, Coresh J, Rebholz CM. Plant-Based Diets and Incident CKD and Kidney Function. Clin J Am Soc Nephrol 2019; 14:682-691. [PMID: 31023928 PMCID: PMC6500948 DOI: 10.2215/cjn.12391018] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/20/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND OBJECTIVES The association between plant-based diets, incident CKD, and kidney function decline has not been examined in the general population. We prospectively investigated this relationship in a population-based study, and evaluated if risk varied by different types of plant-based diets. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Analyses were conducted in a sample of 14,686 middle-aged adults enrolled in the Atherosclerosis Risk in Communities study. Diets were characterized using four plant-based diet indices. In the overall plant-based diet index, all plant foods were positively scored; in the healthy plant-based diet index, only healthful plant foods were positively scored; in the provegetarian diet, selected plant foods were positively scored. In the less healthy plant-based diet index, only less healthful plant foods were positively scored. All indices negatively scored animal foods. We used Cox proportional hazards models to study the association with incident CKD and linear mixed models to examine decline in eGFR, adjusting for confounders. RESULTS During a median follow-up of 24 years, 4343 incident CKD cases occurred. Higher adherence to a healthy plant-based diet (HR comparing quintile 5 versus quintile 1 [HRQ5 versus Q1], 0.86; 95% confidence interval [95% CI], 0.78 to 0.96; P for trend =0.001) and a provegetarian diet (HRQ5 versus Q1, 0.90; 95% CI, 0.82 to 0.99; P for trend =0.03) were associated with a lower risk of CKD, whereas higher adherence to a less healthy plant-based diet (HRQ5 versus Q1, 1.11; 95% CI, 1.01 to 1.21; P for trend =0.04) was associated with an elevated risk. Higher adherence to an overall plant-based diet and a healthy plant-based diet was associated with slower eGFR decline. The proportion of CKD attributable to lower adherence to healthy plant-based diets was 4.1% (95% CI, 0.6% to 8.3%). CONCLUSIONS Higher adherence to healthy plant-based diets and a vegetarian diet was associated with favorable kidney disease outcomes.
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Affiliation(s)
- Hyunju Kim
- Center for Human Nutrition and
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland; and
| | | | | | - Lyn M. Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Morgan E. Grams
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland; and
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland; and
| | - Casey M. Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland; and
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100
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Declèves AE, Mathew AV, Armando AM, Han X, Dennis EA, Quehenberger O, Sharma K. AMP-activated protein kinase activation ameliorates eicosanoid dysregulation in high-fat-induced kidney disease in mice. J Lipid Res 2019; 60:937-952. [PMID: 30862696 PMCID: PMC6495162 DOI: 10.1194/jlr.m088690] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 02/28/2019] [Indexed: 12/15/2022] Open
Abstract
High-fat diet (HFD) causes renal lipotoxicity that is ameliorated with AMP-activated protein kinase (AMPK) activation. Although bioactive eicosanoids increase with HFD and are essential in regulation of renal disease, their role in the inflammatory response to HFD-induced kidney disease and their modulation by AMPK activation remain unexplored. In a mouse model, we explored the effects of HFD on eicosanoid synthesis and the role of AMPK activation in ameliorating these changes. We used targeted lipidomic profiling with quantitative MS to determine PUFA and eicosanoid content in kidneys, urine, and renal arterial and venous circulation. HFD increased phospholipase expression as well as the total and free pro-inflammatory arachidonic acid (AA) and anti-inflammatory DHA in kidneys. Consistent with the parent PUFA levels, the AA- and DHA-derived lipoxygenase (LOX), cytochrome P450, and nonenzymatic degradation (NE) metabolites increased in kidneys with HFD, while EPA-derived LOX and NE metabolites decreased. Conversely, treatment with 5-aminoimidazole-4-carboxamide-1-β-D-furanosyl 5'-monophosphate (AICAR), an AMPK activator, reduced the free AA and DHA content and the DHA-derived metabolites in kidney. Interestingly, kidney and circulating AA, AA metabolites, EPA-derived LOX, and NE metabolites are increased with HFD; whereas, DHA metabolites are increased in kidney in contrast to their decreased circulating levels with HFD. Together, these changes showcase HFD-induced pro- and anti-inflammatory eicosanoid dysregulation and highlight the role of AMPK in correcting HFD-induced dysregulated eicosanoid pathways.
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Affiliation(s)
- Anne-Emilie Declèves
- Institute of Metabolomic Medicine University of California, San Diego, La Jolla, CA; Laboratory of Metabolic and Molecular Biochemistry Faculty of Medicine, Université of Mons, Mons, Belgium.
| | - Anna V Mathew
- Division of Nephrology Department of Internal Medicine, University of Michigan, Ann Arbor, MI
| | - Aaron M Armando
- Departments of Pharmacology, University of California, San Diego, La Jolla, CA
| | - Xianlin Han
- Barshop Institute of Aging, Department of Medicine University of Texas Health San Antonio, San Antonio, TX
| | - Edward A Dennis
- Departments of Pharmacology, University of California, San Diego, La Jolla, CA; Chemistry and Biochemistry University of California, San Diego, La Jolla, CA
| | - Oswald Quehenberger
- Departments of Pharmacology, University of California, San Diego, La Jolla, CA; Medicine, University of California, San Diego, La Jolla, CA
| | - Kumar Sharma
- Institute of Metabolomic Medicine University of California, San Diego, La Jolla, CA; Center for Renal Precision Medicine, Division of Nephrology, Department of Medicine University of Texas Health San Antonio, San Antonio, TX
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