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Renouf D, Wong MMY. From Prophecy to Plate: How to Actualize a Planetary Menu for Kidney Disease Nutrition. Can J Kidney Health Dis 2024; 11:20543581241244965. [PMID: 38712334 PMCID: PMC11072064 DOI: 10.1177/20543581241244965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 03/12/2024] [Indexed: 05/08/2024] Open
Affiliation(s)
- Dani Renouf
- Providence Health Care, Vancouver, BC, Canada
- BC Renal, Vancouver, Canada
| | - Michelle M. Y. Wong
- BC Renal, Vancouver, Canada
- Division of Nephrology, Department of Medicine, The University of British Columbia, Vancouver, Canada
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Mokiao RH, Fretts AM, Deen JF, Umans JG. Diet Quality and Kidney Outcomes in Adolescent and Adult American Indians: the Strong Heart Family Study. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01735-x. [PMID: 37526878 DOI: 10.1007/s40615-023-01735-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND The burden of kidney disease is exceedingly high among American Indians (AIs). We sought to examine the relationship of diet quality, a modifiable risk factor, and kidney outcomes in AI adolescents and adults, hypothesizing that healthier diets are associated with lower odds of incident albuminuria and eGFR decline. METHODS This is an analysis from the Strong Heart Family Study, a longitudinal study of cardiovascular disease and its risk factors among AIs from Arizona, North and South Dakota, and Oklahoma (n = 1720, mean age 39 + / - 16 years, 16% adolescents at baseline). Participants completed two exams (baseline: 2001-2003; follow-up: 2007-2009). The primary exposure was diet quality, expressed as the Alternative Healthy Eating Index 2010 (AHEI), on a 110-point scale (assessed using a 119-item Block food frequency questionnaire). The primary outcomes were as follows: 1) incident albuminuria (albumin to creatinine ratio 30 mg/g or greater); and 2) eGFR decline of 30% or greater. Generalized estimating equations were used to examine the association of AHEI (in quartiles) with outcomes. RESULTS Ten percent of participants (6% of adolescents) had incident albuminuria and 2% of participants (2% of adolescents) had eGFR decline. For those with normal fasting glucose levels, the odds ratio (OR) for incident albuminuria comparing extreme quartiles of diet quality (least healthy [reference] versus healthiest quartiles) was 0.48 (95% CI 0.28, 0.81) after adjustment for demographics and comorbidities. CONCLUSIONS For American Indians with normal fasting glucose, higher diet quality decreases the odds of developing albuminuria. These findings inform future efforts to prevent CKD in American Indian adolescents and young adults.
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Affiliation(s)
- Reya H Mokiao
- Seattle Children's Hospital, 4800 Sandpoint Way NE, Seattle, WA, 98105, USA.
- University of Washington, Seattle, WA, USA.
| | | | - Jason F Deen
- Seattle Children's Hospital, 4800 Sandpoint Way NE, Seattle, WA, 98105, USA
- University of Washington, Seattle, WA, USA
| | - Jason G Umans
- MedStar Health Research Institute, Hyattsville, MD, USA
- Georgetown University, Washington, DC, USA
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Gaeini Z, Bahadoran Z, Mirmiran P, Feyzi Z, Azizi F. High-Fat Dairy Products May Decrease the Risk of Chronic Kidney Disease Incidence: A Long-Term Prospective Cohort Study. J Ren Nutr 2023; 33:307-315. [PMID: 36270480 DOI: 10.1053/j.jrn.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 10/01/2022] [Accepted: 10/11/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The association between consumption of dairy products and risk of chronic kidney disease (CKD) is under debate. We aimed to determine the potential effects of total and subtypes of dairy intake on the occurrence of CKD. METHODS This study was conducted within the Tehran Lipid and Glucose Study (TLGS) on 2416 CKD-free adults. At baseline, consumption of dairy products was estimated using a validated 168-items semiquantitative food frequency questionnaire. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of CKD were calculated in tertile categories of dairy products. Also, the CKD risk was estimated with multivariable Cox regression to substitute total dairy with other dietary protein sources. RESULTS During 8.4 years of follow-up, the incidence rate of CKD was 21%. The participants' mean (±SD) age was 38 (±13) years and 46% were men. Dietary intakes of total dairy, low-fat dairy, and fermented dairy were not associated with CKD risk. There were significant lower risks of CKD in the highest compared to the lowest tertiles of high-fat dairy (HR = 0.76, 95% CI = 0.60-0.95) and high-fat milk (HR = 0.75, 95% CI = 0.59-0.96). However, no significant associations were found between other categories of dairy products and CKD incidence. Substitutions of total dairy with other dietary protein sources were not associated with CKD risk. CONCLUSIONS In this study, higher intakes of high-fat dairy and high-fat milk were associated with lower risks of CKD. No significant associations were found between other dairy products and CKD. More prospective and clinical trials are needed to clarify the issue.
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Affiliation(s)
- Zahra Gaeini
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Bahadoran
- 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.
| | - Zahra Feyzi
- Department of Nutritional Sciences, Texas Tech University, Lubbock, Texas
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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4
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Ma J, Rebholz CM, Braun KV, Reynolds LM, Aslibekyan S, Xia R, Biligowda NG, Huan T, Liu C, Mendelson MM, Joehanes R, Hu EA, Vitolins MZ, Wood AC, Lohman K, Ochoa-Rosales C, van Meurs J, Uitterlinden A, Liu Y, Elhadad MA, Heier M, Waldenberger M, Peters A, Colicino E, Whitsel EA, Baldassari A, Gharib SA, Sotoodehnia N, Brody JA, Sitlani CM, Tanaka T, Hill WD, Corley J, Deary IJ, Zhang Y, Schöttker B, Brenner H, Walker ME, Ye S, Nguyen S, Pankow J, Demerath EW, Zheng Y, Hou L, Liang L, Lichtenstein AH, Hu FB, Fornage M, Voortman T, Levy D. Whole Blood DNA Methylation Signatures of Diet Are Associated With Cardiovascular Disease Risk Factors and All-Cause Mortality. CIRCULATION. GENOMIC AND PRECISION MEDICINE 2020; 13:e002766. [PMID: 32525743 PMCID: PMC7442697 DOI: 10.1161/circgen.119.002766] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 05/05/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND DNA methylation patterns associated with habitual diet have not been well studied. METHODS Diet quality was characterized using a Mediterranean-style diet score and the Alternative Healthy Eating Index score. We conducted ethnicity-specific and trans-ethnic epigenome-wide association analyses for diet quality and leukocyte-derived DNA methylation at over 400 000 CpGs (cytosine-guanine dinucleotides) in 5 population-based cohorts including 6662 European ancestry, 2702 African ancestry, and 360 Hispanic ancestry participants. For diet-associated CpGs identified in epigenome-wide analyses, we conducted Mendelian randomization (MR) analysis to examine their relations to cardiovascular disease risk factors and examined their longitudinal associations with all-cause mortality. RESULTS We identified 30 CpGs associated with either Mediterranean-style diet score or Alternative Healthy Eating Index, or both, in European ancestry participants. Among these CpGs, 12 CpGs were significantly associated with all-cause mortality (Bonferroni corrected P<1.6×10-3). Hypermethylation of cg18181703 (SOCS3) was associated with higher scores of both Mediterranean-style diet score and Alternative Healthy Eating Index and lower risk for all-cause mortality (P=5.7×10-15). Ten additional diet-associated CpGs were nominally associated with all-cause mortality (P<0.05). MR analysis revealed 8 putatively causal associations for 6 CpGs with 4 cardiovascular disease risk factors (body mass index, triglycerides, high-density lipoprotein cholesterol concentrations, and type 2 diabetes mellitus; Bonferroni corrected MR P<4.5×10-4). For example, hypermethylation of cg11250194 (FADS2) was associated with lower triglyceride concentrations (MR, P=1.5×10-14).and hypermethylation of cg02079413 (SNORA54; NAP1L4) was associated with body mass index (corrected MR, P=1×10-6). CONCLUSIONS Habitual diet quality was associated with differential peripheral leukocyte DNA methylation levels of 30 CpGs, most of which were also associated with multiple health outcomes, in European ancestry individuals. These findings demonstrate that integrative genomic analysis of dietary information may reveal molecular targets for disease prevention and treatment.
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Affiliation(s)
- Jiantao Ma
- Nutrition Epidemiology & Data Science, Friedman School of Nutrition Science and Policy, Tufts Univ, Boston
- Population Sciences Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD & the Framingham Heart Study, Framingham, MA
| | - Casey M. Rebholz
- Dept of Epidemiology, Bloomberg School of Public Health, Johns Hopkins Univ, Baltimore, MD
| | - Kim V.E. Braun
- Dept of Epidemiology, Erasmus Univ Medical Ctr, Rotterdam, The Netherlands
| | - Lindsay M. Reynolds
- Dept of Epidemiology & Prevention, Wake Forest School of Medicine, Winston-Salem, NC
| | | | - Rui Xia
- Inst of Molecular Medicine, The Univ of Texas Health Science Ctr at Houston, Houston, TX
| | | | - Tianxiao Huan
- Population Sciences Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD & the Framingham Heart Study, Framingham, MA
| | - Chunyu Liu
- Population Sciences Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD & the Framingham Heart Study, Framingham, MA
- Dept of Biostatistics, Boston Univ, Boston, MA
| | - Michael M. Mendelson
- Population Sciences Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD & the Framingham Heart Study, Framingham, MA
- Dept of Cardiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA
| | - Roby Joehanes
- Population Sciences Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD & the Framingham Heart Study, Framingham, MA
| | - Emily A. Hu
- Dept of Epidemiology, Bloomberg School of Public Health, Johns Hopkins Univ, Baltimore, MD
| | - Mara Z. Vitolins
- Dept of Epidemiology & Prevention, Wake Forest School of Medicine, Winston-Salem, NC
| | - Alexis C. Wood
- USDA/ARS Children’s Nutrition Rsrch Ctr, Baylor College of Medicine, Houston, TX
| | - Kurt Lohman
- Dept of Biostatistics, Wake Forest School of Medicine, Winston-Salem, NC
| | - Carolina Ochoa-Rosales
- Dept of Epidemiology, Erasmus Univ Medical Ctr, Rotterdam, The Netherlands
- Centro de Vida Saludable de la Universidad de Concepción, Concepción, Chile
| | - Joyce van Meurs
- Dept of Internal Medicine, Erasmus Univ Medical Ctr, Rotterdam, The Netherlands
| | - Andre Uitterlinden
- Dept of Internal Medicine, Erasmus Univ Medical Ctr, Rotterdam, The Netherlands
| | - Yongmei Liu
- Dept of Epidemiology & Prevention, Wake Forest School of Medicine, Winston-Salem, NC
| | - Mohamed A. Elhadad
- Inst of Epidemiology, Helmholtz Zentrum München, German Ctr for Environmental Health, Neuherberg
- Rsrch Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Ctr for Environmental Health, Neuherberg
- DZHK (German Centre for Cardiovascular Rsrch), partner site Munich Heart Alliance, Munich
| | - Margit Heier
- Inst of Epidemiology, Helmholtz Zentrum München, German Ctr for Environmental Health, Neuherberg
- KORA Study Centre, Univ Hospital of Augsburg, Augsburg, Germany
| | - Melanie Waldenberger
- Inst of Epidemiology, Helmholtz Zentrum München, German Ctr for Environmental Health, Neuherberg
- Rsrch Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Ctr for Environmental Health, Neuherberg
- DZHK (German Centre for Cardiovascular Rsrch), partner site Munich Heart Alliance, Munich
| | - Annette Peters
- Inst of Epidemiology, Helmholtz Zentrum München, German Ctr for Environmental Health, Neuherberg
- Rsrch Unit of Molecular Epidemiology, Helmholtz Zentrum München, German Ctr for Environmental Health, Neuherberg
- DZHK (German Centre for Cardiovascular Rsrch), partner site Munich Heart Alliance, Munich
| | - Elena Colicino
- Dept of Environmental Health Sciences, Columbia Univ, New York City, NY
| | - Eric A. Whitsel
- Dept of Epidemiology, Gillings School of Global Public Health, Univ of North Carolina, Chapel Hill, NC
- Dept of Medicine, School of Medicine, Univ of North Carolina, Chapel Hill, NC
| | - Antoine Baldassari
- Dept of Epidemiology, Gillings School of Global Public Health, Univ of North Carolina, Chapel Hill, NC
| | - Sina A. Gharib
- The Cardiovascular Health Research Unit, Univ of Washington, Seattle, WA
| | - Nona Sotoodehnia
- The Cardiovascular Health Research Unit, Univ of Washington, Seattle, WA
| | - Jennifer A. Brody
- The Cardiovascular Health Research Unit, Univ of Washington, Seattle, WA
| | - Colleen M. Sitlani
- The Cardiovascular Health Research Unit, Univ of Washington, Seattle, WA
| | - Toshiko Tanaka
- Longitudinal Study Section, Nat Inst of Aging, NIH, Bethesda, MD
| | - W. David Hill
- Lothian Birth Cohorts, Univ of Edinburgh, Edinburgh, UK
- Dept of Psychology, Univ of Edinburgh, Edinburgh, UK
| | - Janie Corley
- Lothian Birth Cohorts, Univ of Edinburgh, Edinburgh, UK
- Dept of Psychology, Univ of Edinburgh, Edinburgh, UK
| | - Ian J. Deary
- Lothian Birth Cohorts, Univ of Edinburgh, Edinburgh, UK
- Dept of Psychology, Univ of Edinburgh, Edinburgh, UK
| | - Yan Zhang
- Division of Clinical Epidemiology & Aging Research, German Cancer Rsrch Ctr (DKFZ)
| | - Ben Schöttker
- Division of Clinical Epidemiology & Aging Research, German Cancer Rsrch Ctr (DKFZ)
- Network Aging Research (NAR), Univ of Heidelberg, Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology & Aging Research, German Cancer Rsrch Ctr (DKFZ)
- Network Aging Research (NAR), Univ of Heidelberg, Heidelberg, Germany
| | - Maura E. Walker
- Section of Preventive Medicine & Epidemiology, Boston Univ School of Medicine, Boston, MA
| | - Shumao Ye
- Cardiovascular Nutrition Laboratory, USDA Human Nutrition Rsrch Ctr on Aging, Tufts Univ, Boston
| | - Steve Nguyen
- Division of Epidemiology & Community Health, School of Public Health, Univ of Minnesota, Minneapolis, MN
| | - Jim Pankow
- Division of Epidemiology & Community Health, School of Public Health, Univ of Minnesota, Minneapolis, MN
| | - Ellen W. Demerath
- Division of Epidemiology & Community Health, School of Public Health, Univ of Minnesota, Minneapolis, MN
| | - Yinan Zheng
- Ctr for Population Epigenetics, Robert H. Lurie Comprehensive Cancer Ctr & Dept of Preventive Medicine, Northwestern Univ Feinberg School of Medicine, Chicago, IL
| | - Lifang Hou
- Ctr for Population Epigenetics, Robert H. Lurie Comprehensive Cancer Ctr & Dept of Preventive Medicine, Northwestern Univ Feinberg School of Medicine, Chicago, IL
| | - Liming Liang
- Dept of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Dept of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Alice H. Lichtenstein
- Cardiovascular Nutrition Laboratory, USDA Human Nutrition Rsrch Ctr on Aging, Tufts Univ, Boston
| | - Frank B. Hu
- Dept of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Dept of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Myriam Fornage
- Inst of Molecular Medicine, The Univ of Texas Health Science Ctr at Houston, Houston, TX
| | - Trudy Voortman
- Dept of Epidemiology, Erasmus Univ Medical Ctr, Rotterdam, The Netherlands
| | - Daniel Levy
- Population Sciences Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD & the Framingham Heart Study, Framingham, MA
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5
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Carrero JJ, González-Ortiz A, Avesani CM, Bakker SJL, Bellizzi V, Chauveau P, Clase CM, Cupisti A, Espinosa-Cuevas A, Molina P, Moreau K, Piccoli GB, Post A, Sezer S, Fouque D. Plant-based diets to manage the risks and complications of chronic kidney disease. Nat Rev Nephrol 2020; 16:525-542. [PMID: 32528189 DOI: 10.1038/s41581-020-0297-2] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2020] [Indexed: 02/07/2023]
Abstract
Traditional dietary recommendations for patients with chronic kidney disease (CKD) focus on the quantity of nutrients consumed. Without appropriate dietary counselling, these restrictions can result in a low intake of fruits and vegetables and a lack of diversity in the diet. Plant nutrients and plant-based diets could have beneficial effects in patients with CKD: increased fibre intake shifts the gut microbiota towards reduced production of uraemic toxins; plant fats, particularly olive oil, have anti-atherogenic effects; plant anions might mitigate metabolic acidosis and slow CKD progression; and as plant phosphorus has a lower bioavailability than animal phosphorus, plant-based diets might enable better control of hyperphosphataemia. Current evidence suggests that promoting the adoption of plant-based diets has few risks but potential benefits for the primary prevention of CKD, as well as for delaying progression in patients with CKD G3-5. These diets might also help to manage and prevent some of the symptoms and metabolic complications of CKD. We suggest that restriction of plant foods as a strategy to prevent hyperkalaemia or undernutrition should be individualized to avoid depriving patients with CKD of these potential beneficial effects of plant-based diets. However, research is needed to address knowledge gaps, particularly regarding the relevance and extent of diet-induced hyperkalaemia in patients undergoing dialysis.
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Affiliation(s)
- Juan J Carrero
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Ailema González-Ortiz
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Nephrology and Mineral Metabolism Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador, Zubirán, Mexico
| | - Carla M Avesani
- Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Vincenzo Bellizzi
- Nephrology Unit, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Philippe Chauveau
- Service de Néphrologie Transplantation Dialyse, Centre Hospitalier Universitaire de Bordeaux et Aurad-Aquitaine, Bordeaux, France
| | - Catherine M Clase
- Departments of Medicine and Health Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Adamasco Cupisti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Angeles Espinosa-Cuevas
- Nephrology and Mineral Metabolism Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador, Zubirán, Mexico
| | - Pablo Molina
- Department of Nephrology, Hospital Universitari Dr Peset, Universitat de València, València, Spain
| | - Karine Moreau
- Renal transplant unit, Pellegrin Hospital, Bordeaux, France
| | - Giorgina B Piccoli
- Department of Clinical and Biological Sciences, University of Torino, Torino, Italy.,Nephrologie, Centre Hospitalier Le Mans, Le Mans, France
| | - Adrian Post
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Siren Sezer
- Department of Nephrology, Baskent University School of Medicine, Ankara, Turkey
| | - Denis Fouque
- Department of Nephrology, Université de Lyon, Carmen, Hospital Lyon-Sud, Lyon, France
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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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8
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A higher ratio of refined grain to whole grain is associated with a greater likelihood of chronic kidney disease: a population-based study. Br J Nutr 2018; 121:1294-1302. [PMID: 30375292 DOI: 10.1017/s0007114518003124] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A growing number of studies suggest that diet and renal function are related. However, little is known about the link between both whole grain (WG) and refined grain (RG) consumption and kidney function parameters. Thus, we investigated the association of WG and RG with urinary albumin to creatinine ratio (ACR) and prevalent chronic kidney disease (CKD). Data from participants of the National Health and Nutrition Examination Surveys (NHANES) from 2005 to 2010 were collected. Estimated glomerular filtration rate (eGFR) was calculated by the CKD Epidemiology Collaboration equation. Survey design and sample weights were taken into consideration for statistical analyses. Finally, we included 16 325 participants from NHANES, 6·9 % of whom had prevalent CKD. In models adjusted for age, sex, race, fasting blood glucose, blood pressure, adiposity, hypertension and diabetes status, mean eGFR significantly increased across increasing quartiles of WG (Q1: 88·2 v. Q4: 95·4 ml/min per 1·73 m2, P<0·001), whereas it significantly decreased across increasing quartiles of RG (Q1: 97·2 v. Q4: 88·4 ml/min per 1·73 m2, P<0·001). Furthermore, serum uric acid levels and ACR significantly decreased across quartiles of WG (both P<0·001). In multivariable-adjusted logistic regression models, the likelihood of prevalent CKD was 21 % lower in the highest WG quartile compared with the lowest one. In conclusion, our results shed light on the beneficial impact of WG on kidney function and CKD, whereas RG is adversely associated with eGFR.
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9
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Costacou T, Crandell J, Kahkoska AR, Liese AD, Dabelea D, Lawrence JM, Pettitt DJ, Reynolds K, Mayer-Davis EJ, Mottl AK. Dietary Patterns Over Time and Microalbuminuria in Youth and Young Adults With Type 1 Diabetes: The SEARCH Nutrition Ancillary Study. Diabetes Care 2018; 41:1615-1622. [PMID: 29903846 PMCID: PMC6054499 DOI: 10.2337/dc18-0319] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/14/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We assessed the association between diet quality and microalbuminuria in youth-onset type 1 diabetes using three indices: a modified Mediterranean diet score for children and adolescents (mKIDMED), the Dietary Approaches to Stop Hypertension (DASH), and the Healthy Eating Index-2010 (HEI). RESEARCH DESIGN AND METHODS Youth and young adults from the SEARCH (SEARCH for Diabetes in Youth) Nutrition Ancillary Study (SNAS) diagnosed with type 1 diabetes in 2002-2008, who had repeated dietary assessments at baseline and follow-up visits and urine albumin-to-creatinine ratio (UACR) measured at the outcome visit (2012-2015) (n = 461), were selected for study. Regression models estimated the association between each longitudinally assessed diet score and UACR and microalbuminuria (UACR ≥30 μg/mg). RESULTS The cohort was 43% female, and at follow-up, mean age was 20 years, disease duration was 108 months, and 7% had microalbuminuria. Adherence to a higher-quality diet was low for the mKIDMED (mean 3.7 of a possible range of -3 to 12) and the DASH (mean 42 of 80) and better, for the HEI (mean 56.3 of 100). A borderline inverse association was observed between the HEI score and microalbuminuria after adjustment for caloric and protein intake and demographic and disease factors (odds ratio [OR]HEI 0.83, P = 0.07), which lost significance with further adjustment for HbA1c and systolic blood pressure (ORHEI 0.86, P = 0.19). Results were similar for continuous UACR. No significant associations were observed for diet quality characterized by the mKIDMED or DASH indices. CONCLUSIONS Greater adherence to the HEI may be beneficial for kidney health in youth and young adults with type 1 diabetes. Low adherence to the mKIDMED and DASH diets may explain the lack of association with microalbuminuria.
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Affiliation(s)
- Tina Costacou
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Jamie Crandell
- Department of Biostatistics, University of North Carolina Chapel Hill School of Nursing, Chapel Hill, NC
| | - Anna R Kahkoska
- Department of Biostatistics, University of North Carolina Chapel Hill School of Nursing, Chapel Hill, NC
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | - Dana Dabelea
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Jean M Lawrence
- Department of Research & Evaluation, Kaiser Permanente Southern California, Santa Barbara, CA
| | - David J Pettitt
- Department of Research & Evaluation, Kaiser Permanente Southern California, Santa Barbara, CA
| | - Kristi Reynolds
- Department of Research & Evaluation, Kaiser Permanente Southern California, Santa Barbara, CA
| | - Elizabeth J Mayer-Davis
- Departments of Nutrition and Medicine, University of North Carolina Chapel Hill, Chapel Hill, NC
| | - Amy K Mottl
- UNC Kidney Center, Department of Medicine, University of North Carolina Chapel Hill, Chapel Hill, NC
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Yang J, Li Q, Henning SM, Zhong J, Hsu M, Lee R, Long J, Chan B, Nagami GT, Heber D, Li Z. Effects of Prebiotic Fiber Xylooligosaccharide in Adenine-Induced Nephropathy in Mice. Mol Nutr Food Res 2018; 62:e1800014. [PMID: 29676858 DOI: 10.1002/mnfr.201800014] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 04/05/2018] [Indexed: 01/24/2023]
Abstract
SCOPE This study evaluates the effect of the prebiotic fiber xylooligosaccharide (XOS) on kidney function and gut microbiome in mice with adenine-induced chronic kidney disease (CKD). METHOD AND RESULTS Mice are fed the control diet containing adenine for 3 weeks to induce CKD and are switched to XOS supplemented (2 or 7%) or control diets for another 3 weeks. Mice with CKD exhibit increased blood urea nitrogen (BUN), creatinine, and kidney histopathology. XOS significantly reverses kidney injuries in CKD mice. Analysis of cecum microbiota reveales that adenine-induced CKD does not change alpha diversity, and XOS induces a decrease of alpha diversity in control mice and mice with CKD. Beta diversity analysis shows significant clustering according to experimental groups. Six out of the nine bacterial genera enriched in CKD are significantly reduced with XOS intervention. Furthermore, XOS increases cecal short-chain fatty acid (SCFA) production in both control and CKD mice. Cecal SCFAs and blood propionate are negatively correlated with BUN. XOS also decreases blood p-cresol sulfate in CKD mice, likely resulting from altered microbial tyrosine metabolism. CONCLUSION These results show that XOS intervention improves kidney function in mice with CKD, and is associated with profound changes in microbial composition and metabolism.
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Affiliation(s)
- Jieping Yang
- Center for Human Nutrition, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Qing Li
- Department of Dietetics, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, P. R. China
| | - Susanne M Henning
- Center for Human Nutrition, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Jin Zhong
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA.,Department of Medicine, VA Greater Los Angeles Health Care System, CA, 90095, USA
| | - Mark Hsu
- Center for Human Nutrition, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Rupo Lee
- Center for Human Nutrition, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Jianfeng Long
- Center for Human Nutrition, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Brenda Chan
- Center for Human Nutrition, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Glenn T Nagami
- Department of Medicine, VA Greater Los Angeles Health Care System, CA, 90095, USA
| | - David Heber
- Center for Human Nutrition, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Zhaoping Li
- Center for Human Nutrition, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, 90095, USA.,Department of Medicine, VA Greater Los Angeles Health Care System, CA, 90095, USA
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Dairy products and chronic kidney disease: protective or harmful? asystematic review of prospective cohort studies. Nutrition 2018; 55-56:21-28. [PMID: 29960152 DOI: 10.1016/j.nut.2018.03.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/04/2018] [Accepted: 03/22/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Evidence on the relationship between food sources of protein and progressive decline in renal function in the general population is still controversial. Among the protein-rich foods, dairy products have gained a lot of attention in research on the prevention of metabolic disorders. This systemic review attempted to summarize the findings of prospective cohort studies on the relationship between dairy foods and incident chronic kidney disease (CKD) in the general population. METHODS The PubMed, Embase, Scopus, and Web of Science databases were searched from inception up to January 2018 with no restriction on the language of publication. Studies conducted in the general population with consumption of dairy foods as the exposure of interest and with incident CKD and/or decline in renal function as the study outcome were eligible for inclusion in the review. RESULTS Of the 391 articles that were extracted through database searching, 7 were included in the review. Of the seven studies, five reported a protective association for dairy consumption, particularly low-fat dairy, against incident CKD or rapid decline in renal function; however, two studies did not find such an association. CONCLUSION Despite the limited studies on this topic, findings from the available reports are generally in favor of a positive association between dairy and renal health in the general population. However, further studies are needed to replicate this finding and to determine whether this relationship could be influenced by the fat content and/or the dairy subtypes.
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12
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Consumption of whole grains, fruit and vegetables is not associated with indices of renal function in the population-based longitudinal Doetinchem study. Br J Nutr 2017; 118:375-382. [PMID: 28901886 DOI: 10.1017/s0007114517001726] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Emerging evidence suggests that diet and renal function are related. Little is known, however, about the association of consumption of whole grains, fruit and vegetables with urinary albumin:creatinine ratio (ACR) and changes in estimated glomerular filtration rate (eGFR). We investigated this in a population-based cohort aged 26-65 years. Data were from 3787 participants from the Doetinchem cohort study, who were examined ≥3 times, 5 years apart. Consumption of food groups was assessed at each round with a validated FFQ. GFR was estimated at each round from routinely measured cystatin C and creatinine using the Chronic Kidney Disease-Epidemiology (CKD-EPI) equation. ACR was measured at the last round. Generalised estimated equation models were performed to examine associations with changes in eGFR. Linear regression was used to examine associations with ACR. Adjustments were made for covariates related to lifestyle, biological factors and diet. Mean baseline eGFR was 104·5 (sd 13·7) and mean annual decline was -0·95 (sd 0·67) ml/min per 1·73 m2 over a 15-year follow-up. A trend was observed towards slightly less annual decline in eGFR among those with higher consumption of whole grains (P=0·06). This association, however, was attenuated and no longer significant in multivariate models (P=0·29). Consumption of fruit and vegetables was not associated with changes in eGFR and urinary ACR. In conclusion, consumption of whole grains, fruit and vegetables is not associated with changes in eGFR and mean ACR. As this was the first longitudinal study into this association in the general population, and as results are only partially in line with related studies, further research is recommended.
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13
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Metzger M, Yuan WL, Haymann JP, Flamant M, Houillier P, Thervet E, Boffa JJ, Vrtovsnik F, Froissart M, Bankir L, Fouque D, Stengel B. Association of a Low-Protein Diet With Slower Progression of CKD. Kidney Int Rep 2017; 3:105-114. [PMID: 29340320 PMCID: PMC5762958 DOI: 10.1016/j.ekir.2017.08.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 06/21/2017] [Accepted: 08/07/2017] [Indexed: 01/17/2023] Open
Abstract
Introduction Reducing protein intake is recommended for slowing chronic kidney disease (CKD) progression, but assessment of its true effectiveness is sparse. Methods Using the Maroni formula, we assessed dietary protein intake (DPI) from 24-hour urinary urea excretion in 1594 patients (67% men and 33% women) with CKD, 784 of whom also had 7-day food records. Cause-specific hazard ratios (HRs) and 95% confidence intervals for the competing risks of DPI-associated end-stage renal disease (ESRD) or death were estimated in 1412 patients with baseline glomerular filtration rate ≥15 ml/min per 1.73 m2, measured by 51Cr-EDTA renal clearance (mGFR). Results Overall, mean DPI estimated from urea excretion was 1.09 ± 0.30 g/kg of body weight per day (range = 0.34-2.76); 20% of patients had values > 1.3 g/kg per day, and 1.9% had values < 0.6 g/kg per day. Urea excretion and food records produced similar estimates of mean DPI. The lower the mGFR, the lower the mean DPI. Over a median follow-up of 5.6 years, there were 319 ESRD events and 189 pre-ESRD deaths. After adjusting for relevant covariates, each 0.1 g/kg daily higher baseline urea excretion-based DPI or food record-based DPI was associated with an HR for ESRD of 1.05 (95% confidence interval 1.01-1.10) or 1.09 (95% confidence interval 1.04-1.14), respectively. HRs were stronger in patients with baseline mGFR < 30 ml/min per 1.73 m2. There was no association with mortality. The mean age of the patients was 59 ± 15 years, and mean body mass index was 26.6 ± 5.2 kg/m2. Conclusion In this prospective observational study, the lower the baseline DPI, the slower the progression toward ESRD. Most importantly, the absence of threshold for the relation between DPI and ESRD risk indicates that there is no optimal DPI in the range observed in this cohort.
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Affiliation(s)
- Marie Metzger
- Centre de recherches en Epidémiologie et Santé des Populations, Inserm, University of Paris-Sud, University of Versailles Saint-Quentin, University of Paris-Saclay, Villejuif, France
| | - Wen Lun Yuan
- Centre des Sciences du Goût et de l’Alimentation, Centre National de la Recherche Scientifique, Institut National de la Recherche Agronomique, University of Bourgogne Franche-Comté, Dijon, France
- Centre de Recherche Épidémiologie et Statistique Sorbonne, Inserm, University of Paris-Descartes, Villejuif, France
| | - Jean-Philippe Haymann
- Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
- Inserm Unité mixte de recherche scientifique, 1155, University Pierre et Marie-Curie, Paris, France
| | - Martin Flamant
- Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Paris, France
- Centre de Recherche sur l’Inflammation, Inserm, Université Paris-Diderot, Paris, France
| | - Pascal Houillier
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
- Inserm Unité mixte de recherche scientifique, 1138, Centre de Recherche des Cordeliers, Paris, 75006, France
- University Paris Descartes, Paris, France
| | - Eric Thervet
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
- Paris Centre de Recherche Cardiovasculaire, Inserm, University of Paris-Descartes, Paris, France
| | - Jean-Jacques Boffa
- Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
- Inserm Unité mixte de recherche scientifique, 1155, University Pierre et Marie-Curie, Paris, France
| | - François Vrtovsnik
- Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Paris, France
- Centre de Recherche sur l’Inflammation, Inserm, Université Paris-Diderot, Paris, France
| | - Marc Froissart
- Centre de recherches en Epidémiologie et Santé des Populations, Inserm, University of Paris-Sud, University of Versailles Saint-Quentin, University of Paris-Saclay, Villejuif, France
- Centre hospitalier universitaire vaudois/University of Lausanne, Centre de Recherche Clinique, Lausanne, Switzerland
| | - Lise Bankir
- Inserm Unité mixte de recherche scientifique, 1138, Centre de Recherche des Cordeliers, Paris, 75006, France
| | - Denis Fouque
- Centre Hospitalier Lyon Sud, Pierre-Bénite, France
- Laboratoire Cardiovasculaire, Métabolisme, Diabétologie et Nutrition, Unité mixte de recherche scientifique, 1060, Inserm, University Lyon-Sud, Oullins, France
| | - Bénédicte Stengel
- Centre de recherches en Epidémiologie et Santé des Populations, Inserm, University of Paris-Sud, University of Versailles Saint-Quentin, University of Paris-Saclay, Villejuif, France
- Correspondence: Bénédicte Stengel, Inserm U1018, CESP, Team 5, 16, avenue P. Vaillant Couturier, F-94807, Villejuif, France.Inserm U1018CESPTeam 5, 16, avenue P. Vaillant Couturier, F-94807VillejuifFrance
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Abstract
Chronic kidney disease (CKD) has a prevalence of approximately 13% and is most frequently caused by diabetes and hypertension. In population studies, CKD etiology is often uncertain. Some experimental and observational human studies have suggested that high-protein intake may increase CKD progression and even cause CKD in healthy people. The protein source may be important. Daily red meat consumption over years may increase CKD risk, whereas white meat and dairy proteins appear to have no such effect, and fruit and vegetable proteins may be renal protective. Few randomized trials exist with an observation time greater than 6 months, and most of these were conducted in patients with preexisting diseases that dispose to CKD. Results conflict and do not allow any conclusion about kidney-damaging effects of long-term, high-protein intake. Until additional data become available, present knowledge seems to substantiate a concern. Screening for CKD should be considered before and during long-term, high-protein intake.
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Affiliation(s)
- Anne-Lise Kamper
- Department of Nephrology, Rigshospitalet, University of Copenhagen, 2100 Copenhagen, Denmark;
| | - Svend Strandgaard
- Department of Nephrology, Herlev Hospital, University of Copenhagen, 2730 Copenhagen, Denmark;
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15
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Affiliation(s)
- Nimrit Goraya
- Baylor Scott and White Health, Dallas, Texas
- Department of Internal Medicine, Texas A&M Health Sciences Center College of Medicine, Temple, Texas; and
| | - Donald E Wesson
- Baylor Scott and White Health, Dallas, Texas;
- Department of Internal Medicine, Texas A&M Health Sciences Center College of Medicine, Temple, Texas; and
- Diabetes Health and Wellness Institute, Dallas, Texas
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