Abstract
BackgroundChronic Kidney Disease (CKD), characterized by impaired kidney function, affects over 1.5 million individuals in Taiwan. Cardiovascular disease (CVD) is commonly found in patients with CKD, and the increased prevalence of obesity can have some implications for the risk of both CKD and CVD. Since diet plays an important role in the development of obesity, CVD and CKD, our study was designed to investigate the association of kidney function-related dietary pattern with weight status, cardiovascular risk factors, and the severity of impaired kidney function in middle-aged and older adults in Taiwan.MethodsA total of 41,128 participants aged 40 to 95 years old with an estimated glomerular filtration rate (eGFR) less than 90 mL/min/1.73 m2 and proteinuria were recruited from Mei Jau Health Institute between 2008 and 2010. The kidney function-related dietary pattern was identified using reduced rank regression (RRR) and was known as high consumption of preserved or processed food, meat, organ meats, rice/flour products, and, low consumption of fruit, dark-colored vegetables, bread, and beans. A multivariable logistic regression analysis was used to identify the association of weight status and cardiovascular risk factors with moderately/severely impaired kidney function (eGFR < 60 mL/min/1.73 m2) and the association of dietary pattern with the outcomes aforementioned.ResultsModerately/severely impaired kidney function participants were heavier and had higher abnormality of cardiovascular risk factors compared with those with mildly impaired kidney function. Weight status (OR = 1.28, 95% CI 1.12–1.45, P < 0.001 for obesity) and cardiovascular risk factors (OR = 1.52, 95% CI 1.31–1.77, P < 0.001 for high total cholesterol/HDL-C ratio and OR = 1.56, 95% CI 1.41–1.72, P < 0.001 for hypercalcemia) were positively associated with increased risk of moderately/severely impaired kidney function. The kidney function-related dietary pattern was correlated with overweight or obese (OR = 2.07, 95% CI 1.89–2.27, P < 0.01) weight status, increased cardiovascular risk by 10–31%, and the risk of moderately/severely impaired kidney function (OR = 1.15, 95% CI 1.02–1.29, P < 0.05).ConclusionsThe RRR-derived kidney function-related dietary pattern, characterized by high intake of processed and animal foods and low intake of plant foods, predicts the risks for developing cardiovascular disease and moderately/severely impaired kidney function among middle-aged and older adults.
Highlights
Chronic kidney disease (CKD), characterized by impaired kidney function, has surfaced as a global health problem
A population-based prospective cohort study in Iceland reported that adjusted hazard ratio (HR) for Cardiovascular disease (CVD) was 1.55 to 4.29 in Chronic Kidney Disease (CKD) stage 1 to 4 [3], and CKD was associated with increased risk for CVD mortality by 100% (HR = 2.00, 95% confidence intervals (CIs) 1.78–2.25) [4]
Few studies in Taiwan have investigated whether abnormal weight status and both traditional as well as non-traditional CVD risk factors are associated with the severity of impaired kidney function
Summary
Chronic kidney disease (CKD), characterized by impaired kidney function, has surfaced as a global health problem. Abnormal calcium and phosphorus metabolism represented as non-traditional CVD risk factors Both high calcium and phosphorus levels can directly increase vascular calcification [7]. Few studies in Taiwan have investigated whether abnormal weight status and both traditional as well as non-traditional CVD risk factors are associated with the severity of impaired kidney function. Chronic Kidney Disease (CKD), characterized by impaired kidney function, affects over 1.5 million individuals in Taiwan. Since diet plays an important role in the development of obesity, CVD and CKD, our study was designed to investigate the association of kidney function-related dietary pattern with weight status, cardiovascular risk factors, and the severity of impaired kidney function in middle-aged and older adults in Taiwan
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