Diet quality and incident chronic kidney disease in the general population: The Lifelines Cohort Study

Qingqing Cai,Louise H Dekker,Petra C Vinke,Eva Corpeleijn,Stephan J.L Bakker,Martin H De Borst,Gerjan J Navis

doi:10.1016/j.clnu.2021.07.033

Abstract

Healthy dietary patterns have been associated with a lower risk of chronic kidney disease (CKD). We aimed to investigate the association of a fully food-based diet quality score assessed by the Lifelines Diet Score (LLDS) with either incident CKD or eGFR decline in the general population. For this study, data from a prospective general population-based Lifelines cohort in the Northern Netherlands was used. Diet was assessed with a 110-item food frequency questionnaire at baseline. The LLDS, based on international evidence for diet-disease relations at the food group level, was calculated to assess diet quality. For the analysis, the score was divided into tertiles. Logistic regression was performed to evaluate the association of the LLDS at baseline with either incident CKD (eGFR <60mL/min/1.73m2) or a ≥20% eGFR decline at the second study visit, adjusted for relevant confounders. A total of 78346 participants free of CKD at baseline were included. During a mean (SD) follow-up of 3.6±0.9 years, 2071 (2.6%) participants developed CKD and 7611 (9.7%) had a ≥20% eGFR decline. Participants in the highest tertile of LLDS had a lower risk of incident CKD (fully adjusted OR 0.83, [95% CI: 0.72-0.96]) and ≥20% eGFR decline (fully adjusted OR 0.80, [95% CI: 0.75-0.86]), compared with those in the lowest tertile. Similar dose-response associations were observed in continuous LLDS. Higher adherence to a high-quality diet was associated with a lower risk of incident CKD or ≥20% eGFR decline in the general population.

Highlights

Chronic kidney disease (CKD) is a growing global public health issue, affecting 8%e16% of the population worldwide [1]
Previous studies illustrated that the Mediterranean diet, one of the natural healthy dietary patterns, is associated with a lower risk of CKD development and progression in the general population [8e12]
Recent evidence shows that sugar-sweetened beverages are associated with a higher risk of incident CKD and kidney function decline [5,14], which are not included in the Mediterranean diet score (MDS)

Summary

Introduction

Chronic kidney disease (CKD) is a growing global public health issue, affecting 8%e16% of the population worldwide [1]. Often rich in plant-based foods, have been associated with a lower incidence and slower progression of CKD [4e7]. Dietary patterns that are considered healthy often share similar characteristics, encouraging higher consumption of vegetables, fruits, legumes, nuts, whole grains, fish, and low-fat dairy, and lower consumption of red and processed meats, sodium, and sugar-sweetened beverages [7]. Previous studies illustrated that the Mediterranean diet, one of the natural healthy dietary patterns, is associated with a lower risk of CKD development and progression in the general population [8e12]. The Mediterranean diet score (MDS) is not completely food-based and not fully in accordance with current scientific evidence [13]. Recent evidence shows that sugar-sweetened beverages are associated with a higher risk of incident CKD and kidney function decline [5,14], which are not included in the MDS

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