Abstract
Associations between dietary patterns and chronic kidney disease are not well established, especially in European populations. We conducted a cross-sectional study of 1033 older Irish women (age range 56–100 years) with a restricted lifestyle. Dietary intake was assessed using a food frequency questionnaire. Renal function was determined by estimated glomerular filtration rate. Two dietary patterns were identified within the study population using factor analysis. A significant negative association was found between unhealthy dietary pattern adherence and renal function in both unadjusted and adjusted models controlling for potential confounding variables (p for trend <0.001), with a mean difference in estimated glomerular filtration rate of −6 ml/min/1.73 m2 between those in the highest fifth of adherence to the unhealthy dietary pattern compared to the lowest, in the fully adjusted model. Chronic kidney disease risk was significantly greater for the highest fifth, compared to the lowest fifth of unhealthy dietary pattern adherence in adjusted models (adjusted odds ratio = 2.62, p < 0.001). Adherence to the healthy dietary pattern was not associated with renal function or chronic kidney disease in adjusted models. In this cohort, an unhealthy dietary pattern was associated with lower renal function and greater prevalence of chronic kidney disease.
Highlights
Diet and nutritional intake are associated with important risk factors for chronic kidney disease (CKD) including type 2 diabetes[1] and hypertension[2], yet dietary guidelines for prevention of CKD are lacking due to a dearth of evidence
In contrast to the a-priori approach, an a-posteriori approach using factor analysis to identify existing dietary patterns within a study population can be used. Such a-posteriori derived dietary patterns have been examined in relation to renal function and damage in a limited number of studies based in the US5,20,21 and China[22], but there is a lack of evidence in European populations
There was a significant association between the unhealthy dietary pattern and both lower estimated glomerular filtration rate (eGFR) and increased odds of CKD stage 3–5
Summary
Diet and nutritional intake are associated with important risk factors for chronic kidney disease (CKD) including type 2 diabetes[1] and hypertension[2], yet dietary guidelines for prevention of CKD are lacking due to a dearth of evidence. In contrast to the a-priori approach, an a-posteriori approach using factor analysis to identify existing dietary patterns within a study population can be used Such a-posteriori derived dietary patterns have been examined in relation to renal function and damage in a limited number of studies based in the US5,20,21 and China[22], but there is a lack of evidence in European populations. The Reasons for Geographic and Racial Differences in Stroke study identified a more diverse set of dietary patterns that reflected the South-Eastern US locality of the study[21] They found no associations with end-stage renal disease but reported higher mortality rates in those with CKD who were consuming a “Southern” dietary pattern, characterized by greater intake of fried food, organ meats, and sweetened beverages, and lower rates in those consuming a “Plant-based” dietary pattern. The aim of this study was to examine the association between a-posteriori dietary patterns and renal function identified within a highly specific cohort of older women with relatively stable and restricted lifestyle behaviours
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