Abstract
Background: We analyzed the dietary patterns of Brazilian individuals with a self-declared diagnosis of chronic kidney disease (CKD) and explored associations with treatment modality. Methods: Weekly consumption of 14 food intake markers was analyzed in 839 individuals from the 2013 Brazil National Health Survey with a self-declared diagnosis of CKD undergoing nondialysis (n = 480), dialysis (n = 48), or renal transplant (n = 17) treatment or no CKD treatment (n = 294). Dietary patterns were derived by exploratory factor analysis of food intake groups. Multiple linear regression models, adjusted by sociodemographic and geographical variables, were used to evaluate possible differences in dietary pattern scores between different CKD treatment groups. Results: Two food patterns were identified: an “Unhealthy” pattern (red meat, sweet sugar beverages, alcoholic beverages, and sweets and a negative loading of chicken, excessive salt, and fish) and a “Healthy” pattern (raw and cooked vegetables, fruits, fresh fruit juice, and milk). The Unhealthy pattern was inversely associated with nondialysis and dialysis treatment (β: −0.20 (95% CI: −0.33; −0.06) and β: −0.80 (−1.16; −0.45), respectively) and the Healthy pattern was positively associated with renal transplant treatment (β: 0.32 (0.03; 0.62)). Conclusions: Two dietary patterns were identified in Brazilian CKD individuals and these patterns were linked to CKD treatment modality.
Highlights
Chronic kidney disease (CKD) is a common noncommunicable disease associated with high morbimortality and has an estimated worldwide prevalence of 11%–13% among adults [1]; in Brazil, the prevalence is approximately 9%, not including patients on dialysis [2]
Most studies and nutritional guidelines addressing the care of individuals with chronic kidney disease (CKD) have focused primarily on dietary recommendations regarding the intake of macronutrients and the restriction of single micronutrients, such as sodium, potassium, and phosphorus [12,13,14,15,16], while usually not considering dietary patterns reflecting the overall quality of the diet, which conceivably may play an even more important role in clinical outcomes
In the current study, we extended our analysis by testing the hypothesis that CKD treatment modality or lack of regular treatment influences dietary patterns
Summary
Chronic kidney disease (CKD) is a common noncommunicable disease associated with high morbimortality and has an estimated worldwide prevalence of 11%–13% among adults [1]; in Brazil, the prevalence is approximately 9%, not including patients on dialysis [2]. Adequate pharmaceutical treatment, and lifestyle changes—with dietary modifications adapted to the stage of CKD and treatment modality (nondialysis, dialysis, and renal transplantation)—are important interventions for reducing the progression of the disease and cardiovascular morbidity and mortality [3]. Most studies and nutritional guidelines addressing the care of individuals with CKD have focused primarily on dietary recommendations regarding the intake of macronutrients (i.e., energy and protein intake) and the restriction of single micronutrients, such as sodium, potassium, and phosphorus [12,13,14,15,16], while usually not considering dietary patterns reflecting the overall quality of the diet, which conceivably may play an even more important role in clinical outcomes. We analyzed the dietary patterns of Brazilian individuals with a self-declared diagnosis of chronic kidney disease (CKD) and explored associations with treatment modality
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