FC 081ULTRA-PROCESSED FOOD CONSUMPTION AND RISK OF INCIDENT CHRONIC KIDNEY DISEASE: THE LIFELINES COHORT

Abstract

Abstract Background and Aims Ultra-processed foods (UPF), that are widespread in Western-style diet, are risk factors for the development of cardiovascular disease, diabetes, obesity, hypertension, and all-cause mortality. The role of UPF in kidney function decline, however, is still unknown. The aim of this study was to investigate the associations of UPF consumption with incident CKD and estimated glomerular filtration rate (eGFR) decline. Additionally, we considered the heterogeneity of UPF by identifying different patterns of UPF consumption. Method The study was performed in a prospective general population-based cohort in the Northern Netherlands. A total of 78 346 participants who were free of CKD at baseline were included in this study. The dietary information was assessed at baseline using a 110-item food frequency questionnaire. The proportion (in weight) of UPF in the total diet was calculated and UPF consumption patterns were identified by principle component analysis (PCA). Multivariable logistic regression analyses were used to evaluated the associations of the proportion of UPF consumption and UPF patterns, respectively, with risk of incident CKD and a ≥20% eGFR decline. Results Average UPF consumption was 37.7% of total food intake in grams. After a mean (SD) follow-up of 7.9±1.1 years, 2 072 participants developed CKD and 7 611 had a ≥20% eGFR decline. The consumption of UPF was independently associated with a higher risk of incident CKD (OR for an absolute increment of 10 % of UPF in the diet 1.07 [95% CI 1.01-1.13], P=0.026) and with a higher risk of ≥20% eGFR decline (OR10% increment 1.07 [95% CI 1.05-1.10], P<0.001). PCA revealed four habitual UPF consumption patterns. The “warm savory snack” pattern was associated with both incident CKD (OR 1.13 [1.04-1.23], P=0.003) and a ≥20% eGFR decline (OR 1.08 [1.05-1.11], P<0.001). The “sweet snack” pattern was associated with eGFR decline (OR 1.06 [1.03-1.09], P<0.001) only, whereas the “Dutch traditional” and the “cold snack” were not associated with CKD or eGFR decline. Conclusion A higher UPF consumption was associated with higher risks of incident CKD and eGFR decline in the general population. Different UPF consumption patterns were identified, with different impact on renal risk. The “warm savory snack” pattern and the “sweet snack” pattern were associated with kidney function decline. Our findings suggest that UPF need to be considered in designing future dietary strategies for CKD prevention.