Dietary patterns and risk of incident chronic kidney disease: the Atherosclerosis Risk in Communities study. Issue 3 (6th August 2019)

• Record Type: Journal Article
• Authors: Hu, Emily A; Steffen, Lyn M; Grams, Morgan E; Crews, Deidra C; Coresh, Josef; Appel, Lawrence J; Rebholz, Casey M
• Is Part Of: American journal of clinical nutrition. Volume 110:Issue 3(2019)
• Page Start: 713
• Page End: 721
• Publication Date: 2019-08-06
• Subjects: AHEI -- ARIC -- DASH -- dietary patterns -- dietary scores -- HEI -- kidney disease -- Mediterranean -- renal disease; Diet therapy -- Periodicals; Nutrition -- Periodicals; Dietetics -- Periodicals; 613.205
• DOI: 10.1093/ajcn/nqz146
• Languages: English
• ISSNs: 0002-9165

Abstract

ABSTRACT: Background: Adherence to healthy dietary patterns, measured by the Healthy Eating Index (HEI), Alternative Healthy Eating Index (AHEI), and alternate Mediterranean diet (aMed) scores, is associated with a reduced risk of cardiovascular disease. The association between these scores and chronic kidney disease (CKD) is undetermined. Objective: We aimed to estimate the association between the HEI, AHEI, and aMed scores and risk of incident CKD. Methods: We conducted a prospective analysis in 12, 155 participants aged 45–64 y from the Atherosclerosis Risk in Communities (ARIC) Study. We calculated HEI-2015, AHEI-2010, and aMed scores for each participant and categorized them into quintiles of each dietary score. Incident CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m 2 accompanied by ≥25% decline in estimated glomerular filtration rate, a kidney disease–related hospitalization or death, or end-stage renal disease. We used cause-specific hazard models to estimate risk of CKD from the quintile of the dietary score through to 31 December 2017. Results: There were 3980 cases of incident CKD over a median follow-up of 24 y. Participants who had higher adherence to the HEI-2015, AHEI-2010, and aMed scores were more likely to be female, have higher educational attainment, higher income level, be nonsmokers, more physically active, and diabetic compared with participants who scored lower. All 3 dietary scores were associated with lower CKD risk ( P -trend < 0.001). Participants who were in the highest quintile of HEI-2015 score had a 17% lower risk of CKD (HR: 0.83; 95% CI: 0.74, 0.92) compared with participants in the lowest quintile. Those in quintile 5 of AHEI-2010 and aMed scores, respectively, had a 20% and 13% lower risk of CKD compared with those in quintile 1. Conclusion: Higher adherence to healthy dietary patterns during middle age was associated with lower risk of CKD.