Proinflammatory Diets and Risk of ESKD in US Adults with CKD. Issue 11 (24th November 2022)

• Record Type: Journal Article
• Authors: Banerjee, Tanushree; McCulloch, Charles E.; Crews, Deidra C.; Burrows, Nilka Rios; Pavkov, Meda E.; Saran, Rajiv; Morgenstern, Hal; Bragg-Gresham, Jennifer; Powe, Neil R.
• Other Names: author non-byline.; Powe Neil author non-byline.; Banerjee Tanushree author non-byline.; Tuot Delphine author non-byline.; Hsu Chi-yuan author non-byline.; McCulloch Charles author non-byline.; Crews Deidra author non-byline.; Hsu Raymond author non-byline.; Chu Chi author non-byline.; Bibbins-Domingo Kirsten author non-byline.; Velasquez Alexandra author non-byline.; Coresh Josef author non-byline.; Saran Rajiv author non-byline.; Shahinian Vahakn author non-byline.; Gillespie Brenda author non-byline.; Morgenstern Hal author non-byline.; Heung Michael author non-byline.; Herman William author non-byline.; Bragg-Gresham Jennifer author non-byline.; Steffick Diane author non-byline.; Yin Maggie author non-byline.; Robinson Ian author non-byline.; Zivin Kara author non-byline.; Han Yun author non-byline.; Wyncott April author non-byline.; Burrows Nilka Ríos author non-byline.; Koyama Alain author non-byline.; Mondesire Juanita author non-byline.; Patel Priti author non-byline.; Pavkov Meda author non-byline.; Rolka Deborah author non-byline.; Saydah Sharon author non-byline.; Waller Larry author non-byline.;
• Is Part Of: Kidney360. Volume 3:Issue 11(2022)
• Page Start: 1852
• Page End: 1860
• Publication Date: 2022-11-24
• Subjects: chronic kidney disease -- ADII -- diet -- end stage kidney disease -- epidemiology and outcomes -- inflammation; 616.61
• DOI: 10.34067/KID.0000442022
• Languages: English
• ISSNs: 2641-7650

Abstract

Key Points: The association between a proinflammatory diet and kidney failure with replacement therapy is strongly mediated by systemic inflammation. Inflammation seems to be a reasonable target for potential preventive and therapeutic interventions in patients with CKD. Visual Abstract: Abstract : Background: Inflammation may affect long-term kidney function. Diet may play a role in chronic inflammation. We hypothesized that proinflammatory diets increase the risk of progression to kidney failure with replacement therapy (KFRT), and systemic inflammation is a mediator of the effect of diet on progression to KFRT. Methods: In the 1988–1994 National Health and Nutrition Examination Survey linked to the national ESKD registry, in adults with CKD (eGFR 15–59 ml/min per 1.73 m 2 ), aged ≥20 years, we calculated the Adapted Dietary Inflammatory Index (ADII) at baseline from a 24-hour dietary recall and an inflammation score (IS) using average of z scores of four inflammation biomarkers. We explored the association of the ADII and IS with risk of incident KFRT using Cox proportional model, adjusting for sociodemographics, physical activity, Framingham risk score, eGFR, and urinary ACR. We evaluated whether, and to what extent, IS mediated the effect of the ADII on KFRT incidence, using causal mediation analysis. Results: Of 1084 adults with CKD, 109 (10%) developed KFRT. The ADII was associated with increased risk of KFRT (relative hazard [RH] per SD increase (2.56): 1.4 [1.04–1.78]). IS was also associated with KFRT (RH: 1.12; 95% CI, 1.02 to 1.25). Approximately 36% of the association between the ADII and KFRT was explained by IS. Conclusions: Among adults with CKD, a proinflammatory diet was associated with risk of KFRT, and that association was partially explained by an increase in inflammatory markers. Dietary interventions that reduce inflammation may offer an approach for preventing KFRT.