Pulse lineResearch With Heart Logo

Plant-Based Diets and Incident CKD and Kidney Function.

TitlePlant-Based Diets and Incident CKD and Kidney Function.
Publication TypeJournal Article
Year of Publication2019
AuthorsKim H, Caulfield LE, Garcia-Larsen V, Steffen LM, Grams ME, Coresh JJ
Secondary AuthorsRebholz CM
JournalClin J Am Soc Nephrol
Volume14
Issue5
Pagination682-691
Date Published2019 05 07
ISSN1555-905X
KeywordsDiet, Healthy, Diet, Vegetarian, Female, Glomerular Filtration Rate, Humans, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, Renal Insufficiency, Chronic
Abstract

BACKGROUND AND OBJECTIVES: The association between plant-based diets, incident CKD, and kidney function decline has not been examined in the general population. We prospectively investigated this relationship in a population-based study, and evaluated if risk varied by different types of plant-based diets.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Analyses were conducted in a sample of 14,686 middle-aged adults enrolled in the Atherosclerosis Risk in Communities study. Diets were characterized using four plant-based diet indices. In the overall plant-based diet index, all plant foods were positively scored; in the healthy plant-based diet index, only healthful plant foods were positively scored; in the provegetarian diet, selected plant foods were positively scored. In the less healthy plant-based diet index, only less healthful plant foods were positively scored. All indices negatively scored animal foods. We used Cox proportional hazards models to study the association with incident CKD and linear mixed models to examine decline in eGFR, adjusting for confounders.

RESULTS: During a median follow-up of 24 years, 4343 incident CKD cases occurred. Higher adherence to a healthy plant-based diet (HR comparing quintile 5 versus quintile 1 [HR], 0.86; 95% confidence interval [95% CI], 0.78 to 0.96; for trend =0.001) and a provegetarian diet (HR, 0.90; 95% CI, 0.82 to 0.99; for trend =0.03) were associated with a lower risk of CKD, whereas higher adherence to a less healthy plant-based diet (HR, 1.11; 95% CI, 1.01 to 1.21; for trend =0.04) was associated with an elevated risk. Higher adherence to an overall plant-based diet and a healthy plant-based diet was associated with slower eGFR decline. The proportion of CKD attributable to lower adherence to healthy plant-based diets was 4.1% (95% CI, 0.6% to 8.3%).

CONCLUSIONS: Higher adherence to healthy plant-based diets and a vegetarian diet was associated with favorable kidney disease outcomes.

DOI10.2215/CJN.12391018
Alternate JournalClin J Am Soc Nephrol
PubMed ID31023928
PubMed Central IDPMC6500948
Grant ListK01 DK107782 / DK / NIDDK NIH HHS / United States
R21 HL143089 / HL / NHLBI NIH HHS / United States
HHSN268201700002C / HL / NHLBI NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
HHSN268201700004C / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States
HHSN268201700005C / HL / NHLBI NIH HHS / United States
HHSN268201700001C / HL / NHLBI NIH HHS / United States
HHSN268201700003C / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States