Title | Plant-Based Diets and Incident CKD and Kidney Function. |
Publication Type | Journal Article |
Year of Publication | 2019 |
Authors | Kim H, Caulfield LE, Garcia-Larsen V, Steffen LM, Grams ME, Coresh JJ |
Secondary Authors | Rebholz CM |
Journal | Clin J Am Soc Nephrol |
Volume | 14 |
Issue | 5 |
Pagination | 682-691 |
Date Published | 2019 05 07 |
ISSN | 1555-905X |
Keywords | Diet, 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. |
DOI | 10.2215/CJN.12391018 |
Alternate Journal | Clin J Am Soc Nephrol |
PubMed ID | 31023928 |
PubMed Central ID | PMC6500948 |
Grant List | K01 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 |