TY - JOUR
T1 - Plant-based diets and incident CKD and kidney function
AU - Kim, Hyunju
AU - Caulfield, Laura E.
AU - Garcia-Larsen, Vanessa
AU - Steffen, Lyn M.
AU - Grams, Morgan E.
AU - Coresh, Josef
AU - Rebholz, Casey M.
N1 - Publisher Copyright:
© 2019 by the American Society of Nephrology.
PY - 2019/5/7
Y1 - 2019/5/7
N2 - Background and objectives The association between plant-based diets, incidentCKD, and kidney function decline has not been examined in the general population.Weprospectively investigated this relationship in a populationbased study, and evaluated if risk varied by different types of plant-based diets. Design, setting, participants, & measurements Analyseswere conducted in a sample of 14,686middle-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 foodswere 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 foodswere 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-baseddiet (HRcomparing quintile 5versusquintile 1 [HRQ5 versus Q1], 0.86; 95%confidence interval [95%CI], 0.78 to 0.96; P for trend =0.001) and a provegetarian diet (HRQ5 versus Q1, 0.90; 95%CI, 0.82 to 0.99; P for trend =0.03) were associated with a lower risk of CKD, whereas higher adherence to a less healthy plant-based diet (HRQ5 versus Q1, 1.11; 95%CI, 1.01 to 1.21; P for trend =0.04)was associatedwith 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.
AB - Background and objectives The association between plant-based diets, incidentCKD, and kidney function decline has not been examined in the general population.Weprospectively investigated this relationship in a populationbased study, and evaluated if risk varied by different types of plant-based diets. Design, setting, participants, & measurements Analyseswere conducted in a sample of 14,686middle-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 foodswere 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 foodswere 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-baseddiet (HRcomparing quintile 5versusquintile 1 [HRQ5 versus Q1], 0.86; 95%confidence interval [95%CI], 0.78 to 0.96; P for trend =0.001) and a provegetarian diet (HRQ5 versus Q1, 0.90; 95%CI, 0.82 to 0.99; P for trend =0.03) were associated with a lower risk of CKD, whereas higher adherence to a less healthy plant-based diet (HRQ5 versus Q1, 1.11; 95%CI, 1.01 to 1.21; P for trend =0.04)was associatedwith 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.
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U2 - 10.2215/CJN.12391018
DO - 10.2215/CJN.12391018
M3 - Article
C2 - 31023928
AN - SCOPUS:85065811008
SN - 1555-9041
VL - 14
SP - 682
EP - 691
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 5
ER -