Plant-Based Diets Linked to Reduced Risk of CKD Progression and Mortality, CRIC Study Finds

The researchers revealed that following an overall plant-based diet and a healthy plant-based diet is associated with a reduced risk of all-cause mortality among patients with chronic kidney disease. By contrast, an unhealthy plant-based diet was associated with an increased risk of CKD progression and all-cause mortality.

"These results suggest the importance of quality of plant-based diets for CKD management," the researchers wrote.

Previous studies have shown that plant-based diets are healthful dietary patterns linked to a lower risk of chronic diseases. However, the effect of plant-based diets on clinical outcomes in CKD patients is not well-established. Considering this, Saira Amir, Johns Hopkins University, Baltimore, Maryland, and colleagues examined the prospective associations of adherence to three different types of plant-based diets with the risks of CKD progression and all-cause mortality in 2,539 individuals with CKD.

Scores for the healthy plant-based diet index, overall plant-based diet index, and unhealthy plant-based diet index were calculated using Diet History Questionnaire responses. Outcomes were CKD progression defined as a decline in ≥50% estimated glomerular filtration rate (eGFR) from baseline or kidney replacement therapy (dialysis, transplant), and (2) all-cause mortality.

The study led to the following findings:

· There were 977 CKD progression events and 836 deaths during a median follow-up period of 7 and 12 years, respectively.

· Participants with the highest versus lowest adherence to overall plant-based diets and healthy plant-based diets had 26% (HR, 0.74) and 21% (HR, 0.79) lower risks of all-cause mortality, respectively.

· Each 10-point higher score of unhealthy plant-based diets was modestly associated with a higher risk of CKD progression (HR, 1.14) and all-cause mortality (HR, 1.11).

The main limitation is that self-reported diet may be subject to measurement error.

In conclusion, higher adherence to an overall plant-based diet and a healthy plant-based diet was linked with a lowered risk of all-cause mortality but not CKD progression or incident cardiovascular disease in a population of kidney disease patients. Per 10-point higher in unhealthy plant-based diets was associated with a higher risk of all-cause mortality, CKD progression, and incident cardiovascular disease.

The researchers suggest that adhering to a plant-based diet may prolong life. There is no clarity on whether overall and healthy plant-based diets can delay CKD progression once kidney disease becomes overt, however, unhealthy plant-based diets may be detrimental to kidney health.

"Efforts to increase high-quality plant-based diet consumption should be facilitated by promoting equitable access to healthy plant foods in individuals with CKD," they wrote.

Reference:

Amir S, Kim H, Hu EA, Ricardo AC, Mills KT, He J, Fischer MJ, Pradhan N, Tan TC, Navaneethan SD, Dobre M, Anderson CAM, Appel LJ, Rebholz CM; CRIC Study Investigators. Adherence to Plant-Based Diets and Risk of CKD Progression and All-Cause Mortality: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study. Am J Kidney Dis. 2024 May;83(5):624-635. doi: 10.1053/j.ajkd.2023.09.020. Epub 2023 Dec 14. PMID: 38103719; PMCID: PMC11034716.