Plant-Based Diets Linked to Reduced Risk of CKD Progression and Mortality, CRIC Study Finds
USA: In a significant stride towards understanding the impact of dietary choices on kidney health, the Chronic Renal Insufficiency Cohort (CRIC) Study has unveiled compelling evidence supporting the benefits of plant-based diets in reducing the risk of chronic kidney disease (CKD) progression and all-cause mortality. Published in the renowned American Journal of Kidney Diseases, the findings underscore the potential of dietary interventions in improving outcomes for individuals with CKD.
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.
