| Title: | Associations of Dietary Index Adherence With the Progression of Chronic Kidney Disease Across Cardio-Metabolic Disorders: Findings From Multi-State Models of a Nationwide Cohort Study |
| Journal: | Journal of Renal Nutrition |
| Published: | 14 Oct 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41101407/ |
| DOI: | https://doi.org/10.1053/j.jrn.2025.10.002 |
Publication 19174
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Abstract
OBJECTIVE: The associations of dietary guidelines with the progression from a healthy state to cardio-metabolic disorders, then to chronic kidney disease (CKD), and ultimately to death remain unclear. This study aimed to evaluate the associations of multiple dietary pattern indices with CKD progression originating from cardio-metabolic disorders.</p>
METHODS: Using data from 205,826 participants in the UK Biobank, we applied multi-state models to trace CKD trajectories. Nine dietary pattern indices were derived from 24-hour dietary recalls, and their associations with the risk of transitioning to CKD from cardio-metabolic, as well as subsequent mortality, were evaluated using Cox regression.</p>
RESULTS: Greater adherence to the American Heart Association (AHA) dietary pattern was significantly associated with the lowest risk of developing CKD (hazard ratio (HR) for Q5 vs. Q1 = 0.63, 95% confidence interval (95% CI): 0.55-0.71). In comparison, adherence to other dietary patterns such as the Diabetes Risk Reduction Diet (DRRD) and EAT-Lancet diets conferred weaker protective associations. Conversely, the high adherence to an unhealthful Plant-Based Diet Index (PDI) was linked to an elevated CKD risk (HR = 1.44, 95% CI: 1.26-1.64, Q5 vs. Q1). Multi-state model analyses revealed that each 1-unit increase in the American Heart Association diet Z-score was associated with a reduced risk of CKD following cardio-metabolic conditions (HR = 0.89, 95% CI: 0.81-0.97), with a more pronounced risk reduction among participants with T2DM (HR = 0.83, 95% CI: 0.71-0.97). However, no significant association was found between dietary indices adherence and mortality after CKD onset.</p>
CONCLUSION: The American Heart Association diet demonstrated superior protection against CKD incidence and progression from cardio-metabolic disorders, highlighting its clinical priority for early intervention. No dietary pattern influenced mortality after CKD onset, emphasizing the need for tailored prevention strategies in high-risk populations.</p>
13 Keywords
- Aged
- Cardiovascular Diseases
- Cohort Studies
- Diet
- Disease Progression
- Female
- Humans
- Male
- Metabolic Diseases
- Middle Aged
- Patient Compliance
- Renal Insufficiency, Chronic
- United Kingdom
6 Authors
- Dong Liu
- Ziwei Liu
- Jun-Yi Ma
- Jing-Ni Wu
- Tong Liu
- Li-Hua Chen
1 Application
| Application ID | Title |
|---|---|
| 62811 | Lifestyle, metabolic/inflammatory profile, genetics and neurological diseases among participants in the UK Biobank |
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