Healthy dietary patterns and risk of mortality and ESRD in CKD: A meta-analysis of cohort studies

Jaimon T Kelly, Suetonia C Palmer, Shu Ning Wai, Marinella Ruospo, Juan-Jesus Carrero, Katrina L Campbell, Giovanni F M Strippoli

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Abstract

BACKGROUND AND OBJECTIVES: Patients with CKD are advised to follow dietary recommendations that restrict individual nutrients. Emerging evidence indicates overall eating patterns may better predict clinical outcomes, however, current data on dietary patterns in kidney disease are limited.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This systematic review aimed to evaluate the association between dietary patterns and mortality or ESRD among adults with CKD. Medline, Embase, and reference lists were systematically searched up to November 24, 2015 by two independent review authors. Eligible studies were longitudinal cohort studies reporting the association of dietary patterns with mortality, cardiovascular events, or ESRD.

RESULTS: A total of seven studies involving 15,285 participants were included. Healthy dietary patterns were generally higher in fruit and vegetables, fish, legumes, cereals, whole grains, and fiber, and lower in red meat, salt, and refined sugars. In six studies, healthy dietary patterns were consistently associated with lower mortality (3983 events; adjusted relative risk, 0.73; 95% confidence interval, 0.63 to 0.83; risk difference of 46 fewer (29-63 fewer) events per 1000 people over 5 years). There was no statistically significant association between healthy dietary patterns and risk of ESRD (1027 events; adjusted relative risk, 1.04; 95% confidence interval, 0.68 to 1.40).

CONCLUSIONS: Healthy dietary patterns are associated with lower mortality in people with kidney disease. Interventions to support adherence to increased fruit and vegetable, fish, legume, whole grain, and fiber intake, and reduced red meat, sodium, and refined sugar intake could be effective tools to lower mortality in people with kidney disease.

Original languageEnglish
Pages (from-to)272-279
Number of pages8
JournalClinical journal of the American Society of Nephrology : CJASN
Volume12
Issue number2
DOIs
Publication statusPublished - 1 Jan 2017

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Chronic Kidney Failure
Meta-Analysis
Cohort Studies
Kidney Diseases
Mortality
Fabaceae
Vegetables
Fruit
Fishes
Confidence Intervals
Longitudinal Studies
Salts
Eating
Sodium
Food
Whole Grains
Red Meat

Cite this

Kelly, J. T., Palmer, S. C., Wai, S. N., Ruospo, M., Carrero, J-J., Campbell, K. L., & Strippoli, G. F. M. (2017). Healthy dietary patterns and risk of mortality and ESRD in CKD: A meta-analysis of cohort studies. Clinical journal of the American Society of Nephrology : CJASN, 12(2), 272-279. https://doi.org/10.2215/CJN.06190616
Kelly, Jaimon T ; Palmer, Suetonia C ; Wai, Shu Ning ; Ruospo, Marinella ; Carrero, Juan-Jesus ; Campbell, Katrina L ; Strippoli, Giovanni F M. / Healthy dietary patterns and risk of mortality and ESRD in CKD: A meta-analysis of cohort studies. In: Clinical journal of the American Society of Nephrology : CJASN. 2017 ; Vol. 12, No. 2. pp. 272-279.
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abstract = "BACKGROUND AND OBJECTIVES: Patients with CKD are advised to follow dietary recommendations that restrict individual nutrients. Emerging evidence indicates overall eating patterns may better predict clinical outcomes, however, current data on dietary patterns in kidney disease are limited.DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This systematic review aimed to evaluate the association between dietary patterns and mortality or ESRD among adults with CKD. Medline, Embase, and reference lists were systematically searched up to November 24, 2015 by two independent review authors. Eligible studies were longitudinal cohort studies reporting the association of dietary patterns with mortality, cardiovascular events, or ESRD.RESULTS: A total of seven studies involving 15,285 participants were included. Healthy dietary patterns were generally higher in fruit and vegetables, fish, legumes, cereals, whole grains, and fiber, and lower in red meat, salt, and refined sugars. In six studies, healthy dietary patterns were consistently associated with lower mortality (3983 events; adjusted relative risk, 0.73; 95{\%} confidence interval, 0.63 to 0.83; risk difference of 46 fewer (29-63 fewer) events per 1000 people over 5 years). There was no statistically significant association between healthy dietary patterns and risk of ESRD (1027 events; adjusted relative risk, 1.04; 95{\%} confidence interval, 0.68 to 1.40).CONCLUSIONS: Healthy dietary patterns are associated with lower mortality in people with kidney disease. Interventions to support adherence to increased fruit and vegetable, fish, legume, whole grain, and fiber intake, and reduced red meat, sodium, and refined sugar intake could be effective tools to lower mortality in people with kidney disease.",
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Healthy dietary patterns and risk of mortality and ESRD in CKD: A meta-analysis of cohort studies. / Kelly, Jaimon T; Palmer, Suetonia C; Wai, Shu Ning; Ruospo, Marinella; Carrero, Juan-Jesus; Campbell, Katrina L; Strippoli, Giovanni F M.

In: Clinical journal of the American Society of Nephrology : CJASN, Vol. 12, No. 2, 01.01.2017, p. 272-279.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Healthy dietary patterns and risk of mortality and ESRD in CKD: A meta-analysis of cohort studies

AU - Kelly, Jaimon T

AU - Palmer, Suetonia C

AU - Wai, Shu Ning

AU - Ruospo, Marinella

AU - Carrero, Juan-Jesus

AU - Campbell, Katrina L

AU - Strippoli, Giovanni F M

N1 - Copyright © 2016 by the American Society of Nephrology.

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Y1 - 2017/1/1

N2 - BACKGROUND AND OBJECTIVES: Patients with CKD are advised to follow dietary recommendations that restrict individual nutrients. Emerging evidence indicates overall eating patterns may better predict clinical outcomes, however, current data on dietary patterns in kidney disease are limited.DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This systematic review aimed to evaluate the association between dietary patterns and mortality or ESRD among adults with CKD. Medline, Embase, and reference lists were systematically searched up to November 24, 2015 by two independent review authors. Eligible studies were longitudinal cohort studies reporting the association of dietary patterns with mortality, cardiovascular events, or ESRD.RESULTS: A total of seven studies involving 15,285 participants were included. Healthy dietary patterns were generally higher in fruit and vegetables, fish, legumes, cereals, whole grains, and fiber, and lower in red meat, salt, and refined sugars. In six studies, healthy dietary patterns were consistently associated with lower mortality (3983 events; adjusted relative risk, 0.73; 95% confidence interval, 0.63 to 0.83; risk difference of 46 fewer (29-63 fewer) events per 1000 people over 5 years). There was no statistically significant association between healthy dietary patterns and risk of ESRD (1027 events; adjusted relative risk, 1.04; 95% confidence interval, 0.68 to 1.40).CONCLUSIONS: Healthy dietary patterns are associated with lower mortality in people with kidney disease. Interventions to support adherence to increased fruit and vegetable, fish, legume, whole grain, and fiber intake, and reduced red meat, sodium, and refined sugar intake could be effective tools to lower mortality in people with kidney disease.

AB - BACKGROUND AND OBJECTIVES: Patients with CKD are advised to follow dietary recommendations that restrict individual nutrients. Emerging evidence indicates overall eating patterns may better predict clinical outcomes, however, current data on dietary patterns in kidney disease are limited.DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This systematic review aimed to evaluate the association between dietary patterns and mortality or ESRD among adults with CKD. Medline, Embase, and reference lists were systematically searched up to November 24, 2015 by two independent review authors. Eligible studies were longitudinal cohort studies reporting the association of dietary patterns with mortality, cardiovascular events, or ESRD.RESULTS: A total of seven studies involving 15,285 participants were included. Healthy dietary patterns were generally higher in fruit and vegetables, fish, legumes, cereals, whole grains, and fiber, and lower in red meat, salt, and refined sugars. In six studies, healthy dietary patterns were consistently associated with lower mortality (3983 events; adjusted relative risk, 0.73; 95% confidence interval, 0.63 to 0.83; risk difference of 46 fewer (29-63 fewer) events per 1000 people over 5 years). There was no statistically significant association between healthy dietary patterns and risk of ESRD (1027 events; adjusted relative risk, 1.04; 95% confidence interval, 0.68 to 1.40).CONCLUSIONS: Healthy dietary patterns are associated with lower mortality in people with kidney disease. Interventions to support adherence to increased fruit and vegetable, fish, legume, whole grain, and fiber intake, and reduced red meat, sodium, and refined sugar intake could be effective tools to lower mortality in people with kidney disease.

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