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Meta-Analysis
. 2017 Feb 7;12(2):272-279.
doi: 10.2215/CJN.06190616. Epub 2016 Dec 8.

Healthy Dietary Patterns and Risk of Mortality and ESRD in CKD: A Meta-Analysis of Cohort Studies

Jaimon T Kelly  1 , Suetonia C Palmer  2 , Shu Ning Wai  1 , Marinella Ruospo  3   4 , Juan-Jesus Carrero  5 , Katrina L Campbell  1 , Giovanni F M Strippoli  4   6   7
Affiliations
Meta-Analysis

Healthy Dietary Patterns and Risk of Mortality and ESRD in CKD: A Meta-Analysis of Cohort Studies

Jaimon T Kelly et al. Clin J Am Soc Nephrol. .

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.

Keywords: Adult; Carbohydrates; Cohort Studies; Confidence Intervals; Dietary Fiber; Edible Grain; Fabaceae; Fruit; Humans; Kidney Failure, Chronic; Longitudinal Studies; Nutrition; Red Meat; Risk; Sodium; Vegetables; Whole Grains; chronic kidney disease; dialysis; diet; diet quality; dietary patterns; mortality.

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Figures

Figure 1.
Figure 1.
Flow chart describing process of study selection.
Figure 2.
Figure 2.
Risk of all-cause mortality associated with healthy dietary patterns among adults with CKD. 95% CI, 95% confidence interval.
Figure 3.
Figure 3.
Risk of ESRD associated with healthy dietary patterns among adults with CKD. 95% CI, 95% confidence interval.
See this image and copyright information in PMC

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