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. 2019 Jun 4;8(6):793.
doi: 10.3390/jcm8060793.

Carbohydrate-Rich Diet Is Associated with Increased Risk of Incident Chronic Kidney Disease in Non-Diabetic Subjects

Ki Heon Nam  1   2 , Seong Yeong An  3 , Young Su Joo  4 , Sangmi Lee  5 , Hae-Ryong Yun  6 , Jong Hyun Jhee  7 , Seung Hyeok Han  8 , Tae-Hyun Yoo  9 , Shin-Wook Kang  10   11 , Jung Tak Park  12
Affiliations

Carbohydrate-Rich Diet Is Associated with Increased Risk of Incident Chronic Kidney Disease in Non-Diabetic Subjects

Ki Heon Nam et al. J Clin Med. .

Abstract

Despite the potential relationship with metabolic derangements, the association between dietary carbohydrate intake and renal function remains unknown. The present study investigated the impact of dietary carbohydrate intake on the development of incident chronic kidney disease (CKD) in a large-scale prospective cohort with normal renal function. A total of 6746 and 1058 subjects without and with diabetes mellitus (DM) were analyzed, respectively. Carbohydrate intake was assessed by a 24-h dietary recall food frequency questionnaire. The primary endpoint was CKD development, defined as a composite of estimated glomerular filtration rate (eGFR) of ≤60 mL/min/1.73 m2 and the development of proteinuria. CKD newly developed in 20.1% and 36.0% of subjects during median follow-ups of 140 and 119 months in the non-DM and DM subjects, respectively. Categorization of non-DM subjects into dietary carbohydrate density quartiles revealed a significantly higher risk of CKD development in the third and fourth quartiles than in the first quartile (P = 0.037 for first vs. third; P = 0.001 for first vs. fourth). A significant risk elevation was also found with increased carbohydrate density when carbohydrate density was treated as a continuous variable (P = 0.008). However, there was no significant difference in the incident CKD risk among those with DM according to dietary carbohydrate density quartiles. Carbohydrate-rich diets may increase the risk of CKD development in non-DM subjects.

Keywords: carbohydrate density; chronic kidney disease; dietary carbohydrate; renal nutrition.

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Conflict of interest statement

All the authors declared no competing interests

Figures

Figure 1
Figure 1
Flow diagram of the study cohort. (Abbreviation: eGFR, estimated glomerular filtration rate).
Figure 2
Figure 2
Changes of metabolic parameters according to dietary carbohydrate density in (A) non-DM and (B) DM subjects. (Abbreviations: SBP, systolic blood pressure; HOMA-IR, homeostasis model assessment of insulin resistance; HDL-C, high-density lipoprotein cholesterol; TG, triglyceride).
Figure 3
Figure 3
Cumulative curves of CKD-free survival according to dietary carbohydrate density in non-DM (A) and DM (B) subjects. (Abbreviations: CKD, chronic kidney disease; DM, diabetes mellitus).
See this image and copyright information in PMC

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