Vegan Diet Is Associated with a Lower Risk of Chronic Kidney Disease in Patients with Hyperuricemia

Abstract

Hyperuricemia is a well-known risk factor for chronic kidney disease (CKD). Little is known about whether a vegetarian diet is associated with a lower risk of CKD in patients with hyperuricemia. From 5 September 2005, to 31 December 2016, we retrospectively included clinically stable patients with hyperuricemia who received health check-ups at Taipei Tzu Chi Hospital. All participants completed a dietary habits questionnaire to determine whether they were omnivorous, lacto-ovo vegetarian, or vegan. CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m² or the presence of proteinuria. A total of 3618 patients with hyperuricemia were recruited for this cross-sectional study, consisting of 225 vegans, 509 lacto-ovo vegetarians, and 2884 omnivores. After adjusting for age and sex, vegans had a significantly lower odds ratio (OR) of CKD than omnivores (OR, 0.62; p = 0.006). The OR of CKD remained significantly lower in vegans after adjusting for additional confounders (OR, 0.69; p = 0.04). Additionally, age (per year OR, 1.06; p < 0.001), diabetes mellitus (OR, 2.12; p < 0.001), hypertension (OR, 1.73; p < 0.001), obesity (OR, 1.24; p = 0.02), smoking (OR, 2.05; p < 0.001), and very high uric acid levels (OR, 2.08; p < 0.001) were independent risk factors for CKD in patients with hyperuricemia. Moreover, structural equation modeling revealed that a vegan diet was associated with a lower OR of CKD (OR, 0.69; p < 0.05). A vegan diet is associated with a 31% lower risk of CKD in patients with hyperuricemia. A vegan diet may be beneficial in reducing the occurrence of CKD in patients with hyperuricemia.

Keywords: acid load; chronic kidney disease; hyperuricemia; plant-based diet; vegan diet; vegetarian diet.

Figure 1

CONSORT diagram of the study. From 5 September 2005, to 31 December 2016, 53,854 participants had a health check-up at Taipei Tzu Chi Hospital. We excluded participants younger than 40 years (n = 4086), participants without hyperuricemia or a diagnosis of gout (n = 33,105), participants with incorrect or incomplete identity information (n = 1944), and participants with missing biochemistry data (n = 1101). Finally, 3618 participants with hyperuricemia or gout entered the final analyses. CONSORT, consolidated standards of reporting trials.

Figure 2

The odds ratios of potential risk factors for CKD in the multilevel structural equation modeling. Odds ratios are shown near the lines indicating the association between the variables and outcome. Blue dotted lines indicate significantly reduced odds ratios. Red solid lines indicate significantly higher odds ratios. Grey solid or dotted lines indicate non-significant associations. BMI, body mass index. CKD, chronic kidney disease. * p value < 0.05. ** p value < 0.001.