Dairy products and kidney function decline after myocardial infarction: A prospective analysis in the Alpha Omega Cohort

Abstract

Background & aims: Population-based studies have shown both beneficial and neutral associations between dairy consumption and kidney function outcomes. We investigated the association between dairy products and kidney function decline in drug-treated post-myocardial infarction (MI) patients.

Methods: We analysed data of 2169 post-MI patients (aged 60-80 years, 81% male) of the Alpha Omega Cohort. Dietary data were collected at baseline (2002-2006) using a validated 203-item food frequency questionnaire. The 2021 Chronic Kidney Disease Epidemiology (CKD-EPI) equation was used to estimate 40-months change in creatinine-cystatin C based glomerular filtration rate (eGFR_cr-cysC, mL/min per 1.73 m²). Beta coefficients and 95% confidence intervals (CIs) for dairy products in relation to annual eGFR_cr-cysC change were obtained from multivariable linear regression, adjusted for age, sex, energy intake, and other lifestyle and dietary factors.

Results: Baseline energy-adjusted median intakes were 64 g/day for total milk, 20 g/day for hard cheeses, 18 g/day for plain yogurt, and 70 g/day for dairy desserts. Mean ± SD eGFR_cr-cysC was 84 ± 20 (13% with CKD), and annual eGFR_cr-cysC change was -1.71 ± 3.85. In multivariable models, high vs. low intakes of total milk, cheese, and dairy desserts were not associated with annual eGFR_cr-cysC change (β_{total milk}: -0.21 [-0.60; 0.19], β_cheese: -0.08 [-0.52; 0.36], β_{dairy desserts}: -0.24 [-0.72; 0.24]). High vs. low intake of yogurt was adversely associated with annual eGFR_cr-cysC change (β_{total yogurt}: -0.50 [-0.91;-0.09]), but subsequent spline analyses showed no clear dose-response association.

Conclusions: Intakes of milk, cheese or dairy desserts were not associated with a delayed kidney function decline after MI. The observed adverse association for yogurt should be interpreted with caution. Our findings require confirmation in other cohorts of coronary heart disease patients.

Keywords: CKD; Cohort study; Dairy; Kidney function; Milk; eGFR.