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. 2024 Jun;63(4):1373-1385.
doi: 10.1007/s00394-024-03355-5. Epub 2024 Mar 2.

Diet quality in relation to kidney function and its potential interaction with genetic risk of kidney disease among Dutch post-myocardial infarction patients

Anniek C van Westing  1 , Luc Heerkens  1 , Esther Cruijsen  1 , Trudy Voortman  2 , Johanna M Geleijnse  3
Affiliations

Diet quality in relation to kidney function and its potential interaction with genetic risk of kidney disease among Dutch post-myocardial infarction patients

Anniek C van Westing et al. Eur J Nutr. 2024 Jun.

Abstract

Purpose: We examined the relation between diet quality, its components and kidney function decline in post-myocardial infarction (MI) patients, and we explored differences by genetic risk of chronic kidney disease (CKD).

Methods: We analysed 2169 patients from the Alpha Omega Cohort (aged 60-80 years, 81% male). Dietary intake was assessed at baseline (2002-2006) using a validated food-frequency questionnaire and diet quality was defined using the Dutch Healthy Diet Cardiovascular Disease (DHD-CVD) index. We calculated 40-months change in estimated glomerular filtration rate (eGFR, mL/min per 1.73m2). We constructed a weighted genetic risk score (GRS) for CKD using 88 single nucleotide polymorphisms previously linked to CKD. Betas with 95%-confidence intervals (CIs) were obtained using multivariable linear regression models for the association between DHD-CVD index and its components and eGFR change, by GRS.

Results: The average DHD-CVD index was 79 (SD 15) points and annual eGFR decline was 1.71 (SD 3.86) mL/min per 1.73 m2. The DHD-CVD index was not associated with annual eGFR change (per 1-SD increment in adherence score: -0.09 [95% CI -0.26,0.08]). Results for adherence to guidelines for red meat showed less annual eGFR decline (per 1-SD: 0.21 [0.04,0.38]), whereas more annual eGFR decline was found for legumes and dairy (per 1-SD: -0.20legumes [-0.37,-0.04] and - 0.18dairy [-0.34,-0.01]). Generally similar results were obtained in strata of GRS.

Conclusion: The DHD-CVD index for overall adherence to Dutch dietary guidelines for CVD patients was not associated with kidney function decline after MI, irrespective of genetic CKD risk. The preferred dietary pattern for CKD prevention in CVD patients warrants further research.

Keywords: Cohort study; Coronary heart disease; DHD-CVD index; Estimated glomerular filtration rate; Nutrition.

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Conflict of interest statement

TV reports grants from Erasmus MC, Erasmus University, Delft University, The European Society for Clinical Nutrition and Metabolism, National Dairy Association, and European Union. JM Geleijnse reports grants from the Ministry of Health, Welfare and Sports in the Netherlands, and the European Union. EC and LH declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Continuous associations of the DHD-CVD index with differences in annual eGFR change in female (n = 417, panel A) and male (n = 1752, panel B) patients of the Alpha Omega Cohort. Solid lines represent beta coefficients and dashed lines represent 95% CIs. The histogram represents the distribution of the DHD-CVD score. Three-knot restricted cubic splines was used, with the median of tertile 1 (69 for women and 64 for men) as reference point. Betas were adjusted for age, education, energy intake, smoking status, physical activity, lipid-lowering medication use, and renin-angiotensin-aldosterone blockers. Abbreviations: eGFR, estimated glomerular filtration rate; CI, confidence interval; DHD-CVD index, Dutch Healthy Diet for cardiovascular disease patients
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