The association between a Mediterranean-style diet and kidney function in the Northern Manhattan Study cohort

Clin J Am Soc Nephrol. 2014 Nov 7;9(11):1868-75. doi: 10.2215/CJN.01080114. Epub 2014 Oct 30.

Abstract

Background and objectives: Various dietary strategies have been investigated to slow kidney function decline. However, it is unknown whether a Mediterranean diet, which has been associated with improved cardiovascular risk, is associated with change in kidney function.

Design, setting, participants, & measurements: This study used the Northern Manhattan Study, a prospective, multiethnic, observational cohort of participants who were stroke free at baseline. Data were collected between 1993 and 2008. Serum creatinine measurements were taken a mean 6.9 years apart. A baseline dietary questionnaire was extrapolated into a previously used 9-point scoring system (MeDi). The primary outcome was incident eGFR<60 ml/min per 1.73 m(2)using the Modification of Diet in Renal Disease formula. A secondary outcome was the upper quartile of annualized eGFR decline (≥ 2.5 ml/min per 1.73 m(2) per year). Conditional logistic regression models adjusted for demographics and baseline vascular risk factors.

Results: Mean baseline age was 64 years, with 59% women and 65% Hispanics (N=900); mean baseline eGFR was 83.1 ml/min per 1.73 m(2). Incident eGFR<60 ml/min per 1.73 m(2) developed in 14% . In adjusted models, every 1-point increase in the MeDi score, indicating increasing adherence to a Mediterranean diet, was associated with decreased odds of incident eGFR<60 ml/min per 1.73 m(2) (odds ratio, 0.83; 95% confidence interval, 0.71 to 0.96) and decreased odds of being in the upper quartile of eGFR decline (odds ratio, 0.88; 95% confidence interval, 0.79 to 0.98).

Conclusions: A Mediterranean diet was associated with a reduced incidence of eGFR<60 ml/min per 1.73 m(2) and upper quartile of eGFR decline in a multiethnic cohort.

Keywords: CKD; nutrition; progression of chronic renal failure.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Angiotensin Receptor Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Creatinine / blood
  • Diabetes Mellitus / epidemiology
  • Diet Surveys
  • Diet, Mediterranean*
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • Incidence
  • Kidney / physiology*
  • Male
  • Middle Aged
  • New York City
  • Patient Compliance
  • Prospective Studies
  • Renal Insufficiency / epidemiology*
  • Renal Insufficiency / physiopathology*
  • Risk Factors
  • Vegetables

Substances

  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Creatinine