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Abstract: TH-PO147

Fruit and Vegetable Consumption and Cardiovascular Mortality in Renal Transplant Recipients: A Prospective Cohort Study

Session Information

Category: Transplantation

  • 1802 Transplantation: Clinical

Authors

  • Sotomayor, Camilo G., University Medical Center Groningen, Groningen, Netherlands
  • Gomes Neto, Antonio, University Medical Center Groningen, Groningen, Netherlands
  • Eisenga, Michele F., University Medical Center Groningen, Groningen, Netherlands
  • Anderson, Josephine, University Medical Center Groningen, Groningen, Netherlands
  • Nolte, Ilja M., University Medical Center Groningen, Groningen, Netherlands
  • De Borst, Martin H., University Medical Center Groningen, Groningen, Netherlands
  • Osté, Maryse, University Medical Center Groningen, Groningen, Netherlands
  • Rodrigo, Ramon, Faculty of Medicine, University of Chile, Santiago, Chile
  • Gans, Reinold O.B., University Medical Center Groningen, Groningen, Netherlands
  • Berger, Stefan P., University Medical Center Groningen, Groningen, Netherlands
  • Bakker, Stephan J.L., University Medical Center Groningen, Groningen, Netherlands
Background

We investigated the associations of fruit and vegetable (F&V) consumption after kidney transplantation with risk of CV mortality in an extensively phenotyped cohort of renal transplant recipients (RTR) with long-term follow-up.

Methods

F&V consumption were assessed by means of an item-specific food-frequency questionnaire. Multivariable-adjusted Cox-proportional hazards regression analysis was performed to assess the risk of CV mortality.

Results

We included 400 RTR (age 52±12 (SD) years old, 54% males). At a median follow-up of 7.2 [interquartile range, 6.7-7.6] years, 93 (23%) patients died, of which 49 (53%) were due to CV disease. Overall, fruit consumption was not associated with CV mortality, whereas vegetable consumption was inversely associated with risk of CV mortality (Table 1). This association remained independent of adjustment for several potential confounders. The association of fruit consumption with CV mortality was significantly modified by renal function (Pint=0.01) and proteinuria (Pint=0.01), with significant inverse associations in patients with estimated Glomerular Filtration Rate (eGFR)>45 mL/min/1.73m2 (HR, 0.56; 95% CI, 0.35-0.92; P=0.02) or absence of proteinuria (HR, 0.62; 95% CI, 0.41-0.92; P=0.02).

Conclusion

In RTR, a relatively high vegetable consumption is independently and strongly associated with lower risk of premature CV mortality. A relatively high fruit consumption is also associated with lower risk of premature CV mortality, although particularly in RTR with eGFR>45 mL/min/1.73m2 or absence of proteinuria. Further studies are warranted to investigate whether increasing F&V consumption may open opportunities for interventional pathways to decrease the burden of CV mortality in RTR.

Table 1. Association of fruit and vegetable consumption with CV and all-cause mortality of RTR
OutcomeFruit consumption, servings/dayVegetable consumption, tablespoons/day
HR (95% CI)P valueHR (95% CI)P value
Cardiovascular mortality0.90 (0.64-1.27)0.550.50 (0.35-0.72)<0.001
All-cause mortality0.91 (0.71-1.16)0.450.73 (0.56-0.95)0.02

Hazard ratios are adjusted for age, sex, income, educational level, physical activity, eGFR, proteinuria, time since transplantation, primary renal disease, total cholesterol, blood pressure, BMI, diabetes and smoking status.

Funding

  • Government Support - Non-U.S.