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Abstract: PO2026

Mediterranean Diet and the Risk of CKD: A Systematic Review and Meta-Analysis

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Hansrivijit, Panupong, UPMC Pinnacle, Harrisburg, Pennsylvania, United States
  • Oli, Sharad, Maimonides Medical Center, Brooklyn, New York, United States
  • Khanal, Resha, UPMC Pinnacle, Harrisburg, Pennsylvania, United States
  • Ghahramani, Nasrollah, Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Thongprayoon, Charat, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Cheungpasitporn, Wisit, University of Mississippi Medical Center, Jackson, Mississippi, United States
Background

Mediterranean diet has been shown to be associated with lower risk for cardiovascular disease. However, its association with chronic kidney disease (CKD) remains inconclusive as the results were not consistent among population-based studies. Thus, this study aims to assess the association between Mediterranean diet adherence and CKD prevention.

Methods

Ovid MEDLINE, EMBASE, and the Cochrane Library were searched from database inception to March 2020 without language restrictions. We included studies describing the risk for CKD in community-dwelling subjects > 18 years of age. CKD was defined by eGFR < 60 mL/min/1.73m2. Mediterranean diet adherence was assessed by standardized food frequency questionnaires. Meta-analysis and meta-regression analysis were used to evaluate the risk of CKD and the association between clinical factors and incidence of CKD, respectively.

Results

Of 168 citations, a total of ten (n = 19,151) and five studies (n = 9,099) were included in the systematic review and meta-analysis, respectively. Only studies adopting Mediterranean Diet Scale (MDS) were included in the meta-analysis. The mean score was 4.0 ± 0.1 points. The mean age was 53.1 ± 8.2 years. The mean eGFR was 77.3 ± 29.6 mL/min/1.73m2. The average total daily energy intake was 1,989.4 ± 258.0 kilocalories per day. Up to 50.4% were male, 7.1% were black, and 14.9% had a history of diabetes mellitus. With the mean follow-up duration of 11.5 ± 9.5 years, the pooled adjusted odds ratio (OR) for CKD was 0.897 (95% CI, 0.865-0.930; I2 26.5%). By excluding kidney transplant patients, the pooled adjusted OR for CKD was 0.901 (95% CI, 0.868-0.935; I2 9.4%). Both findings remained significant on sensitivity analysis. No publication bias was detected. The incidence of CKD was 0.028 events per person-year (95% CI, 0.012-0.044). From meta-regression analysis, male sex was associated with higher incidence of CKD in an adjusted model. There was no significant association between age, black race, eGFR, and total daily energy intake vs. CKD incidence.

Conclusion

Adherence to Mediterranean diet by a 1-point increment of MDS was associated with 10% lower risk of CKD. However, this only applies to healthy individual without a history of pre-existing CKD, whether Mediterranean diet slows CKD progression is to be discovered.