Kidney Week

Abstract: SA-PO0888

Planetary Health Diet Index and the Risk of CKD Progression and All-Cause Mortality Among West Africans: Results from the Diet, CKD, and Apolipoprotein L1 Study

Session Information

• Health Maintenance, Nutrition, and Metabolism
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1500 Health Maintenance, Nutrition, and Metabolism

Authors

• Omotoso, Bolanle Aderonke, Obafemi Awolowo University College of Health Sciences, Ife, Osun, Nigeria

Bolanle Aderonke Omotoso, MD, MS

• Lu, Minxin, Boston University, Boston, Massachusetts, United States

Minxin Lu, PhD

• Neupane, Raghavee, Boston University, Boston, Massachusetts, United States

Raghavee Neupane, MPH

• Zhao, Runqi, Boston University, Boston, Massachusetts, United States

Runqi Zhao, MS

• Raji, Yemi R., University of Ibadan, Ibadan, Oyo, Nigeria

Yemi R. Raji, MBChB

• Solarin, Adaobi, Lagos State University College of Medicine, Ojo, Lagos, Nigeria

Adaobi Solarin, MBBS

• Umeizudike, Theophilus I., Lagos State University College of Medicine, Ojo, Lagos, Nigeria

Theophilus I. Umeizudike, MBBS, MSc

• Kwakyi, Edward Papa Kwabena, Korle Bu Teaching Hospital, Accra, Greater Accra Region, Ghana

Edward Papa Kwabena Kwakyi, MD, FASN

• Olokode, Bola Fatima, Human Hereditary and Health in Africa Kidney Disease Network, Lagos, Nigeria

Bola Fatima Olokode, MSc, RDN

• Amira, Christiana Oluwatoyin, University of Abuja, Abuja, FCT, Nigeria

Christiana Oluwatoyin Amira, MD

• Ripiye, Nanna R., University of Abuja, Abuja, FCT, Nigeria

Nanna R. Ripiye, MBBS

• Mamven, Manmak, University of Abuja, Abuja, FCT, Nigeria

Manmak Mamven, MBBS

• Ulasi, Ifeoma I., College of Medicine, University of Nigeria Nsukka, Enugu, Nigeria

Ifeoma I. Ulasi, MBBS, MS, MSc

• Mitchell, Diane C., Texas A&M AgriLife Research, Texas, Texas, United States

Diane C. Mitchell, MS, RD

• Arogundade, Fatiu Abiola, Obafemi Awolowo University College of Health Sciences, Ife, Osun, Nigeria

Fatiu Abiola Arogundade, MD

• Salako, Babatunde L., University College Hospital Ibadan, Ibadan, Oyo, Nigeria

Babatunde L. Salako, MBBS

• Gbadegesin, Rasheed A., Duke University Medical Center, Durham, North Carolina, United States

Rasheed A. Gbadegesin, MD, MBBS, FASN

• Parekh, Rulan S., Woman's College Hospital, Toronto, Ontario, Canada

Rulan S. Parekh, MD, MS, FASN

• Dupuis, Josée, Boston University School of Public Health, Boston, Massachusetts, United States

Josée Dupuis, MSc, PhD

• Adu, Dwomoa, University of Ghana, Accra, Greater Accra Region, Ghana

Dwomoa Adu, MD

• Ojo, Akinlolu, The University of Kansas Medical Center, Kansas City, Kansas, United States

Akinlolu Ojo, MD, PhD, MBA, MPH, FASN

• Waikar, Sushrut S., Boston Medical Center, Boston, Massachusetts, United States

Sushrut S. Waikar, MD, MPH

• Anderson, Cheryl A., University of California San Diego, La Jolla, California, United States

Cheryl A. Anderson, PhD, MPH

• Ilori, Titilayo O., Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, United States

Titilayo O. Ilori, MD, MS, MSc, FASN

Background

The Planetary Health Diet Index (PHDI) may influence disease outcomes, yet evidence from Africans with chronic kidney disease (CKD) remains limited. This study examined the association between adherence to the planetary health diet and the risks of CKD progression and all-cause mortality among adults enrolled in the Diet, CKD, and Apolipoprotein L1 (DCA) study. The DCA study is a prospective cohort and ancillary study to the Human Hereditary and Health (H3) in Africa Kidney Disease study.

Methods

We conducted a prospective cohort analysis of 426 African adults with established CKD participating in the DCA Study. Dietary intake was assessed at baseline using 24-hour dietary recalls and converted into PHDI scores reflecting adherence to the EAT-Lancet dietary recommendations. Outcomes included CKD progression defined as ≥40% decline in eGFR from baseline or initiation of dialysis and the composite endpoint of CKD progression, dialysis, and all-cause mortality. The study used Cox proportional hazards models to estimate hazard ratios (HRs) for the association between PHDI quartiles and CKD progression, adjusting for sociodemographic, clinical laboratory, APOL1, and lifestyle covariates.

Results

We analyzed 426 participants with a mean age of 49 (±17) years and a mean eGFR of 73 (±36) mL/min per 1.73 m2 CKD progression event rate decreased across higher PHDI quintiles (Q1–Q5: 31, 28, 19, 16, and 19 events). Compared with the lowest quintile (Q1), unadjusted analyses showed a significantly reduced risk of CKD progression in middle-higher quintiles Q3 (HR = 0.53; 95% CI: 0.30–0.95), Q4 (HR = 0.48; 95% CI: 0.26–0.87), and Q5 (HR = 0.56; 95% CI: 0.32-0.99). After multivariable adjustment, participants in Q4 vs. Q1 retained a significantly lower risk of CKD progression (HR = 0.50; 95% CI: 0.26–0.98) (Table 1).
With the composite endpoint of CKD progression and death, we found that adherence to PHDI was not significantly associated with the composite endpoint after adjusting for covariates.

Conclusion

Moderately high adherence to the Planetary Health Diet may be associated with lower risk of CKD progression among Africans with CKD.

Funding

• NIDDK Support