Association of kidney function-related dietary pattern, weight status, and cardiovascular risk factors with severity of impaired kidney function in middle-aged and older adults with chronic kidney disease

a cross-sectional population study

Adi Lukas Kurniawan, Chien Yeh Hsu, Hsiao Hsien Rau, Li Yin Lin, Jane C.J. Chao

Research output: Contribution to journalArticle

Abstract

Background: Chronic Kidney Disease (CKD), characterized by impaired kidney function, affects over 1.5 million individuals in Taiwan. Cardiovascular disease (CVD) is commonly found in patients with CKD, and the increased prevalence of obesity can have some implications for the risk of both CKD and CVD. Since diet plays an important role in the development of obesity, CVD and CKD, our study was designed to investigate the association of kidney function-related dietary pattern with weight status, cardiovascular risk factors, and the severity of impaired kidney function in middle-aged and older adults in Taiwan. Methods: A total of 41,128 participants aged 40 to 95 years old with an estimated glomerular filtration rate (eGFR) less than 90 mL/min/1.73 m2 and proteinuria were recruited from Mei Jau Health Institute between 2008 and 2010. The kidney function-related dietary pattern was identified using reduced rank regression (RRR) and was known as high consumption of preserved or processed food, meat, organ meats, rice/flour products, and, low consumption of fruit, dark-colored vegetables, bread, and beans. A multivariable logistic regression analysis was used to identify the association of weight status and cardiovascular risk factors with moderately/severely impaired kidney function (eGFR < 60 mL/min/1.73 m2) and the association of dietary pattern with the outcomes aforementioned. Results: Moderately/severely impaired kidney function participants were heavier and had higher abnormality of cardiovascular risk factors compared with those with mildly impaired kidney function. Weight status (OR = 1.28, 95% CI 1.12-1.45, P < 0.001 for obesity) and cardiovascular risk factors (OR = 1.52, 95% CI 1.31-1.77, P < 0.001 for high total cholesterol/HDL-C ratio and OR = 1.56, 95% CI 1.41-1.72, P < 0.001 for hypercalcemia) were positively associated with increased risk of moderately/severely impaired kidney function. The kidney function-related dietary pattern was correlated with overweight or obese (OR = 2.07, 95% CI 1.89-2.27, P < 0.01) weight status, increased cardiovascular risk by 10-31%, and the risk of moderately/severely impaired kidney function (OR = 1.15, 95% CI 1.02-1.29, P < 0.05). Conclusions: The RRR-derived kidney function-related dietary pattern, characterized by high intake of processed and animal foods and low intake of plant foods, predicts the risks for developing cardiovascular disease and moderately/severely impaired kidney function among middle-aged and older adults.

Original languageEnglish
Article number27
JournalNutrition Journal
Volume18
Issue number1
DOIs
Publication statusPublished - Apr 22 2019

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Chronic Renal Insufficiency
Cross-Sectional Studies
Kidney
Weights and Measures
Population
Cardiovascular Diseases
Obesity
Glomerular Filtration Rate
Taiwan
Meat
Cardiovascular Abnormalities
Edible Plants
Bread
Hypercalcemia
Flour
Proteinuria
Vegetables
HDL Cholesterol
Fruit
Eating

Keywords

  • Cardiovascular risk factors
  • Dietary pattern
  • Kidney function
  • Reduced rank regression
  • Weight status

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

@article{70bcb903aba04191b4d5b1162c997f28,
title = "Association of kidney function-related dietary pattern, weight status, and cardiovascular risk factors with severity of impaired kidney function in middle-aged and older adults with chronic kidney disease: a cross-sectional population study",
abstract = "Background: Chronic Kidney Disease (CKD), characterized by impaired kidney function, affects over 1.5 million individuals in Taiwan. Cardiovascular disease (CVD) is commonly found in patients with CKD, and the increased prevalence of obesity can have some implications for the risk of both CKD and CVD. Since diet plays an important role in the development of obesity, CVD and CKD, our study was designed to investigate the association of kidney function-related dietary pattern with weight status, cardiovascular risk factors, and the severity of impaired kidney function in middle-aged and older adults in Taiwan. Methods: A total of 41,128 participants aged 40 to 95 years old with an estimated glomerular filtration rate (eGFR) less than 90 mL/min/1.73 m2 and proteinuria were recruited from Mei Jau Health Institute between 2008 and 2010. The kidney function-related dietary pattern was identified using reduced rank regression (RRR) and was known as high consumption of preserved or processed food, meat, organ meats, rice/flour products, and, low consumption of fruit, dark-colored vegetables, bread, and beans. A multivariable logistic regression analysis was used to identify the association of weight status and cardiovascular risk factors with moderately/severely impaired kidney function (eGFR < 60 mL/min/1.73 m2) and the association of dietary pattern with the outcomes aforementioned. Results: Moderately/severely impaired kidney function participants were heavier and had higher abnormality of cardiovascular risk factors compared with those with mildly impaired kidney function. Weight status (OR = 1.28, 95{\%} CI 1.12-1.45, P < 0.001 for obesity) and cardiovascular risk factors (OR = 1.52, 95{\%} CI 1.31-1.77, P < 0.001 for high total cholesterol/HDL-C ratio and OR = 1.56, 95{\%} CI 1.41-1.72, P < 0.001 for hypercalcemia) were positively associated with increased risk of moderately/severely impaired kidney function. The kidney function-related dietary pattern was correlated with overweight or obese (OR = 2.07, 95{\%} CI 1.89-2.27, P < 0.01) weight status, increased cardiovascular risk by 10-31{\%}, and the risk of moderately/severely impaired kidney function (OR = 1.15, 95{\%} CI 1.02-1.29, P < 0.05). Conclusions: The RRR-derived kidney function-related dietary pattern, characterized by high intake of processed and animal foods and low intake of plant foods, predicts the risks for developing cardiovascular disease and moderately/severely impaired kidney function among middle-aged and older adults.",
keywords = "Cardiovascular risk factors, Dietary pattern, Kidney function, Reduced rank regression, Weight status",
author = "Kurniawan, {Adi Lukas} and Hsu, {Chien Yeh} and Rau, {Hsiao Hsien} and Lin, {Li Yin} and Chao, {Jane C.J.}",
year = "2019",
month = "4",
day = "22",
doi = "10.1186/s12937-019-0452-4",
language = "English",
volume = "18",
journal = "Nutrition Journal",
issn = "1475-2891",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Association of kidney function-related dietary pattern, weight status, and cardiovascular risk factors with severity of impaired kidney function in middle-aged and older adults with chronic kidney disease

T2 - a cross-sectional population study

AU - Kurniawan, Adi Lukas

AU - Hsu, Chien Yeh

AU - Rau, Hsiao Hsien

AU - Lin, Li Yin

AU - Chao, Jane C.J.

PY - 2019/4/22

Y1 - 2019/4/22

N2 - Background: Chronic Kidney Disease (CKD), characterized by impaired kidney function, affects over 1.5 million individuals in Taiwan. Cardiovascular disease (CVD) is commonly found in patients with CKD, and the increased prevalence of obesity can have some implications for the risk of both CKD and CVD. Since diet plays an important role in the development of obesity, CVD and CKD, our study was designed to investigate the association of kidney function-related dietary pattern with weight status, cardiovascular risk factors, and the severity of impaired kidney function in middle-aged and older adults in Taiwan. Methods: A total of 41,128 participants aged 40 to 95 years old with an estimated glomerular filtration rate (eGFR) less than 90 mL/min/1.73 m2 and proteinuria were recruited from Mei Jau Health Institute between 2008 and 2010. The kidney function-related dietary pattern was identified using reduced rank regression (RRR) and was known as high consumption of preserved or processed food, meat, organ meats, rice/flour products, and, low consumption of fruit, dark-colored vegetables, bread, and beans. A multivariable logistic regression analysis was used to identify the association of weight status and cardiovascular risk factors with moderately/severely impaired kidney function (eGFR < 60 mL/min/1.73 m2) and the association of dietary pattern with the outcomes aforementioned. Results: Moderately/severely impaired kidney function participants were heavier and had higher abnormality of cardiovascular risk factors compared with those with mildly impaired kidney function. Weight status (OR = 1.28, 95% CI 1.12-1.45, P < 0.001 for obesity) and cardiovascular risk factors (OR = 1.52, 95% CI 1.31-1.77, P < 0.001 for high total cholesterol/HDL-C ratio and OR = 1.56, 95% CI 1.41-1.72, P < 0.001 for hypercalcemia) were positively associated with increased risk of moderately/severely impaired kidney function. The kidney function-related dietary pattern was correlated with overweight or obese (OR = 2.07, 95% CI 1.89-2.27, P < 0.01) weight status, increased cardiovascular risk by 10-31%, and the risk of moderately/severely impaired kidney function (OR = 1.15, 95% CI 1.02-1.29, P < 0.05). Conclusions: The RRR-derived kidney function-related dietary pattern, characterized by high intake of processed and animal foods and low intake of plant foods, predicts the risks for developing cardiovascular disease and moderately/severely impaired kidney function among middle-aged and older adults.

AB - Background: Chronic Kidney Disease (CKD), characterized by impaired kidney function, affects over 1.5 million individuals in Taiwan. Cardiovascular disease (CVD) is commonly found in patients with CKD, and the increased prevalence of obesity can have some implications for the risk of both CKD and CVD. Since diet plays an important role in the development of obesity, CVD and CKD, our study was designed to investigate the association of kidney function-related dietary pattern with weight status, cardiovascular risk factors, and the severity of impaired kidney function in middle-aged and older adults in Taiwan. Methods: A total of 41,128 participants aged 40 to 95 years old with an estimated glomerular filtration rate (eGFR) less than 90 mL/min/1.73 m2 and proteinuria were recruited from Mei Jau Health Institute between 2008 and 2010. The kidney function-related dietary pattern was identified using reduced rank regression (RRR) and was known as high consumption of preserved or processed food, meat, organ meats, rice/flour products, and, low consumption of fruit, dark-colored vegetables, bread, and beans. A multivariable logistic regression analysis was used to identify the association of weight status and cardiovascular risk factors with moderately/severely impaired kidney function (eGFR < 60 mL/min/1.73 m2) and the association of dietary pattern with the outcomes aforementioned. Results: Moderately/severely impaired kidney function participants were heavier and had higher abnormality of cardiovascular risk factors compared with those with mildly impaired kidney function. Weight status (OR = 1.28, 95% CI 1.12-1.45, P < 0.001 for obesity) and cardiovascular risk factors (OR = 1.52, 95% CI 1.31-1.77, P < 0.001 for high total cholesterol/HDL-C ratio and OR = 1.56, 95% CI 1.41-1.72, P < 0.001 for hypercalcemia) were positively associated with increased risk of moderately/severely impaired kidney function. The kidney function-related dietary pattern was correlated with overweight or obese (OR = 2.07, 95% CI 1.89-2.27, P < 0.01) weight status, increased cardiovascular risk by 10-31%, and the risk of moderately/severely impaired kidney function (OR = 1.15, 95% CI 1.02-1.29, P < 0.05). Conclusions: The RRR-derived kidney function-related dietary pattern, characterized by high intake of processed and animal foods and low intake of plant foods, predicts the risks for developing cardiovascular disease and moderately/severely impaired kidney function among middle-aged and older adults.

KW - Cardiovascular risk factors

KW - Dietary pattern

KW - Kidney function

KW - Reduced rank regression

KW - Weight status

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U2 - 10.1186/s12937-019-0452-4

DO - 10.1186/s12937-019-0452-4

M3 - Article

VL - 18

JO - Nutrition Journal

JF - Nutrition Journal

SN - 1475-2891

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M1 - 27

ER -