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Diet and Kidney Disease in High-Risk Individuals with Type 2 Diabetes

How does diet, alcohol consumption, and sodium intake affect incidence or progression of CKD in diabetic patients?…

The study recruited 6213 participants with type 2 diabetes and without macroalbuminuria from the Ongoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial (ONTARGET) from January 2002 to July 2003, with follow-up through January 2008. To assess the outcome, researcher defined chronic kidney disease as new microalbuminuria or macroalbuminuria or glomerular filtration rate decline of more than 5% per year or end stage kidney disease. They also used the modified Alternate Healthy Eating Index (mAHEI) to assess the diet.

After 5.5 year of prospective follow ups, 1,971 participants (31.7%) had developed CKD and 516 (8.3%) had passed away. The results have shown that participants with healthy diet in mAHEI score had a significant lower risk of CKD compare to least healthy diet (adjusted odds ratio [OR], 0.74; 95% CI, 0.64-0.84). Moreover, participants with healthy diet also had lower risk of mortality (OR 0.61; 95% CI, 0.48-0.78). Participants eating more than 3 servings of fruits per week had lower risk of developing CKD. Furthermore, moderate alcohol intake with median of five drinks a week can reduce the risk of CKD (OR 0.75; 95% CI, 0.65-0.87) and mortality (OR 0.69; 95% CI, 0.53-0.89). However, study showed no association between sodium intake and CKD progressions.

In conclusion, a healthy diet is important for patients with type 2 diabetes to prevent risk of incidence and progression of chronic kidney disease and overall diabetes complications. However, the researchers noted that this study is an observational study; it only showed the association and not causation between diet and progression of CKD among T2DM patients.

Dunkler D, Dehghan M, Teo KK,et al. Diet and Kidney Disease in High-Risk Individuals With Type 2 Diabetes Mellitus. JAMA Intern Med. 2013 Aug 12.