Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon; Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University.
Department of Internal Medicine, Hangang Sacred Heart Hospital, Hallym University, Seoul.
Am J Kidney Dis. 2019 Oct;74(4):491-500. doi: 10.1053/j.ajkd.2019.02.023. Epub 2019 Apr 27.
RATIONALE & OBJECTIVE: A diet rich in vegetables and fruit can lower blood pressure and may reduce cardiovascular risk. However, the association between this dietary pattern and incident chronic kidney disease in the general population is unknown.
A community-based prospective cohort study.
SETTING & PARTICIPANTS: 9,229 study participants with normal kidney function from the Korean Genome and Epidemiology Study database.
Daily consumption of nonfermented and fermented vegetables and fruit classified into tertiles based on a validated semiquantitative food-frequency questionnaire.
Incident occurrence of estimated glomerular filtration rate (eGFR) < 60mL/min/1.73m, incident proteinuria (≥1+ by dipstick test), and repeated measures of estimated net endogenous acid production.
Multivariable cause-specific hazards model to assess the association of vegetable and fruit intake with incident chronic kidney disease.
During a mean follow-up of 8.2 years, 1,741 (21.9/1,000 person-years [PY]) participants developed eGFRs < 60mL/min/1.73m. Incident eGFR < 60mL/min/1.73m occurred less frequently with higher intake of nonfermented vegetables, occurring at rates of 22.8/1,000 PY, 22.7/1,000 PY, and 20.1/1,000 PY for the lowest, middle, and highest tertiles, respectively; P for trend < 0.001. The incidence of proteinuria was also lower in the middle and highest tertiles. In a multivariable cause-specific hazards model, the highest tertile of nonfermented vegetable intake was associated with 14% lower risk for incident eGFR < 60mL/min/1.73m than the lowest tertile. The highest tertile was also associated with 32% lower risk for proteinuria than the lowest tertile. There were no associations of fermented vegetable and fruit intake with incidence of eGFR < 60mL/min/1.73m. However, the highest tertiles of both fermented vegetable and fruit intake were associated with 14% and 45% lower risks for incident proteinuria compared with the lowest tertiles (both P < 0.001). During follow-up, estimated net endogenous acid production increased in the lowest tertile of intake of nonfermented or fermented vegetables and fruit, whereas it decreased in the highest tertile.
Self-reported dietary intake, single ethnicity population.
A diet rich in vegetables and fruit may reduce the risk for kidney disease.
富含蔬菜和水果的饮食可以降低血压，降低心血管疾病风险。然而，一般人群中这种饮食模式与慢性肾脏病事件之间的关系尚不清楚。
基于人群的前瞻性队列研究。
韩国基因与流行病学研究数据库中 9229 名肾功能正常的研究参与者。
根据经过验证的半定量食物频率问卷，将非发酵和发酵蔬菜和水果的每日摄入量分为三分位数。
估计肾小球滤过率（eGFR）<60mL/min/1.73m、蛋白尿（尿试纸检测≥1+）和估计的净内源性酸产生的重复测量的发生。
多变量特定原因风险模型评估蔬菜和水果摄入与慢性肾脏病事件的关系。
在平均 8.2 年的随访期间，1741 名（21.9/1000 人年[PY]）参与者出现 eGFR<60mL/min/1.73m。随着非发酵蔬菜摄入量的增加，eGFR<60mL/min/1.73m 的发生率较低，发生率分别为 22.8/1000 PY、22.7/1000 PY 和 20.1/1000 PY，最低、中、最高三分位数；趋势 P<0.001。中间和最高三分位数的蛋白尿发生率也较低。在多变量特定原因风险模型中，与最低三分位数相比，非发酵蔬菜摄入量最高三分位数与 eGFR<60mL/min/1.73m 的发生率降低 14%相关。最高三分位数与最低三分位数相比，蛋白尿的风险也降低了 32%。发酵蔬菜和水果摄入量与 eGFR<60mL/min/1.73m 的发生率无关联。然而，与最低三分位数相比，发酵蔬菜和水果摄入量最高三分位数与蛋白尿发生率分别降低 14%和 45%（均 P<0.001）。在随访期间，非发酵或发酵蔬菜和水果摄入量最低三分位数的估计净内源性酸产生增加，而最高三分位数则减少。
自我报告的饮食摄入，单一种族人群。
富含蔬菜和水果的饮食可能降低肾脏病的风险。
