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台湾肾移植受者的饮食质量指数与复发性慢性肾病

Dietary quality indices and recurrent chronic kidney disease in Taiwanese post-renal transplant recipients.

作者信息

Lin I-Hsin, Wong Te-Chih, Duong Tuyen Van, Nien Shih-Wei, Tseng I-Hsin, Wang Hsu-Han, Chiang Yang-Jen, Yang Shwu-Huey

机构信息

Department of Medical Nutrition Therapy, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.

School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan.

出版信息

Front Nutr. 2023 Jan 9;9:1023000. doi: 10.3389/fnut.2022.1023000. eCollection 2022.

Abstract

BACKGROUND

This study investigated the association between dietary quality indices and recurrent chronic kidney disease (rCKD) in Taiwanese post-renal transplant recipients (RTRs).

METHODS

This prospective study recruited RTRs aged >18 years with a functioning allograft and without any acute rejection in the past 3 months from September 2016 to June 2018. Dietary quality indices included the Alternative Healthy Eating Index (AHEI) and AHEI-2010, and the Taiwanese version of the AHEI (AHEI-Taiwan) was calculated using 3-day dietary records, and calculated scores were divided into quartiles. Laboratory data were collected from medical records. rCKD was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m. Logistic regression analysis was performed to analyze the associations.

RESULTS

This study included 102 RTRs. The RTRs with higher AHEI, AHEI-Taiwan, and AHEI-2010 scores were older and had higher eGFRs and lower odds of rCKD. As compared with the lowest quartile, patients with the highest quartiles of the AHEI [odds ratio (OR), 0.10; 95% confidence interval (95% CI): 0.02, 0.49; -trend = 0.004), AHEI-2010 (OR, 0.17; 95% CI: 0.04, 0.72; -trend = 0.016], and AHEI-Taiwan (OR, 0.13; 95% CI: 0.03-0.59; -trend = 0.008) had lower odds of rCKD, respectively. As compared with the lowest quartile, patients who consumed the highest quartiles of red and processed meat had 11.43 times higher odds of rCKD (OR, 11.43; 95% CI: 2.30-56.85; for trend <0.01).

CONCLUSION

Higher dietary quality indices are associated with lower odds of rCKD in Taiwanese RTRs. Particularly, a positive association between a higher intake of red meat and processed meat and higher odds of rCKD remained exists after transplantation in Taiwanese RTRs. Further dietary guidelines and individualized dietary education were necessary for RTRs to prevent graft function deterioration.

摘要

背景

本研究调查了台湾肾移植受者(RTRs)的饮食质量指数与复发性慢性肾脏病(rCKD)之间的关联。

方法

这项前瞻性研究招募了年龄大于18岁、移植肾功能正常且在2016年9月至2018年6月的过去3个月内无任何急性排斥反应的RTRs。饮食质量指数包括替代健康饮食指数(AHEI)和AHEI-2010,使用3天饮食记录计算台湾版AHEI(AHEI-Taiwan),计算得分分为四分位数。从病历中收集实验室数据。rCKD定义为估计肾小球滤过率(eGFR)<60 mL/min/1.73 m²。进行逻辑回归分析以分析关联。

结果

本研究纳入了102名RTRs。AHEI、AHEI-Taiwan和AHEI-2010得分较高的RTRs年龄较大,eGFR较高,rCKD几率较低。与最低四分位数相比,AHEI最高四分位数的患者[rCKD比值比(OR),0.10;95%置信区间(95%CI):0.02,0.49;-趋势 = 0.004]、AHEI-2010(OR,0.17;95%CI:0.04,0.72;-趋势 = 0.016)和AHEI-Taiwan(OR,0.13;95%CI:0.03 - 0.59;-趋势 = 0.008)的rCKD几率分别较低。与最低四分位数相比,食用红肉和加工肉最高四分位数的患者rCKD几率高11.43倍(OR,11.43;95%CI:2.30 - 56.85;趋势<0.01)。

结论

较高的饮食质量指数与台湾RTRs较低的rCKD几率相关。特别是,台湾RTRs移植后红肉和加工肉摄入量较高与rCKD几率较高之间仍存在正相关。需要进一步的饮食指南和个性化饮食教育来防止RTRs的移植肾功能恶化。

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本文引用的文献

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Dietary Nutrients and Cardiovascular Risk Factors among Renal Transplant Recipients.
Int J Environ Res Public Health. 2021 Aug 10;18(16):8448. doi: 10.3390/ijerph18168448.
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Healthful dietary patterns and risk of end-stage kidney disease: the Singapore Chinese Health Study.
Am J Clin Nutr. 2021 Mar 11;113(3):675-683. doi: 10.1093/ajcn/nqaa348.
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KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update.
Am J Kidney Dis. 2020 Sep;76(3 Suppl 1):S1-S107. doi: 10.1053/j.ajkd.2020.05.006.
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A Prospective Study of Dietary Meat Intake and Risk of Incident Chronic Kidney Disease.
J Ren Nutr. 2020 Mar;30(2):111-118. doi: 10.1053/j.jrn.2019.06.008. Epub 2019 Aug 14.
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Dietary Compliance Among Renal Transplant Recipients: A Single-Center Study in Taiwan.
Transplant Proc. 2019 Jun;51(5):1325-1330. doi: 10.1016/j.transproceed.2019.02.026. Epub 2019 May 2.
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A Diet Rich in Vegetables and Fruit and Incident CKD: A Community-Based Prospective Cohort Study.
Am J Kidney Dis. 2019 Oct;74(4):491-500. doi: 10.1053/j.ajkd.2019.02.023. Epub 2019 Apr 27.

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