Dietary inflammatory index and the aging kidney in older women: a 10-year prospective cohort study
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ORIGINAL CONTRIBUTION
Dietary inflammatory index and the aging kidney in older women: a 10‑year prospective cohort study Nicola P. Bondonno1,2 · Lauren C. Blekkenhorst1,2 · Anna L. Bird3 · Joshua R. Lewis1,2,4 · Jonathan M. Hodgson1,2 · Nitin Shivappa5,6,7 · James R. Hébert5,6,7 · Richard J. Woodman8 · Germaine Wong4 · Deborah A. Kerr3 · Wai H. Lim2,9 · Richard L. Prince2,10 Received: 8 August 2019 / Accepted: 4 December 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Purpose Chronic inflammation plays a role in the pathogenesis of age-related renal disease and the diet can moderate systemic inflammation. The primary objective of this study was to examine the associations between a dietary inflammatory index (DII®) score and renal function, the trajectory of renal function decline, and renal disease-related hospitalizations and/ or mortality over 10 years. Methods The study was conducted in 1422 Western Australian women without prevalent chronic kidney disease and aged ≥ 70 years. Baseline dietary data, obtained from a validated food frequency questionnaire, were used to calculate a DII score for each individual. Results In this cohort, the mean [range] DII score was 0.19 [− 6.14 to 6.39]. A higher DII score was associated with poorer renal function at baseline and a greater renal function decline over 10 years; after multivariable adjustments, a one-unit higher DII score was associated with a 0.55 mL/min/1.73 m2 lower eGFR at baseline (p = 0.01) and a 0.06 mL/min/1.73 m2 greater annual decline in eGFR over 10 years (p = 0.05). Restricted cubic splines provide evidence of a non-linear association between baseline DII score and risk of a renal disease-related event. Compared to participants in the lowest quintile, those in the highest quintile of DII score were at a higher risk of experiencing a renal disease-related event (adjusted HR 2.06, 95% CI 0.97, 4.37). Conclusion Recommending an increased consumption of foods with a higher anti-inflammatory potential could form part of a multifaceted approach to reduce the risk of renal disease through diet and lifestyle changes. Keywords Dietary inflammatory index · Chronic kidney disease · Renal disease · Renal decline · Prospective cohort study
Introduction Chronic kidney disease (CKD) has emerged as a major public health concern and significant driver of healthcare expenditures [1, 2]. The incidence of CKD is steadily increasing, with a global prevalence of up to 13% [3]. Although a substantial proportion of older individuals in the general population have stage 2–3 CKD, individuals exhibiting a rapid decline in kidney function have the greatest risk of adverse health outcomes Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00394-019-02160-9) contains supplementary material, which is available to authorized users. * Nicola P. Bondonno [email protected]
[4]. It has been suggested that chronic inflammation may play a critical role in the pathogenesis of age-related CKD and/or kid
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