The Combined Effects of the Most Important Dietary Patterns on the Incidence and Prevalence of Chronic Renal Failure: Results from the US National Health and Nutrition Examination Survey and Mendelian Analyses

Abstract

Background: We aimed to comprehensively assess the relationship of specific dietary patterns and various nutrients with chronic kidney disease (CKD) and its progression. Methods: The observational study data were from the NHANES 2005–2020. We calculated four dietary pattern scores (healthy eating index 2020 (HEI-2020), dietary inflammatory index (DII), alternative mediterranean diet (aMed), and dietary approaches to stop hypertension (DASH)) and the intakes of various nutrients and defined CKD, CKD—very high risk, and kidney dialysis. Associations between dietary patterns and nutrients and disease were assessed by means of two logistic regression models. Two-sample MR was performed with various food and nutrients as the exposure and CKD, kidney dialysis as the outcome. Sensitivity analyses were conducted to verify the reliability of the results. Results: A total of 25,167 participants were included in the analyses, of whom 4161 had CKD. HEI-2020, aMed, and DASH were significantly negatively associated with CKD and CKD—very high risk at higher quartiles, while DII was significantly positively associated. A higher intake of vitamins and minerals may reduce the incidence and progression of CKD to varying degrees. The MR results, corrected for false discovery rates, showed that a higher sodium intake was associated with a higher prevalence of CKD (OR: 3.91, 95%CI: 2.55, 5.99). Conclusions: Adhering to the three dietary patterns of HEI-2020, aMed, and DASH and supplementing with vitamins and minerals benefits kidney health.