Many of the same healthy lifestyle options recommended for the prevention of cardiovascular disease (CVD) are also Chronic kidney disease (CKD), according to a new systematic review and meta-analysis in a healthy adult population.
“The evidence-based lifestyle recommendations for primary prevention of CKD have not been revealed so far,” said Jaimon Kelly, PhD, postdoctoral fellow, Griffith University, Southeast Queensland, Australia, and colleagues. I wrote in the article. Published online August 31 Journal of the American Society of Nephrology.
“We have discovered that lifestyle plays a major role and have identified some recommendations that can be passed on to healthy people who want to reduce their risk of developing chronic kidney disease,” Kelly said in a press release.
“We found that increased potassium and vegetable intake, decreased sodium intake, physical activity, moderate alcohol consumption, and avoidance of smoking were consistently associated with a reduced risk of CKD.” Emphasizes his colleague.
They calculate that adhering to these recommendations can reduce the risk of CKD by 14% to 22%.
“In the absence of a randomized intervention study in this area, this study is the best evidence we have ever of what lifestyle choices can help with primary prevention of kidney disease.” Said Dr. Juan Jesus Carrero, a senior author and professor of epidemiology. Faculty of Medical Epidemiology and Biostatistics, Karolinska Institute, Sweden.
“This result can be used to make public health recommendations and discuss with patients how to reduce the risk of kidney disease,” he added.
Researchers emphasize that this advice applies to healthy people at risk of developing kidney problems, and those who are already suffering from kidney disease avoid unnecessary strain on the kidneys according to other lifestyle recommendations. doing.
Survey on diet, physical activity, smoking, and alcohol consumption
Their study examined the association between lifestyle factors and the risk of CKD incidents in 51 studies of 1,221,018 adults who did not establish CKD at baseline.
“The main result was an incident CKD defined as a progression of estimated glomerular filtration rate (eGFR) <60 mL / min / 1.73 m.2 “Follow-up”, the investigator observes.
Thirty-one studies, including 176,625 participants, investigated the association between dietary factors and CKD risk, and 10 studies, including 78,301 participants, showed the effect of physical activity on endpoints of the same risk. Was evaluated.
The effect of alcohol intake on incident CKD was described in 14 studies involving 211,072 participants, and the effect of smoking on CKD risk was outlined in 12 studies involving 985,086 participants.
The lifestyle factors associated with CKD risk in adults are summarized below.
Table 1. Factors related to the risk of CKD in adults
| factor | Odds ratio |
|---|---|
| Increased vegetable intake | 0.79 |
| Higher potassium intake | 0.78 |
| Physical activity | 0.82 |
| Moderate alcohol intake | 0.87 |
| smoking | 1.18 |
| Higher sodium intake | 1.21 |
Marker of kidney damage
A meta-analysis also showed risk factors consistent with other markers of renal damage, including the need for renal replacement therapy (RRT), decreased eGFR, and risk of proteinuria.
For example, the risk of lowering eGFR was 51% lower in participants with high potassium intake (relative risk). [RR], 0.49), the author notes.
The higher the vegetable intake, the higher the potassium intake, and the latter “is associated with a reduced reduction in CKD and GFR in incidents, increasing the basis for a protective association of potassium intake,” they observe. ing.
“Similarly, higher sodium intake was consistently associated with an increased risk of lowering incident CKD, RRT, and GFR,” said Dr. Kelly and colleagues.
In addition, among those with active physical activity, the risk of lowering eGFR was 34% lower than those with low physical activity (OR, 0.76). Similarly, the risk of albuminuria was 12% lower among physically active adults (OR, 0.88).
This finding is consistent with the results of other studies and supports the idea that physical activity (defined as at least 30 minutes of physical activity per day) reduces the risk of kidney damage.
On the other hand, researchers point out that the inverse correlation between alcohol intake and risk of CKD, as well as the secondary endpoint of lowering RRT and eGFR, has been previously supported by multiple studies.
However, this association seems to apply only to moderate alcohol intake of 1 to 4 glasses per day, as high alcohol intake is thought to directly damage the kidneys.
Finally, the risk of RRT was 59% higher among current and previous smokers compared to nonsmokers (RR, 1.59), and the risk of albuminuria was among smokers with smokers. It was 67% higher than that (OR, 1.67).
“In summary, these risk factors for renal dysfunction clearly support the public health message to avoid smoking to prevent kidney disease and CVD,” Kelly and colleagues advise.
The study was unfunded. Kelly reports that he has received consulting fees from Amgen and HealthCert.
J Am Soc Nephrol. Published online on August 31, 2020. Overview
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