BACKGROUND AND OBJECTIVES: Despite improvement of short-term graft survival over recent years, long-term graft survival after kidney transplantation has not improved. Studies in the general population suggest the Mediterranean diet benefits kidney function preservation. We investigated whether adherence to the Mediterranean diet is associated with kidney outcomes in kidney transplant recipients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We included 632 adult kidney transplant recipients with a functioning graft for ≥1 year. Dietary intake was inquired using a 177-item validated food frequency questionnaire. Adherence to the Mediterranean diet was assessed using a nine-point Mediterranean Diet Score. Primary end point of the study was graft failure and secondary end points included kidney function decline (doubling of serum creatinine or graft failure) and graft loss (graft failure or death with a functioning graft). Cox regression analyses were used to prospectively study the associations of the Mediterranean Diet Score with study end points. RESULTS: During median follow-up of 5.4 (interquartile range, 4.9-6.0) years, 76 participants developed graft failure, 119 developed kidney function decline, and 181 developed graft loss. The Mediterranean Diet Score was inversely associated with all study end points (graft failure: hazard ratio [HR], 0.68; 95% confidence interval [95% CI], 0.50 to 0.91; kidney function decline: HR, 0.68; 95% CI, 0.55 to 0.85; and graft loss: HR, 0.74; 95% CI, 0.63 to 0.88 per two-point increase in Mediterranean Diet Score) independent of potential confounders. We identified 24-hour urinary protein excretion and time since transplantation to be an effect modifier, with stronger inverse associations between the Mediterranean Diet Score and kidney outcomes observed in participants with higher urinary protein excretion and participants transplanted more recently. CONCLUSIONS: Adherence to the Mediterranean diet is associated with better kidney function outcomes in kidney transplant recipients.
BACKGROUND AND OBJECTIVES: Despite improvement of short-term graft survival over recent years, long-term graft survival after kidney transplantation has not improved. Studies in the general population suggest the Mediterranean diet benefits kidney function preservation. We investigated whether adherence to the Mediterranean diet is associated with kidney outcomes in kidney transplant recipients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We included 632 adult kidney transplant recipients with a functioning graft for ≥1 year. Dietary intake was inquired using a 177-item validated food frequency questionnaire. Adherence to the Mediterranean diet was assessed using a nine-point Mediterranean Diet Score. Primary end point of the study was graft failure and secondary end points included kidney function decline (doubling of serum creatinine or graft failure) and graft loss (graft failure or death with a functioning graft). Cox regression analyses were used to prospectively study the associations of the Mediterranean Diet Score with study end points. RESULTS: During median follow-up of 5.4 (interquartile range, 4.9-6.0) years, 76 participants developed graft failure, 119 developed kidney function decline, and 181 developed graft loss. The Mediterranean Diet Score was inversely associated with all study end points (graft failure: hazard ratio [HR], 0.68; 95% confidence interval [95% CI], 0.50 to 0.91; kidney function decline: HR, 0.68; 95% CI, 0.55 to 0.85; and graft loss: HR, 0.74; 95% CI, 0.63 to 0.88 per two-point increase in Mediterranean Diet Score) independent of potential confounders. We identified 24-hour urinary protein excretion and time since transplantation to be an effect modifier, with stronger inverse associations between the Mediterranean Diet Score and kidney outcomes observed in participants with higher urinary protein excretion and participants transplanted more recently. CONCLUSIONS: Adherence to the Mediterranean diet is associated with better kidney function outcomes in kidney transplant recipients.
Authors: Teresa T Fung; Marjorie L McCullough; P K Newby; Joann E Manson; James B Meigs; Nader Rifai; Walter C Willett; Frank B Hu Journal: Am J Clin Nutr Date: 2005-07 Impact factor: 7.045
Authors: P Junchotikul; C Charoenthanakit; A Saiyud; W Parapiboon; A Ingsathit; S Jirasiritham; V Sumethkul Journal: Transplant Proc Date: 2015 Jul-Aug Impact factor: 1.066
Authors: Else van den Berg; Mariëlle F Engberink; Elizabeth J Brink; Marleen A van Baak; Michel M Joosten; Reinold O B Gans; Gerjan Navis; Stephan J L Bakker Journal: Clin J Am Soc Nephrol Date: 2012-08-30 Impact factor: 8.237
Authors: Emily A Hu; Lyn M Steffen; Morgan E Grams; Deidra C Crews; Josef Coresh; Lawrence J Appel; Casey M Rebholz Journal: Am J Clin Nutr Date: 2019-09-01 Impact factor: 7.045
Authors: Josipa Radić; Marijana Vučković; Andrea Gelemanović; Marija Roguljić; Josip Orešković; Katja Kovačević; Ela Kolak; Dora Bučan Nenadić; Mislav Radić Journal: Sci Rep Date: 2022-07-08 Impact factor: 4.996
Authors: Maryse C J Osté; Ming-Jie Duan; Antonio W Gomes-Neto; Petra C Vinke; Juan-Jesus Carrero; Carla Avesani; QingQing Cai; Louise H Dekker; Gerjan J Navis; Stephan J L Bakker; Eva Corpeleijn Journal: Am J Clin Nutr Date: 2022-06-07 Impact factor: 8.472
Authors: Camilo G Sotomayor; Dion Groothof; Joppe J Vodegel; Tomás A Gacitúa; António W Gomes-Neto; Maryse C J Osté; Robert A Pol; Catterina Ferreccio; Stefan P Berger; Guillermo Chong; Riemer H J A Slart; Ramón Rodrigo; Gerjan J Navis; Daan J Touw; Stephan J L Bakker Journal: J Clin Med Date: 2020-02-03 Impact factor: 4.241
Authors: Dora Bučan Nenadić; Josipa Radić; Ela Kolak; Marijana Vučković; Ivana Novak; Marija Selak; Mislav Radić Journal: Int J Environ Res Public Health Date: 2022-02-17 Impact factor: 3.390