Vegetable- and fruit-rich diet may protect against kidney disease

Individuals who adopt a diet rich in vegetables and fruits appear to have a lower risk of developing kidney disease, a study suggests.

The community-based prospective cohort study used data from the Korean Genome and Epidemiology Study database and included 9,229 participants (mean age, 52.0 years; 48.1 percent male) with normal kidney function. Researchers measured daily consumption of nonfermented and fermented vegetables and fruit classified into tertiles based on a validated semiquantitative food-frequency questionnaire.

A total of 1,741 participants developed estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² (21.9/1,000 person-years [PY]) and 1,476 developed proteinuria (22.1/1,000 PY) over a mean follow-up of 8.2 years.

The frequency of incident eGFR <60 mL/min/1.73 m² was lower in the group of participants with higher intake of nonfermented vegetables. The rates were 22.8, 22.7 and 20.1 per 1,000 PY for the lowest, middle and highest intake tertiles (p-trend<0.001), respectively. The same trend was observed for the incidence of proteinuria.

Multivariable cause-specific hazards model revealed that the highest vs lowest intake tertile of nonfermented vegetable conferred a 14-percent lower risk of incident eGFR <60 mL/min/1.73 m² and a 32-percent lower risk of proteinuria.

No associations emerged for fermented vegetable and fruit intake with incidence of eGFR <60 mL/min/1.73 m². However, the highest vs the lowest tertiles of both fermented vegetable and fruit intake were associated with reductions of 14 percent and 45 percent in the risk of incident proteinuria (p-both<0.001).

Finally, estimated net endogenous acid production during follow-up increased in the lowest intake tertile of nonfermented or fermented vegetables and fruit but dropped in the highest tertile.

The study was limited by self-reported dietary intake and single ethnicity population.