Mediterranean diet and the risk of chronic kidney disease: A systematic review and meta‐analysis
Abstract
Objective: Mediterranean diet has been shown to be associated with lower risk of cardiovascular disease. However, its association with chronic kidney disease (CKD) remains inconclusive as the results were not consistent among population‐based studies. This study aims to assess the association between Mediterranean diet adherence and CKD prevention. Methods: We performed a systematic review and meta‐analysis of studies describing the risk for CKD in community‐dwelling subjects ≥18 years of age. Mediterranean diet adherence was assessed by standardized food frequency questionnaires. The search was conducted through MEDLINE, EMBASE and Cochrane Library. Results: Of 168 citations, a total of nine (n = 19 151) and four studies (n = 8467) were included in the systematic review and meta‐analysis, respectively. Only studies adopting Mediterranean Diet Scale (MDS) were included in the analysis. The mean score was 3.8 ± 0.3 points. With the mean follow‐up duration of 20.6 ± 7.0 years, the pooled odds ratio (OR) for CKD was 0.901 (95% confidence interval [CI] 0.868‐0.935) for each 1‐point increment of MDS. The incidence of CKD was 0.026 events per person‐year (95% CI 0.008‐0.045). Moreover, male sex was associated with the incidence of CKD in an adjusted meta‐regression analysis. In contrast, there was no significant association between age, black race, smoking, diabetes, hypertension estimated glomerular filtration rate and total daily energy intake vs CKD incidence. Conclusion: Adherence to Mediterranean diet by a 1‐point increment of MDS was associated with 10% lower risk of CKD. However, there were insufficient data on patients with pre‐existing CKD or dialysis.
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Increases in Mediterranean diet score by 1 point were associated with 10% lower risk of chronic kidney disease.
“Of note, increases in MD score by 1-point were associated with 10% lower risk of CKD (mean follow-up 20.6 ± 7.0 years) as shown in a meta-analysis (13 studies, n = 27,618 individuals) [67].”
From Mediterranean Diet and Obesity-related Disorders: What is the Evidence? (2022) · cites this paper as [67]
Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823 · see citing works
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000097 · Cited by 64,042 · see citing works
Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & the PRISMA Group* (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00135 · Cited by 37,554 · see citing works
Quantifying heterogeneity in a meta‐analysis
Higgins, J. P. T., & Thompson, S. G. (2002) · Statistics in Medicine · doi:10.1002/sim.1186 · Cited by 36,763 · see citing works
Stroup, D. F. (2000) · JAMA · doi:10.1001/jama.283.15.2008 · Cited by 20,623 · see citing works
ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions
Sterne, J. A., Hernán, M. A., Reeves, B. C., Savović, J., Berkman, N. D., Viswanathan, M., Henry, D., Altman, D. G., Ansari, M. T., Boutron, I., et al. (2016) · BMJ · doi:10.1136/bmj.i4919 · Cited by 20,329 · see citing works
Adherence to a Mediterranean diet and survival in a Greek population
Trichopoulou, A., Costacou, T., Bamia, C., & Trichopoulos, D. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa025039 · Cited by 4,397 · see citing works
Ludwig (2002) · doi:10.1001/jama.287.18.2414 · Cited by 1,775 · see citing works
Schröder, H., Fitó, M., Estruch, R., Martínez-González, M. A., Corella, D., Salas-Salvadó, J., Lamuela-Raventós, R., Ros, E., Salaverría, I., Fiol, M., et al. (2011) · The Journal of Nutrition · doi:10.3945/jn.110.135566 · Cited by 1,624 · see citing works
Panagiotakos, D. B., Pitsavos, C. E., & Stefanadis, C. (2006) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2005.08.006 · Cited by 993 · see citing works
Panagiotakos, D. B., Pitsavos, C., Arvaniti, F., & Stefanadis, C. (2006) · Preventive Medicine · doi:10.1016/j.ypmed.2006.12.009 · Cited by 636 · see citing works
Healthy Traditional Mediterranean Diet: An Expression of Culture, History, and Lifestyle
Trichopoulou, A., & Λάγιου, Π. (2009) · Nutrition Reviews · doi:10.1111/j.1753-4887.1997.tb01578.x · Cited by 614 · see citing works
Raj Krishnamurthy, V. M., Wei, G., Baird, B. C., Murtaugh, M., Chonchol, M. B., Raphael, K. L., Greene, T., & Beddhu, S. (2012) · Kidney International · doi:10.1038/ki.2011.355 · Cited by 409 · see citing works
Li, Y. J., Chen, X., Kwan, T., Loh, Y. W., Singer, J., Liu, Y., Ma, J., Tan, J., Macia, L., Mackay, C. R., et al. (2020) · Journal of the American Society of Nephrology · doi:10.1681/asn.2019101029 · Cited by 369 · see citing works
Katsouyanni, K. (1997) · International Journal of Epidemiology · doi:10.1093/ije/26.suppl_1.s118 · Cited by 347 · see citing works
Tektonidis, T. G., Åkesson, A., Gigante, B., Wolk, A., & Larsson, S. C. (2015) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2015.08.039 · Cited by 216 · see citing works
Taler, S. J., Agarwal, R., Bakris, G. L., Flynn, J. T., Nilsson, P. M., Rahman, M., Sanders, P. W., Textor, S. C., Weir, M. R., & Townsend, R. R. (2013) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2013.03.018 · Cited by 197 · see citing works
Mediterranean Diet, Kidney Function, and Mortality in Men with CKD
Huang, X., Jiménez‐Moleón, J. J., Lindholm, B., Cederholm, T., Ärnlöv, J., Risérus, U., Sjögren, P., & Carrero, J. J. (2013) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.01780213 · Cited by 167 · see citing works
Mediterranean diet as the diet of choice for patients with chronic kidney disease
Chauveau, P., Aparicio, M., Bellizzi, V., Campbell, K., Hong, X., Johansson, L., Kolko, A., Molina, P., Sezer, S., Wanner, C., et al. (2018) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfx085 · Cited by 165 · see citing works
Epidemiological support for the protection of whole grains against diabetes
Murtaugh, M. A., Jacobs, D. R., Jacob, B., Steffen, L. M., & Marquart, L. F. (2003) · Proceedings of The Nutrition Society · doi:10.1079/pns2002223 · Cited by 160 · see citing works
Khatri, M., Moon, Y. P., Scarmeas, N., Gu, Y., Gardener, H. E., Cheung, K., Wright, C. B., Sacco, R. L., Nickolas, T. L., & Elkind, M. S. V. (2014) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.01080114 · Cited by 152 · see citing works
Dietary Fiber, Kidney Function, Inflammation, and Mortality Risk
Xu, H., Huang, X., Risérus, U., Krishnamurthy, V. M. R., Cederholm, T., Ärnlöv, J., Lindholm, B., Sjögren, P., & Carrero, J. J. (2014) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.02260314 · Cited by 132 · see citing works
Urpí-Sardà, M., Casas, R. M., Chiva‐Blanch, G., Romero-Mamani, E.-S., Valderas-Martínez, P., Salas‐Salvadó, J., Covas, C., Toledo, E., Andrés‐Lacueva, C., Llorach, R., et al. (2012) · Journal of Nutrition · doi:10.3945/jn.111.148726 · Cited by 111 · see citing works
Alcohol consumption is inversely associated with the risk of developing chronic kidney disease
Koning, S. H., Gansevoort, R. T., Mukamal, K. J., Rimm, E. B., Bakker, S. J. L., & Joosten, M. M. (2015) · Kidney International · doi:10.1038/ki.2014.414 · Cited by 109 · see citing works
Alkerwi, A., Vernier, C., Crichton, G. E., Sauvageot, N., Shivappa, N., & Hébert, J. R. (2014) · British Journal Of Nutrition · doi:10.1017/s0007114514003456 · Cited by 97 · see citing works
Hu, E. A., Steffen, L. M., Grams, M. E., Crews, D. C., Coresh, J., Appel, L. J., & Rebholz, C. M. (2019) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/nqz146 · Cited by 89 · see citing works
Asghari, G., Farhadnejad, H., Mirmiran, P., Dizavi, A., Yuzbashian, E., & Azizi, F. (2016) · Hypertension Research · doi:10.1038/hr.2016.98 · Cited by 86 · see citing works
Chrysohoou, C. A., Panagiotakos, D. B., Pitsavos, C. E., Skoumas, J., Zeimbekis, A., Kastorini, C.-M., & Stefanadis, C. (2009) · Journal of Renal Nutrition · doi:10.1053/j.jrn.2009.08.006 · Cited by 77 · see citing works
Effects of Mediterranean Diets on Kidney Function: A Report From the PREDIMED Trial
Díaz‐López, A., Bulló, M., Martínez‐González, M. Á., Guasch‐Ferré, M., Ros, E., Basora, J., Covas, M., López‐Sabater, M. C., & Salas‐Salvadó, J. (2012) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2012.02.334 · Cited by 74 · see citing works
Mediterranean Style Diet and Kidney Function Loss in Kidney Transplant Recipients.
Gomes-Neto, A., Osté, M., Sotomayor, C. G., van den Berg, E., Geleijnse, J., Berger, S., Gans, R., Bakker, S., & Navis, G. (2020) · American Society of Nephrology. Clinical Journal · doi:10.2215/cjn.06710619 · Cited by 69 · see citing works
Anti-Inflammatory Effect of White Wine in CKD Patients and Healthy Volunteers
MIGLIORI, M., Panichi, V., de la Torre, R., Fitó, M., Covas, M. I., Bertelli, A. A. A., Muñoz‐Aguayo, D., Scatena, A., Paoletti, S., & Ronco, C. (2015) · Blood Purification · doi:10.1159/000371570 · Cited by 56 · see citing works
Ramos, C. I., de Lima, A. F. A., Grilli, D. G., & Cuppari, L. (2014) · Journal of Renal Nutrition · doi:10.1053/j.jrn.2014.07.009 · Cited by 53 · see citing works
Heindel, J., Baid‐Agrawal, S., Rebholz, C. M., Nadal, J., Schmid, M. C., Schäeffner, E., Schneider, M. P., Meiselbach, H., Kaesler, N., Bergmann, M. M., et al. (2019) · Journal of Renal Nutrition · doi:10.1053/j.jrn.2019.09.008 · Cited by 44 · see citing works
Chrysohoou, C. A., Panagiotakos, D. B., Pitsavos, C., Skoumas, J., Toutouza, M. G., Papaioannou, I., & Stefanadis, C. (2010) · QJM · doi:10.1093/qjmed/hcq045 · Cited by 28 · see citing works
Chrysohoou, C. A., Panagiotakos, D. B., Pitsavos, C. E., et al. (2010) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(10)60540-2 · Cited by 8 · see citing works
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Mediterranean Diet and Obesity-related Disorders: What is the Evidence?
Muscogiuri, G., Verde, L., Sulu, C., Katsiki, N., Hassapidou, M., Frias-Toral, E., Cucalón, G., Pazderska, A., Yumuk, V. D., Colao, A., et al. (2022) · Current Obesity Reports · doi:10.1007/s13679-022-00481-1 · Cited by 207 · see citing works
- Authors
- Hansrivijit, P., Oli, S., Khanal, R., Ghahramani, N., Thongprayoon, C., & Cheungpasitporn, W.
- Affiliations
- Harrisburg Hospital (US)
- Maimonides Medical Center (US)
- Pennsylvania State University (US)
- Mayo Clinic (US)
- University of Mississippi Medical Center (US)
- Corresponding author
- Hansrivijit, Panupong
- ORCID
- Venue
- Nephrology
- Publisher
- Wiley
- Published
- 2020-09-07
- Volume
- 25
- Issue
- 12
- Pages
- 913-918
- ISSN
- 1320-5358 (ISSN-L)
- 1440-1797
- OpenAlex
- W3080822864
- Cited by
- 56
- References
- 35
- Citations by year
- 2026: 17 · 2025: 10 · 2024: 7 · 2023: 8 · 2022: 12 · 2021: 2
- FWCI
- 0.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nephrology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Keywords
- Mediterranean diet, chronic kidney disease, dietary adherence, CKD incidence, sex differences, cardiovascular disease
- MeSH terms
- Humans, Diet, Mediterranean, Renal Insufficiency, Chronic
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