Dietary Choline Intake and Chronic Kidney Disease: Evidence from NHANES 2005 to 2020

Chronic kidney disease (CKD) is a prevalent condition with substantial morbidity and mortality, and dietary and nutritional factors often play a key role in its progression. Choline, an essential nutrient, has been linked to various health outcomes, including cardiovascular diseases and nonalcoholic fatty liver disease. However, the association between dietary choline intake and CKD remains unclear.

Using data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005 to 2020, this study aimed to investigate the association between dietary choline intake and CKD among 29,094 participants. Dietary choline intake was assessed through two 24-hour recall interviews, and CKD was defined according to the 2021 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guidelines. To analyze the relationship between choline intake and CKD, weighted binary logistic regression models and restricted cubic spline (RCS) analysis were applied.

The study found that a higher dietary choline intake was inversely associated with the risk of CKD (odds ratio [OR], 0.85; 95% confidence interval [CI], 0.78-0.93; p < 0.001). Participants in the highest quartile of choline intake had a significantly lower risk of CKD than those in the lowest quartile (OR, 0.84; 95% CI, 0.72-0.98; p < 0.001). RCS analysis revealed a linear relationship between dietary choline intake and the risk of CKD.

This study provides evidence of an inverse relationship between dietary choline intake and CKD risk, suggesting a potential protective role of choline in the prevention and management of CKD. Further longitudinal and molecular studies are required to confirm this hypothesis.