Planetary Health Diet Index and Risk of Chronic Kidney Disease in Middle-Aged and Older Adults: Insights From Two...

To assess whether the EAT-Lancet reference diet is related to the risk of chronic kidney disease (CKD) in middle-aged and older adults.

This multicohort study included 12,259 and 176,720 participants without baseline CKD from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) cohort (May 1, 2013, to December 31, 2018) and the UK Biobank cohort (March 13, 2006, to October 10, 2010), respectively. The EAT-Lancet reference diet was assessed by the Planetary Health Diet Index (PHDI). Incident CKD was defined according to the 4-variable Modification of Diet in Renal Disease Study equation in the TCLSIH cohort and the International Classification of Diseases, Tenth Revision codes in the UK Biobank. Cox proportional hazards models were used to determine the relationship between PHDI and risk of CKD.

The median follow-up was 4.10 years and 10.48 years in the TCLSIH cohort and UK Biobank, respectively. The fully adjusted hazard ratios (95% confidence intervals) of incident CKD for increasing quartiles of the PHDI were 1.00 (reference), 1.15 (0.67 to 1.96), 1.47 (0.87 to 2.48), and 0.80 (0.46 to 1.41) (P=.55 for trend) in males and 1.00 (reference), 0.68 (0.35 to 1.35), 0.63 (0.32 to 1.24), and 0.38 (0.18 to 0.82) (P=.01 for trend) in females in the TCLSIH cohort and 1.00 (reference), 0.96 (0.85 to 1.09), 0.84 (0.74 to 0.96), and 0.90 (0.79 to 1.03) (P=.03 for trend) in males and 1.00 (reference), 0.87 (0.77 to 0.98), 0.85 (0.74 to 0.96), and 0.79 (0.69 to 0.90) (P<.001 for trend) in females in the UK Biobank, respectively. Interactions with sex were observed (P<.10 for interaction).

Adherence to the PHDI is related to a decreased risk of CKD, and the relationship is stronger in females than in males.