Nut Consumption, Kidney Function, Chronic Kidney Disease and Mortality: A Systematic Review

This systematic review evaluates the association between nut consumption and kidney health outcomes, including kidney function markers and chronic kidney disease (CKD) incidence, prevalence, and mortality. Given the nutritional benefits of nuts and the growing burden of CKD, we aimed to assess whether nut consumption is associated with kidney-related outcomes and to assess the strength and consistency of the available evidence.

Recent observational studies and cohort analyses provide emerging but heterogeneous evidence on the relationship between nut intake and kidney outcomes. Higher nut consumption and substitution of red and processed meat with nuts are associated with lower CKD risk or prevalence in some populations. However, findings for specific kidney function markers, such as estimated glomerular filtration rate and albuminuria, remain inconsistent across studies. Nuts have also been evaluated within plant-based dietary indices and through biomarker-based approaches, yielding complementary but non-uniform results. Evidence in individuals with established CKD or high-risk populations is limited. Overall, variability in exposure definitions, outcome measures, and study populations contributes to uncertainty in the strength and consistency of associations. Current evidence suggests that nut consumption, particularly when nuts replace red and processed meat, may be associated with favorable kidney-related outcomes in some populations. However, the evidence is predominantly observational and does not establish causality or an optimal level of nut consumption for kidney health. The heterogeneity in study design and outcome assessment further constrains definitive conclusions. Future research should prioritize well-designed prospective studies and randomized controlled trials to establish causality, clarify dose-response relationships, and determine the role of nuts in CKD-specific dietary recommendations for its prevention and management.