title: Carbohydrate nutrition is associated with the 5-year incidence of chronic kidney disease.
abstract: It has been shown that dietary glycemic index (GI) and fiber could have a role in the development of chronic diseases; however, the link between carbohydrate nutrition and development of chronic kidney disease (CKD) is unclear. We aimed to determine whether cross-sectional and longitudinal associations exist between carbohydrate nutrition (mean dietary GI, dietary intakes of carbohydrate, sugar, starch, and fiber) and CKD. Data included 2600 Blue Mountains Eye Study (1997-1999) participants aged ≥50 y. Baseline biochemistry including serum creatinine was measured. Moderate CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL·min(-1)·1.73 m(-2). Dietary data were collected in a semiquantitative FFQ. Cross-sectionally, participants in the 4th quartile of mean dietary GI intake compared with those in the first quartile (reference) had a 55% increased likelihood of having eGFR < 60 mL·min(-1)·1.73 m(-2) [multivariable-adjusted OR = 1.55 (95% CI = 1.07-2.26); P-trend = 0.01]. After multivariable adjustment, participants in the 4th quartile of dietary cereal fiber intake compared with those in the first quartile (reference) had a 50% reduced risk of incident moderate CKD (P-trend = 0.03). Higher baseline consumption of energy-dense, nutrient-poor sources of carbohydrate (e.g. cookies) yielded a 3-fold higher risk of incident CKD (P-trend = 0.01). In summary, we observed a novel link between high cereal fiber intake and reduced incidence of moderate CKD and this was supported by the cross-sectional association with dietary GI. Conversely, our data suggest that higher intake of energy-dense, nutrient-poor sources of carbohydrate, potentially through acute hyperglycemia, could impair renal function.
authors.affiliation: Centre for Vision Research, Department of Ophthalmology, Westmead Millennium Institute, Sydney, NSW, Australia.
authors.forename: Bamini
authors.initials: B
authors.lastname: Gopinath
authors.forename: David C
authors.initials: DC
authors.lastname: Harris
authors.forename: Victoria M
authors.initials: VM
authors.lastname: Flood
authors.forename: George
authors.initials: G
authors.lastname: Burlutsky
authors.forename: Jennie
authors.initials: J
authors.lastname: Brand-Miller
authors.forename: Paul
authors.initials: P
authors.lastname: Mitchell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004040:Dietary Carbohydrates / Q000009:adverse effects*; D004043:Dietary Fiber / Q000008:administration & dosage* / Q000009:adverse effects; D002523:Edible Grain; D005260:Female; D038321:Glycemic Index; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology* / Q000517:prevention & control*; D012307:Risk Factors
chemical_list: D004040:Dietary Carbohydrates; D004043:Dietary Fiber