title: The association between a Mediterranean-style diet and kidney function in the Northern Manhattan Study cohort.
abstract: OBJECTIVE
  Various dietary strategies have been investigated to slow kidney function decline. However, it is unknown whether a Mediterranean diet, which has been associated with improved cardiovascular risk, is associated with change in kidney function.
  
  
  METHODS
  This study used the Northern Manhattan Study, a prospective, multiethnic, observational cohort of participants who were stroke free at baseline. Data were collected between 1993 and 2008. Serum creatinine measurements were taken a mean 6.9 years apart. A baseline dietary questionnaire was extrapolated into a previously used 9-point scoring system (MeDi). The primary outcome was incident eGFR<60 ml/min per 1.73 m(2)using the Modification of Diet in Renal Disease formula. A secondary outcome was the upper quartile of annualized eGFR decline (≥ 2.5 ml/min per 1.73 m(2) per year). Conditional logistic regression models adjusted for demographics and baseline vascular risk factors.
  
  
  RESULTS
  Mean baseline age was 64 years, with 59% women and 65% Hispanics (N=900); mean baseline eGFR was 83.1 ml/min per 1.73 m(2). Incident eGFR<60 ml/min per 1.73 m(2) developed in 14% . In adjusted models, every 1-point increase in the MeDi score, indicating increasing adherence to a Mediterranean diet, was associated with decreased odds of incident eGFR<60 ml/min per 1.73 m(2) (odds ratio, 0.83; 95% confidence interval, 0.71 to 0.96) and decreased odds of being in the upper quartile of eGFR decline (odds ratio, 0.88; 95% confidence interval, 0.79 to 0.98).
  
  
  CONCLUSIONS
  A Mediterranean diet was associated with a reduced incidence of eGFR<60 ml/min per 1.73 m(2) and upper quartile of eGFR decline in a multiethnic cohort.
authors.affiliation: Division of Nephrology, Departments of Medicine and mk2642@columbia.edu.
authors.forename: Minesh
authors.initials: M
authors.lastname: Khatri
authors.affiliation: Neurology, College of Physicians and Surgeons.
authors.forename: Yeseon P
authors.initials: YP
authors.lastname: Moon
authors.affiliation: Neurology, College of Physicians and Surgeons, Gertrude H. Sergievsky Center, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, and Department of Social Medicine, Psychiatry, and Neurology, Medical School, National and Kapodistrian University of Athens, Athens, Greece; and.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Scarmeas
authors.affiliation: Taub Institute for Research in Alzheimer's Disease and the Aging Brain, and.
authors.forename: Yian
authors.initials: Y
authors.lastname: Gu
authors.affiliation: Evelyn F. McKnight Brain Institute, Department of Neurology, University of Miami, Miami, Florida.
authors.forename: Hannah
authors.initials: H
authors.lastname: Gardener
authors.affiliation: Neurology, College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York;
authors.forename: Ken
authors.initials: K
authors.lastname: Cheung
authors.affiliation: Evelyn F. McKnight Brain Institute, Department of Neurology, University of Miami, Miami, Florida.
authors.forename: Clinton B
authors.initials: CB
authors.lastname: Wright
authors.affiliation: Evelyn F. McKnight Brain Institute, Department of Neurology, University of Miami, Miami, Florida.
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Sacco
authors.affiliation: Division of Nephrology, Departments of Medicine and.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Nickolas
authors.affiliation: Neurology, College of Physicians and Surgeons, Gertrude H. Sergievsky Center, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York;
authors.forename: Mitchell S V
authors.initials: MS
authors.lastname: Elkind
mesh_terms: D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D003920:Diabetes Mellitus / Q000453:epidemiology; D004034:Diet Surveys; D038441:Diet, Mediterranean; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009519:New York City; D010349:Patient Compliance; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000453:epidemiology* / Q000503:physiopathology*; D012307:Risk Factors; D014675:Vegetables
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D003404:Creatinine
keywords: CKD; nutrition; progression of chronic renal failure