title: Healthy Dietary Patterns and Risk of Mortality and ESRD in CKD: A Meta-Analysis of Cohort Studies.
abstract: Patients with CKD are advised to follow dietary recommendations that restrict individual nutrients. Emerging evidence indicates overall eating patterns may better predict clinical outcomes, however, current data on dietary patterns in kidney disease are limited.
  
  
  
  This systematic review aimed to evaluate the association between dietary patterns and mortality or ESRD among adults with CKD. Medline, Embase, and reference lists were systematically searched up to November 24, 2015 by two independent review authors. Eligible studies were longitudinal cohort studies reporting the association of dietary patterns with mortality, cardiovascular events, or ESRD.
  
  
  
  A total of seven studies involving 15,285 participants were included. Healthy dietary patterns were generally higher in fruit and vegetables, fish, legumes, cereals, whole grains, and fiber, and lower in red meat, salt, and refined sugars. In six studies, healthy dietary patterns were consistently associated with lower mortality (3983 events; adjusted relative risk, 0.73; 95% confidence interval, 0.63 to 0.83; risk difference of 46 fewer (29-63 fewer) events per 1000 people over 5 years). There was no statistically significant association between healthy dietary patterns and risk of ESRD (1027 events; adjusted relative risk, 1.04; 95% confidence interval, 0.68 to 1.40).
  
  
  
  Healthy dietary patterns are associated with lower mortality in people with kidney disease. Interventions to support adherence to increased fruit and vegetable, fish, legume, whole grain, and fiber intake, and reduced red meat, sodium, and refined sugar intake could be effective tools to lower mortality in people with kidney disease.
authors.affiliation: Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia.
authors.forename: Jaimon T
authors.initials: JT
authors.lastname: Kelly
authors.affiliation: Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand.
authors.forename: Suetonia C
authors.initials: SC
authors.lastname: Palmer
authors.affiliation: Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia.
authors.forename: Shu Ning
authors.initials: SN
authors.lastname: Wai
authors.affiliation: Department of Translational Medicine, University of Eastern Piedmont Amedeo Avogadro, Alessandria, Italy.|Diaverum Academy, Lund, Sweden.
authors.forename: Marinella
authors.initials: M
authors.lastname: Ruospo
authors.affiliation: Division of Renal Medicine, Department of Clinical Science, Intervention and technology, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Juan-Jesus
authors.initials: JJ
authors.lastname: Carrero
authors.affiliation: Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia.
authors.forename: Katrina L
authors.initials: KL
authors.lastname: Campbell
authors.affiliation: Diaverum Academy, Lund, Sweden.|Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy. Diaverum Academy, Sweden; and.|Sydney School of Public Health, University of Sydney, New South Wales, Australia.
authors.forename: Giovanni F M
authors.initials: GFM
authors.lastname: Strippoli
mesh_terms: D015331:Cohort Studies; D000072001:Diet, Healthy; D018450:Disease Progression; D005502:Food; D006801:Humans; D051437:Renal Insufficiency / Q000453:epidemiology; D051436:Renal Insufficiency, Chronic / Q000401:mortality*
keywords: Adult; Carbohydrates; Cohort Studies; Confidence Intervals; Dietary Fiber; Edible Grain; Fabaceae; Fruit; Humans; Kidney Failure, Chronic; Longitudinal Studies; Nutrition; Red Meat; Risk; Sodium; Vegetables; Whole Grains; chronic kidney disease; dialysis; diet; diet quality; dietary patterns; mortality