Carbohydrate-Rich Diet Is Associated with Increased Risk of Incident Chronic Kidney Disease in Non-Diabetic Subjects

Abstract

Despite the potential relationship with metabolic derangements, the association between dietary carbohydrate intake and renal function remains unknown. The present study investigated the impact of dietary carbohydrate intake on the development ofincidentchronickidneydisease(CKD) in a large-scale prospective cohort with normal renal function. A total of 6746 and 1058subjectswithout and with diabetes mellitus (DM) were analyzed, respectively. Carbohydrate intake was assessed by a 24-h dietary recall food frequency questionnaire. The primary endpoint was CKD development, defined as a composite of estimated glomerular filtration rate (eGFR) of ≤60 mL/min/1.73 m2and the development of proteinuria. CKD newly developed in 20.1% and 36.0% ofsubjectsduring median follow-ups of 140 and 119 months in the non-DM and DMsubjects, respectively. Categorization of non-DMsubjectsinto dietary carbohydrate density quartiles revealed a significantly higherriskof CKD development in the third and fourth quartiles than in the first quartile (P= 0.037 for first vs. third;P= 0.001 for first vs. fourth). A significantriskelevation was also found withincreasedcarbohydrate density when carbohydrate density was treated as a continuous variable (P= 0.008). However, there was no significant difference in theincidentCKDriskamong those with DM according to dietary carbohydrate density quartiles.Carbohydrate-richdiets may increase theriskof CKD development in non-DMsubjects.