Abstract
Chronic kidney disease is a major global public health problem. Worldwide, an estimated 200 million people have chronic kidney disease with the numbers expected to rise with the increasing aging population as prevalence in individuals over age 60 is approximately 25%. Chronic kidney disease can lead to an increased risk of end-stage renal disease (ESRD), cardiovascular disease, and premature mortality.
The high adherence to a Western lifestyle is associated with increased renal dysfunction, which can evolve into chronic kidney disease and progress to ESRD.
Healthy dietary patterns including fiber-rich whole grains and fruits and vegetables have been shown to improve renal function and decrease metabolic acidosis compared to poor quality diets low in fruits and vegetables and high in processed foods and animal products.
In patients with chronic kidney disease, a 10 g/day increase in total fiber was shown to reduce C-reactive protein by 38% and overall mortality by 17%.
Several observational studies and intervention trials suggest that the increased consumption of fiber-rich foods and/or fiber supplements is associated with improved renal function and lower risk of chronic kidney disease because of fiber’s beneficial effects on microbiota health, attenuation of systemic inflammation, and lessening of the risk of weight gain.
In older adults, healthy fiber-rich dietary patterns including the Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diet were found to help improve renal function and reduce risk of chronic kidney disease or related mortality.
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References
Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382:260–72.
Lozano R, Naghavi M, Foreman K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2013;380:2095–128.
Ojo A. Addressing the global burden of chronic kidney disease through clinical and translational research. Trans Am Clin Climatol Assoc. 2014;125:229–46.
Sharma K. Obesity, oxidative stress, and fibrosis in chronic kidney disease. Kidney Int Suppl. 2014;4:113–7.
Hall ME, do Carmo JM, da Silva AA, et al. Obesity, hypertension, and chronic kidney disease. Int J Nephrol Renovasc Dis. 2014;7:75–88.
McCullough K, Sharma P, Ali T, et al. Measuring the population burden of chronic kidney disease: a systematic literature review of the estimated prevalence of impaired kidney function. Nephrol Dial Transplant. 2012;27(5):1812–21.
US Renal Data System. Annual Data Report: Atlas of chronic kidney disease & end-stage renal disease in the United States. Bethesda: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2013.
American Kidney Fund. End stage renal disease. 2015. http://www.kidneyfund.org/kidney-disease/kidney-failure/end-stage-renal-disease/. Accessed 5 Dec 2015.
Said S, Hernandez GT. The link between chronic kidney disease and cardiovascular disease. J Nephropathol. 2014;3(3):99–104.
DÃaz-López A, Bulló M, Basora J, et al. Cross-sectional associations between macronutrient intake and chronic kidney disease in a population at high cardiovascular risk. Clin Nutr. 2013;32:606–12. doi:10.1016/j.clnu.2012.10.013.
Odermatt A. The Western-style diet: a major risk factor for impaired kidney function and chronic kidney disease. Am J Physiol Renal Physiol. 2011;301:919–31.
Garland JS. Elevated body mass index as a risk factor for chronic kidney disease: current perspectives. Diabetes Metab Syndr Obes. 2014;7:347–55.
Navarroa G, Ardiles L. Association between obesity and chronic renal disease. Rev Med Chil. 2015;143:77–84.
Foster MC, Hwang S-J, Porter SA, et al. Fatty kidney, hypertension, and chronic kidney disease: the Framingham Heart Study. Hypertension. 2011;58(5):784–90.
Oh H, Quan SA, Jeong J-Y, et al. Waist circumference, not body mass index, is associated with renal function decline in Korean population: Hallym Aging Study. PLoS One. 2013;8(3):e59071. doi:10.1371/journal.pone.0059071.
Oh SW, Ahn SY, Jianwei X, et al. Relationship between changes in body fat and a decline of renal function in the elderly. PLoS One. 2014;9(1):e84052. doi:10.1371/journal.pone. 0084052.
Kang SH, Cho KH, Park JW, Yoon KW, Do JY. Association of visceral fat area with chronic kidney disease and metabolic syndrome risk in the general population: analysis using multi-frequency bioimpedance. Kidney Blood Press Res. 2015;40:223–30.
Ricardo AC, Anderson CA, Yang W, et al. Healthy lifestyle and risk of kidney disease progression, atherosclerotic events, and death in CKD: findings from the Chronic Renal Insufficiency Cohort (CRIC) Study. Am J Kidney Dis. 2015;65(3):412–24.
de Vries AP, Ruggenenti P, Ruan XZ, et al. Fatty kidney: emerging role of ectopic lipid in obesity-related renal disease. Lancet Diabetes Endocrinol. 2014;2(5):417–26.
Prasad GVR. Metabolic syndrome and chronic kidney disease: Current status and future directions. World J Nephrol. 2014;3(4):210–9.
Sarathy H, Henriquez G, Abramowitz MK, et al. Abdominal obesity, race and chronic kidney disease in young adults: results from NHANES 1999-2010. PLoS One. 2016;11(5):e0153588. doi:10.1371/journal.pone.0153588.
Rebholz CM, Anderson CAM, Grams ME, et al. Relationship of the American Heart Association’s impact goals (Life’s Simple 7) with risk of chronic kidney disease: results from the Atherosclerosis Risk in Communities (ARIC) Cohort Study. J Am Heart Assoc. 2016;5:e003192. doi:10.1161/JAHA.116.003192.
Evenepoel P, Meijers BK. Dietary fiber and protein: nutritional therapy in chronic kidney disease and beyond. Kidney Int. 2012;81:227–9.
Chiavaroli L, Mirrahimi A, Sievenpiper JL, et al. Dietary fiber effects in chronic kidney disease: a systematic review and meta-analysis of controlled feeding trials. Eur J Clin Nutr. 2014;69(7):761–8. doi:10.1038/ejcn.2014.237.
Krishnamurthy VMR, Wei G, Baird BC, et al. High dietary fiber intake is associated with decreased inflammation and all-cause mortality in patients with chronic kidney disease. Kidney Int. 2012;81:300–6.
Xu H, Huang X, Riserus U, et al. Dietary fiber, kidney function, inflammation, and mortality risk. Clin J Am Soc Nephrol. 2014;9(12):2104–10.
Jiao J, Xu J, Zhang W, et al. Effect of dietary fiber on circulating C-reactive protein in overweight and obese adults: a meta-analysis of randomized controlled trials. Int J Food Sci Nutr. 2015;66(1):114–9.
Shu H-S, Tai Y-Y, Chang K-T, et al. Plasma high-sensitivity C-reactive protein level is associated with impaired estimated glomerular filtration rate in hypertensives. Acta Cardiol Sin. 2015;31:91–7.
Lu L, Huang Y-F, Wang M-Q, et al. Dietary fiber intake is associated with chronic kidney disease (CKD) progression and cardiovascular risk, but not protein nutrition status, in adults with CKD. Asia Pac J Clin Nutr. 2017;26(4):598–605.
Ramezani A, Raj DS. The gut microbiome, kidney disease, and targeted interventions. J Am Soc Nephrol. 2014;25:657–70.
Salmean YA, Segal MS, Palil SP, Dahl WJ. Fiber supplementation lowers plasma p-cresol in chronic kidney disease patients. J Ren Nutr. 2015;25(3):316–20.
Rossi M, Johnson DW, Xu H, et al. Dietary protein-fiber ratio with circulating levels of indoxyl sulfate and p-cresyl sulfate in chronic kidney disease patients. Nutr Metab Cardiovasc Dis. 2015;25(9):860–5.
Xu H, Rossi M, Campbell KL, et al. Excess protein intake relative to fiber and cardiovascular events in elderly men with chronic kidney disease. Nutr Metab Cardiovasc Dis. 2016;26(7):597–602.
Williams C, Ronco C, Kotanko P. Whole grains in the renal diet - is it time to reevaluate their role? Blood Purif. 2013;36:210–4.
Gopinath B, Harris DC, Flood VM, et al. Carbohydrate nutrition is associated with the 5-year incidence of chronic kidney disease. J Nutr. 2011;141:433–9.
Adeva MM, Souto G. Diet-induced metabolic acidosis. Clin Nutr. 2011;30:416–21.
Goraya N, Simoni J, Jo C-H, Wesson DE. A comparison of treating metabolic acidosis in CKD stage 4 hypertensive kidney disease with fruits and vegetables or sodium bicarbonate. Clin J Am Soc Nephrol. 2013;8:371–81.
Goraya N, Simoni J, Jo C-H, Wesson DA. Treatment of metabolic acidosis in patients with stage 3 chronic kidney disease with fruits and vegetables or oral bicarbonate reduces urine angiotensinogen and preserves glomerular filtration rate. Kidney Int. 2014;86(5):1031–8.
Hariharan D, Vellanki K, Kramer H. The Western diet and chronic kidney disease. Curr Hypertens Rep. 2015;17:16. doi:10.1007/s11906-014-0529-6.
Oyabu C, Hashimoto Y, Fukuda T. Impact of low-carbohydrate diet on renal function: a meta-analysis of over 1000 individuals from nine randomised controlled trials. Br J Nutr. 2016;116(4):632–8. doi:10.1017/S00071145516002178.
Smyth A, Griffin M, Yusuf S, et al. Diet and major renal outcomes: a prospective cohort study. The NIH-AARP Diet and Health Study. J Ren Nutr. 2016;26(5):288–98. doi:10.1053/j.jrn.2016.01.016.
Banerjee T, Crews DC, Wesson DE, et al. High dietary acid load predicts ESRD among adults with CKD. J Am Soc Nephrol. 2015;26:1693–700.
Foster MC, Hwang SJ, Massaro JM, et al. Lifestyle factors and indices of kidney function in the Framingham heart study. Am J Nephrol. 2015;41:267–74.
Gutierrez OM, Muntner P, Rizk DV, et al. Dietary patterns and risk of death and progression to ESRD in individuals with CKD: a cohort study. Am J Kidney Dis. 2014;64(2):204–13.
Chang A, Van Horn L, Jacobs DR, et al. Lifestyle-related factors, obesity, and incident microalbuminuria: the CARDIA (Coronary Artery Risk Development in Young Adults) study. Am J Kidney Dis. 2013;62(2):267–75.
Huang X, Jimenez-Moleon JJ, Lindholm B, et al. Mediterranean diet, kidney function, and mortality in men with CKD. Clin J Am Soc Nephrol. 2013;8:1548–55.
Lin J, Fung TT, FB H, Curhan GC. Association of dietary patterns with albuminuria and kidney function decline in older white women: a subgroup analysis from the Nurses’ Health Study. Am J Kidney Dis. 2011;57(2):245–54.
DÃaz-López A, Bulló M, MartÃnez-González MA, et al. Effects of Mediterranean diets on kidney function: a report from the PREDIMED trial. Am J Kidney Dis. 2012;60(3):380–9.
Kidney Disease Outcomes Quality Initiative (K/DOQI). K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. Am J Kidney Dis. 2004;43(5 Suppl 1):S1–290. PMID:15114537
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Appendix 1. Fifty High-Fiber Foods Ranked by Amount of Fiber Per Standard Food Portiona
Appendix 1. Fifty High-Fiber Foods Ranked by Amount of Fiber Per Standard Food Portiona
Food | Standard portion size | Dietary fiber (g) | Calories (kcal) | Energy density (calories/g) |
|---|---|---|---|---|
High-fiber bran ready-to-eat-cereal | 1/3–3/4 cup (30 g) | 9.1–14.3 |  60–80 | 2.0–2.6 |
Navy beans, cooked | 1/2 cup cooked (90 g) | 9.6 | 127 | 1.4 |
Small white beans, cooked | 1/2 cup (90 g) | 9.3 | 127 | 1.4 |
Shredded wheat ready-to-eat cereal | 1–1 1/4 cup (50-60 g) | 5.0–9.0 | 155–220 | 3.2–3.7 |
Black bean soup, canned | 1/2 cup (130 g) | 8.8 | 117 | 0.9 |
French beans, cooked | 1/2 cup (90 g) | 8.3 | 114 | 1.3 |
Split peas, cooked | 1/2 cup (100 g) | 8.2 | 114 | 1.2 |
Chickpeas (Garbanzo) beans, canned | 1/2 cup (120 g) | 8.1 | 176 | 1.4 |
Lentils, cooked | 1/2 cup (100 g) | 7.8 | 115 | 1.2 |
Pinto beans, cooked | 1/2 cup (90 g) | 7.7 | 122 | 1.4 |
Black beans, cooked | 1/2 cup (90 g) | 7.5 | 114 | 1.3 |
Artichoke, global or French, cooked | 1/2 cup (84 g) | 7.2 |  45 | 0.5 |
Lima beans, cooked | 1/2 cup (90 g) | 6.6 | 108 | 1.2 |
White beans, canned | 1/2 cup (130 g) | 6.3 | 149 | 1.1 |
Wheat bran flakes ready-to-eat cereal | 3/4 cup (30 g) | 4.9–5.5 |  90–98 | 3.1–3.3 |
Pear with skin | 1 medium (180 g) | 5.5 | 100 | 0.6 |
Pumpkin seeds, whole, roasted | 1 ounce (about 28 g) | 5.3 | 126 | 4.5 |
Baked beans, canned, plain | 1/2 cup (125 g) | 5.2 | 120 | 0.9 |
Soybeans, cooked | 1/2 cup (90 g) | 5.2 | 150 | 1.7 |
Plain rye wafer crackers | 2 wafers (22 g) | 5.0 |  73 | 3.3 |
Avocado, Hass | 1/2 fruit (68 g) | 4.6 | 114 | 1.7 |
Apple, with skin | 1 medium (180 g) | 4.4 |  95 | 0.5 |
Green peas, cooked (fresh, frozen, canned) | 1/2 cup (80 g) | 3.5–4.4 |  59–67 | 0.7–0.8 |
Refried beans, canned | 1/2 cup (120 g) | 4.4 | 107 | 0.9 |
Mixed vegetables, cooked from frozen | 1/2 cup (45 g) | 4.0 |  59 | 1.3 |
Raspberries | 1/2 cup (65 g) | 3.8 |  32 | 0.5 |
Blackberries | 1/2 cup (65 g) | 3.8 |  31 | 0.4 |
Collards, cooked | 1/2 cup (95 g) | 3.8 |  32 | 0.3 |
Soybeans, green, cooked | 1/2 cup (75 g) | 3.8 | 127 | 1.4 |
Prunes, pitted, stewed | 1/2 cup (125 g) | 3.8 | 133 | 1.1 |
Sweet potato, baked | 1 medium (114 g) | 3.8 | 103 | 0.9 |
Multi-grain bread | 2 slices regular (52 g) | 3.8 | 140 | 2.7 |
Figs, dried | 1/4 cup (about 38 g) | 3.7 |  93 | 2.5 |
Potato baked, with skin | 1 medium (173 g) | 3.6 | 163 | 0.9 |
Popcorn, air-popped | 3 cups (24 g) | 3.5 |  93 | 3.9 |
Almonds | 1 ounce (about 28 g) | 3.5 | 164 | 5.8 |
Whole wheat spaghetti, cooked | 1/2 cup (70 g) | 3.2 |  87 | 1.2 |
Sunflower seed kernels, dry roasted | 1 ounce (about 28 g) | 3.1 | 165 | 5.8 |
Orange | 1 medium (130 g) | 3.1 |  69 | 0.5 |
Banana | 1 medium (118 g) | 3.1 | 105 | 0.9 |
Oat bran muffin | 1 small (66 g) | 3.0 | 178 | 2.7 |
Vegetable soup | 1 cup (245 g) | 2.9 |  91 | 0.4 |
Dates | 1/4 cup (about 38 g) | 2.9 | 104 | 2.8 |
Pistachios, dry roasted | 1 ounce (about 28 g) | 2.8 | 161 | 5.7 |
Hazelnuts or filberts | 1 ounce (about 28 g) | 2.7 | 178 | 6.3 |
Peanuts, oil roasted | 1 ounce (about 28 g) | 2.7 | 170 | 6.0 |
Quinoa, cooked | 1/2 cup (90 g) | 2.7 |  92 | 1.0 |
Broccoli, cooked | 1/2 cup (78 g) | 2.6 |  27 | 0.3 |
Potato baked, without skin | 1 medium (145 g) | 2.3 | 145 | 1.0 |
Baby spinach leaves | 3 ounces (90 g) | 2.1 |  20 | 0.2 |
Blueberries | 1/2 cup (74 g) | 1.8 |  42 | 0.6 |
Carrot, raw or cooked | 1 medium (60 g) | 1.7 |  25 | 0.4 |
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Dreher, M.L. (2018). Fiber-Rich Diets in Chronic Kidney Disease. In: Dietary Fiber in Health and Disease. Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-319-50557-2_15
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DOI: https://doi.org/10.1007/978-3-319-50557-2_15
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