New studies point to the importance of diet for kidney health in the general population as well as for the longevity of patients on dialysis. The studies, which are both published in the Clinical Journal of the American Society of Nephrology (CJASN), suggest that more research is needed to fine-tune certain dietary recommendations.
The first study, by Casey Rebholz, PhD, MPH, of the Johns Hopkins Bloomberg School of Public Health, and her colleagues, was conducted to clarify the effects of certain beverages on kidney health.
“There is a lack of comprehensive information on the health implications of the wide range of beverage options that are available in the food supply,” Rebholz said. “In particular, there is limited information on which types of beverages and patterns of beverages are associated with kidney disease risk in particular.”
Of note, the study focused on African Americans, who experience a disproportionate burden of kidney disease but are under-represented in clinical research. The team prospectively studied 3003 African American men and women with normal kidney function who were enrolled in the Jackson Heart Study.
Participants completed a food frequency questionnaire administered at the start of the study in 2000–2004, and they were followed until 2009–2013. Among the 3003 participants, 185 (6%) developed chronic kidney disease (CKD) over a median follow-up of 8 years. After adjustment for confounding factors, consuming a beverage pattern consisting of soda, sweetened fruit drinks, and water was associated with a higher risk of developing CKD. Participants in the top tertile for consumption of this beverage pattern were 61% more likely to develop CKD than those in the bottom tertile.
It was surprising that water was a component of the beverage pattern that was linked with a higher risk of CKD, although study participants may have reported their consumption of a wide variety of types of water, including flavored and sweetened water. The investigators did not collect information about specific brands or types of bottled water in the Jackson Heart Study.
In an accompanying editorial, Holly Kramer, MD, MPH, and David Shoham, PhD, of Loyola University Chicago, noted that the findings hold strong public health implications. “Although a few cities in the United States have reduced sugar-sweetened beverage consumption via taxation, most municipalities have resisted public health efforts to lower its consumption,” they wrote. “This cultural resistance to reducing sugar-sweetened beverage consumption can be compared with the cultural resistance to smoking cessation during the 1960s after the Surgeon General report was released. During the 1960s, tobacco use was viewed as a social choice and not a medical or social public health problem.”
In an accompanying Patient Voice editorial, Duane Sunwold said he is a patient with CKD who changed his eating and drinking patterns to put his disease in remission. As a chef, he offers a number of recommendations to fellow patients trying to decrease their consumption of sugar-sweetened drinks.