High dietary fiber intake is associated with decreased inflammation and all-cause mortality in patients with chronic kidney disease

Abstract

Chronic kidney disease is considered an inflammatory state and a high fiber intake is associated with decreased inflammation in the general population. Here, we determined whether fiber intake is associated with decreased inflammation and mortality in chronic kidney disease, and whether kidney disease modifies the associations of fiber intake with inflammation and mortality. To do this, we analyzed data from 14,543 participants in the National Health and Nutrition Examination Survey III. The prevalence of chronic kidney disease (estimated glomerular filtration rate less than 60 ml/min per 1.73 m(2)) was 5.8%. For each 10-g/day increase in total fiber intake, the odds of elevated serum C-reactive protein levels were decreased by 11% and 38% in those without and with kidney disease, respectively. Dietary total fiber intake was not significantly associated with mortality in those without but was inversely related to mortality in those with kidney disease. The relationship of total fiber with inflammation and mortality differed significantly in those with and without kidney disease. Thus, high dietary total fiber intake is associated with lower risk of inflammation and mortality in kidney disease and these associations are stronger in magnitude in those with kidney disease. Interventional trials are needed to establish the effects of fiber intake on inflammation and mortality in kidney disease.

Conflict of interest statement

DISCLOSURE

All the authors declared no competing interests.

Figures

Figure 1. Associations of dietary fiber with elevated serum C-reactive protein (>3 mg/l) in the non-chronic kidney disease (CKD) and CKD sub-populations

Odds ratio for every 10-g/day increase in each type of fiber intake in CKD and non-CKD sub-populations. Models adjusted for age, gender, race, myocardial infarction, congestive heart failure, stroke, cancer, smoking, alcohol use, leisure-time physical inactivity, systolic blood pressure, diastolic blood pressure, calorie and protein intakes, serum triglycerides, serum high-density lipoprotein cholesterol, and serum low-density lipoprotein cholesterol.

Figure 2. Associations of dietary fiber with all-cause mortality in the chronic kidney disease (CKD) and non-CKD sub-populations

Hazard ratio for every 10-g/day increase in each type of fiber intake in CKD and non-CKD sub-populations. Models adjusted for age, gender, race, smoking, alcohol, leisure-time physical inactivity, and calorie intake and protein intakes.