Association of Diet Quality Indices with Longitudinal Changes in Kidney Function in U.S. Hispanics/Latinos

Abstract

Background: Recent studies suggest an association between diet quality and incident chronic kidney disease. However, Hispanics/Latinos were under-represented in these studies. We examined the relationship of diet quality with change in kidney function in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: Individuals who participated in HCHS/SOL Visits 1 (2008-2011) and 2 (2014-2017) were analyzed (n=9921). Alternate Healthy Eating Index 2010 (AHEI-2010), Dietary Approaches to Stop Hypertension (DASH), and Mediterranean Diet (MeDS) scores were used as measures of dietary quality and were calculated from two 24-hour dietary recalls administered at Visit 1 and categorized into quartiles of each dietary score (higher quartiles correspond to a healthier diet). Kidney function was assessed at both visits using estimated glomerular filtration rate (eGFR), and urine albumin-to-creatinine ratio (UACR). Annualized change was computed as the difference in eGFR or UACR between visits divided by follow-up time in years. Linear regression models were used to examine the association between quartiles of each dietary quality index and annualized change in eGFR and UACR adjusted for potential confounders. Results: At Visit 1, mean (SD) age was 41 (SD=0.28) years and 56% were female. The baseline mean eGFR was 107.1 mL/min/1.73 m2 and baseline median UACR was 6.1 mg/g. On average, eGFR declined by 0.65 mL/min/1.73 m2 per year and UACR increased by 0.79 mg/g per year over a 6-year period. Lower AHEI-2010 quartiles were associated with eGFR decline in a dose-response manner (p trend=0.02). Higher AHEI-2010 quartiles showed trend toward lower annualized change in UACR, but the result was not significant. Neither MeDS nor DASH scores were associated with eGFR decline or change in UACR. Conclusions: Unhealthy diet assessed by AHEI-2010 was associated with kidney function decline. Improving the quality of the foods/nutrients comprised within the AHEI-2010 may help maintain kidney function in the Hispanic/Latino community