Mediterranean diet in primary and secondary prevention of chronic kidney disease

Chronic kidney disease (CKD), a condition characterized by a progressive and irreversible decline in kidney function, is a major global and national health problem. In Italy, for example, the prevalence of CKD is around 8%. Considering its role as an independent risk factor for cardiovascular events and its correlation with metabolic diseases such as obesity and diabetes, it is essential to define preventive strategies that can reduce its incidence or slow down its progression. Several studies have focused on the impact of individual nutrients, but what is the role of a healthy and balanced dietary pattern, such as the Mediterranean diet, on kidney function?

The authors of a recent review of observational and intervention studies analyzing the role of the Mediterranean Diet on primary and secondary prevention of chronic kidney disease sought to answer this question.

A qualitative analysis of the studies showed that high adherence to Mediterranean diet is associated with reduced albuminuria, higher creatinine clearance rates and, more generally, a reduced risk of developing CKD. In particular, nuts, fruit, whole grains and moderate alcohol consumption were associated with a lower risk of developing the CKD, while high consumption of red and processed meat was correlated with an increased risk.

Regarding secondary prevention, it has been observed that patients with CKD and higher adherence to Mediterranean diet report a slower reduction in glomerular filtration rate (eGFR). In particular, this could be linked to a higher consumption of cereals, fish and unsaturated fats.

The data from this review demonstrate the potential beneficial effect of Mediterranean diet, both in terms of primary prevention and in terms of slowing disease progression. However, further studies are needed to clarify its effectiveness, especially in the presence of various comorbidities and in relation to different factors, including ethnicity.

Source: Seethaler B, et al. Short-chain fatty acids are key mediators of the favorable effects of the Mediterranean diet on intestinal barrier integrity: data from the randomized controlled LIBRE trial. Am J Clin Nutr. 2022;116:928-942.