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已发表论文
基于 NHANES 的研究：不健康植物性饮食与无心血管疾病的慢性肾病患者全因死亡率之间的关联
Authors Li K, Xia Y, Sun X, Shi B, Wu J
Received 1 May 2025
Accepted for publication 3 September 2025
Published 12 September 2025 Volume 2025:18 Pages 5759—5770
DOI https://doi.org/10.2147/JMDH.S537988
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr David C. Mohr
Kejia Li, Yang Xia, Xian Sun, Bairu Shi, Jiajun Wu
Department of Nephrology, The First People’s Hospital of Jiashan, Jiaxing, Zhejiang, 314100, People’s Republic of China
Correspondence: Kejia Li, Department of Nephrology, The First People’s Hospital of Jiashan, 1218 Tiyu South Road, Jiaxing, Zhejiang, 314100, People’s Republic of China, Email xuyunze2012@sina.com
Purpose: A plant-based diet (PBD) has been demonstrated to reduce the risk of chronic kidney disease (CKD) and cardiovascular diseases (CVD). This study aimed to examine the associations of PBD indices with all-cause and CVD mortality in a cohort of community-dwelling adults with predominantly early-stage CKD and no comorbid CVD.
Methods: Adult CKD patients, defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 and/or urinary albumin-to-creatinine ratio (uACR) > 30mg/g, without known CVD, were included from the 1999– 2018 National Health and Nutrition Examination Survey. The primary exposures were scores from the healthy PBD index (hPDI), unhealthy PBD index (uPDI), and total PDI. The Cox proportional hazards model was used for survival analysis.
Results: A total of 4098 participants (mean age 55.50 years, mean eGFR 80.62 mL/min/1.73m2) were included. During a median follow-up time of 102 months, 1191 (19.52%) participants died, of which 397 were from CVD mortality. Neither the total PDI nor the hPDI was associated with all-cause or CVD mortality. The hazard ratios and 95% confidence intervals for the association between uPDI and all-cause or CVD mortality were 1.02 (1.01– 1.04) and 1.01 (0.98– 1.04), respectively. Restricted cubic spline analysis indicated a linearly positive relationship between uPDI and all-cause mortality. Subgroup analysis revealed that the associations between uPDI and all-cause mortality were stronger in women and non-diabetic individuals compared to men and diabetic individuals.
Conclusion: Adherence to unhealthy PBD is associated with increased all-cause mortality in US CKD individuals without CVD, especially women and non-diabetic individuals.
Keywords: cardiovascular disease, chronic kidney disease, mortality, NHANES, plant-based diet
Department of Nephrology, The First People’s Hospital of Jiashan, Jiaxing, Zhejiang, 314100, People’s Republic of China
Correspondence: Kejia Li, Department of Nephrology, The First People’s Hospital of Jiashan, 1218 Tiyu South Road, Jiaxing, Zhejiang, 314100, People’s Republic of China, Email xuyunze2012@sina.com
Purpose: A plant-based diet (PBD) has been demonstrated to reduce the risk of chronic kidney disease (CKD) and cardiovascular diseases (CVD). This study aimed to examine the associations of PBD indices with all-cause and CVD mortality in a cohort of community-dwelling adults with predominantly early-stage CKD and no comorbid CVD.
Methods: Adult CKD patients, defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 and/or urinary albumin-to-creatinine ratio (uACR) > 30mg/g, without known CVD, were included from the 1999– 2018 National Health and Nutrition Examination Survey. The primary exposures were scores from the healthy PBD index (hPDI), unhealthy PBD index (uPDI), and total PDI. The Cox proportional hazards model was used for survival analysis.
Results: A total of 4098 participants (mean age 55.50 years, mean eGFR 80.62 mL/min/1.73m2) were included. During a median follow-up time of 102 months, 1191 (19.52%) participants died, of which 397 were from CVD mortality. Neither the total PDI nor the hPDI was associated with all-cause or CVD mortality. The hazard ratios and 95% confidence intervals for the association between uPDI and all-cause or CVD mortality were 1.02 (1.01– 1.04) and 1.01 (0.98– 1.04), respectively. Restricted cubic spline analysis indicated a linearly positive relationship between uPDI and all-cause mortality. Subgroup analysis revealed that the associations between uPDI and all-cause mortality were stronger in women and non-diabetic individuals compared to men and diabetic individuals.
Conclusion: Adherence to unhealthy PBD is associated with increased all-cause mortality in US CKD individuals without CVD, especially women and non-diabetic individuals.
Keywords: cardiovascular disease, chronic kidney disease, mortality, NHANES, plant-based diet