Exploring the association of dietary inflammatory index, disease progression and cellular integrity in chronic kidney disease: A cross-sectional study.

Abstract

Background: While the anti-inflammatory effects of specific nutrients are well established, there is limited research on the relationship between overall dietary patterns and chronic kidney disease (CKD). Therefore, we aimed to assess the association between dietary inflammatory index (DII) scores and biochemical and body composition parameters in pre-dialysis CKD patients.

Methods: The DII scores of 143 pre-dialysis CKD subjects were calculated using 24-h recalls. Body composition was measured using bioelectric impedance-based InBody 770. Oxidative stress and total antioxidant capacity were measured using thiobarbituric acid reactive substances (TBARS), ferric-reducing antioxidant power (FRAP), and uric acid-independent FRAP (FRAP_UA) assays respectively. C-reactive protein (CRP) was selected as an inflammatory marker while other biochemical parameters were analysed using diagnostic kits.

Results: Subjects were categorized into early-stage CKD (ES; eGFR: 30 to 59 ml/min/1.73 m²) and late-stage CKD (LS; eGFR: < 30 ml/min/1.73 m²). The ES group had a lower extracellular to total body water ratio (p < 0.01) and higher levels of whole-body phase angle (p < 0.01) compared to the LS group. However, FRAP_UA was higher in the LS group (p < 0.05). For each increase in DII score by 1, eGFR decreased by 2.31 ml/min/1.73 m² (p < 0.01) and phase angle by 0.11 degrees (p < 0.05). Consuming cereals and millets, other vegetables, roots and tubers, spices, poultry, oils and fats significantly contributed to the anti-inflammatory potential of the diet (p < 0.01).

Conclusion: A pro-inflammatory diet was associated with disease progression and decreased cell integrity, underscoring the importance of its consideration in CKD management.