Sugar- and Artificially Sweetened Drinks, Unhealthy Fats May Up CKD Risk – Renal and Urology News

Reducing intake of sweetened beverages and unhealthy fats may help prevent the development of chronic kidney disease (CKD), according to 2 new studies.

In a study of 127,830 adults aged 40 to 69 years in the UK Biobank database, consuming more than 1 serving of sugar-sweetened or any artificially sweetened beverages daily was significantly associated with a 19% and 26% increased risk of developing CKD, respectively, compared with consuming neither of these sweetened beverages, Hyung Woo Kim, MD, of the Institute of Kidney Disease Research at Yonsei University College of Medicine in Seoul, Korea, and colleagues reported in JAMA Network Open. Consuming up to 1 artificially sweetened drink also carried a significant 10% excess risk of CKD. One drink was defined as 250 mL, or approximately 8.5 ounces.

Substituting sugar-sweetened beverages with artificially sweetened beverages did not lower the risk for CKD, the investigators reported.

Replacing 1 serving per day of sugar-sweetened sweetened beverages with natural juices or water was significantly associated with a 7% reduced risk of CKD. Similarly, replacing 1 serving per day of artificially sweetened beverages with natural juices or water was significantly associated with a 10% and 9% reduced risk of CKD, respectively. Natural juices, which contain no added sweeteners, did not increase the risk of CKD by themselves. But excessive consumption of natural juices can increase the risk of various metabolic diseases that are risk factors for CKD, the investigators pointed out.

According to Dr Kim’s team, these study findings contribute to “the growing evidence supporting the restriction of both sugar-sweetened beverages and artificially sweetened beverages to prevent CKD.” Sugar, especially fructose, can contribute to a high glycemic load, weight gain, and glomerular hyperfiltration, they explained. Both sugar-sweetened beverages and artificially sweetened beverages tend to be high in phosphorus and dietary acid.

In a separate study of 78,950 adults without CKD in the UK Biobank Study, adults with higher plasma levels of polyunsaturated fatty acids (PUFAs) had a lower risk of adverse kidney outcomes. The risk for CKD was a significant 17%, 15%, and 29% lower for quartiles 2, 3, and 4 of PUFA intake, respectively, compared with quartile 1, Seung Hyeok Han, MD, PhD, of Yonsei University, Institute of Kidney Disease Research, in Seoul, Korea, and colleagues reported in the American Journal of Kidney Diseases. Quartiles 4, 3, 2, and 1 contained 46.5%, 44.1%, 41.9%, and 38.1% PUFA as a proportion of total fatty acid, respectively.

Various types of PUFAs showed lower associations with CKD risk, including omega-3 fatty acid, omega-6 fatty acid, docosahexaenoic acid (DHA), and linoleic acid. The higher PUFA quartiles also were significantly associated with 24%, 32%, and 42% lower risks of all-cause mortality, respectively.

Among 7233 adults with pre-existing CKD, only DHA was significantly associated with a significant 15%, 60%, and 54% lower risk of kidney failure requiring replacement therapy for individuals in quartiles 2-4 compared with quartile 1, the investigators reported.

According to Dr Han’s team, PUFAs may exert beneficial effects on the kidney as in the cardiovascular system, serving as antioxidants. In patients with pre-existing CKD, the PUFA type (DHA) appears to matter.