# Dietary inflammatory index in relation to incident CKD: A prospective study of UK Biobank participants

## TL;DR

A pro-inflammatory diet is linked to a higher risk of early-stage chronic kidney disease, according to a large UK Biobank study.

## Contribution

This study is the first to prospectively investigate the association between the dietary inflammatory index and incident CKD in a large cohort.

## Key findings

- Higher E-DII scores were associated with increased risk of incident CKD (HR: 1.05 per unit increment).
- The risk of early-stage CKD increased significantly when E-DII exceeded 1.857.
- An anti-inflammatory diet may help prevent early-stage CKD, though causality cannot be confirmed.

## Abstract

The relationship between increased inflammatory diet patterns and chronic kidney disease (CKD) remains unknown and has not been investigated in large cohorts.

A total of 154,070 adults registered in UKB database were enrolled and followed, free of CKD and eGFR > 90 mL/min/1.73 m2 at baseline. The energy-adjusted dietary inflammatory index (E-DII) was evaluated using the 24-h recall diet. Cox proportional hazards regression models were used, adjusting for confounders such as demographic indicators, socioeconomic status, and lifestyle factors. Additionally, a subgroup analysis was conducted to investigate the relationship with incident CKD. The nonlinear relationship between E-DII and CKD risk was analyzed using a restricted cubic spline.

During a median follow-up of 11.4 years, 3402 (2.21%) cases occurred. After adjustment for all potential confounders, a higher E-DII was associated with an increased risk of incident CKD (HR for 1 unit increment: 1.05 (1.00–1.10), p = 0.034). According to the result of the restricted cubic spline, when E-DII > 1.857, the risk of early-stage CKD would increase significantly.

A higher pro-inflammatory diet was associated with an increased risk of early-stage CKD in the fully adjusted model. An anti-inflammatory diet may serve as a potential preventive strategy for early-stage CKD, although causal inference cannot be established from this observational study.