Does Mediterranean Adequacy Index Correlate with Cardiovascular Events in Patients with Advanced Chronic Kidney Disease? An Exploratory Study

Overview

Journal Nutrients

Date 2022 May 14

PMID 35565655

Authors

Andreana De Mauri

Deborah Carrera

Matteo Vidali

Marco Bagnati

Roberta Rolla

Sergio Riso

Doriana Chiarinotti

Massimo Torreggiani

Affiliations

Soon will be listed here.

Abstract

The Mediterranean Diet (MD) is a healthy dietary pattern, demonstrated to reduce the risk of cancer, diabetes, cardiovascular and neurodegenerative diseases, and early death. The Mediterranean Adequacy Index (MAI) is used to measure adherence to the MD in perspective studies in the general population and correlates with cardiovascular events. The aim of this study was to calculate the MAI among patients with advanced chronic kidney disease (CKD) and correlate it with traditional uremic, microbiota-derived, and proatherogenic toxins as well as nutritional status, quality of life, and cardiovascular events. A total of 60 adult patients with advanced CKD were enrolled and their MAI was calculated. According to the median value, patients were divided into lower (l-MAI, <1.80) and higher (h-MAI, ≥1.80) MAI groups. Biochemical parameters, microbiota-derived and proatherogenic toxins (p-Cresyl sulphate, Indoxyl-sulphate, and Lipoprotein-associated phospholipase A2), nutritional status, quality of life, and cardiovascular events that occurred in the previous three years were recorded. The mean value of the MAI was 2.78 ± 2.86. The MAI was significantly higher in foreigners (median (IQR) 6.38 (8.98) vs. 1.74 (1.67), p < 0.001) and diabetic patients. The l-MAI and h-MAI groups had similar routinary blood, p-Cresyl-sulphate, Indoxyl-sulphate, and Lp-PLA2 as well as nutritional status and quality of life parameters. The MAI was not associated with previous cardiovascular events and did not correlate with cardiovascular events in CKD patients. New and nephro-tailored indexes are warranted to evaluate nutritional therapy in CKD patients.

Citing Articles

Pea hull fiber supplementation does not modulate uremic metabolites in adults receiving hemodialysis: a randomized, double-blind, controlled trial.

Fatani A, Suh J, Auger J, Alabasi K, Wang Y, Segal M Front Nutr. 2023; 10:1179295.

PMID: 37457968 PMC: 10349378. DOI: 10.3389/fnut.2023.1179295.

References

Cukor D, Fruchter Y, Ver Halen N, Naidoo S, Patel A, Saggi S . A preliminary investigation of depression and kidney functioning in patients with chronic kidney disease. Nephron Clin Pract. 2013; 122(3-4):139-45. DOI: 10.1159/000349940. View

Dinu M, Pagliai G, Casini A, Sofi F . Mediterranean diet and multiple health outcomes: an umbrella review of meta-analyses of observational studies and randomised trials. Eur J Clin Nutr. 2017; 72(1):30-43. DOI: 10.1038/ejcn.2017.58. View

da Silva R, Bach-Faig A, Raido Quintana B, Buckland G, de Almeida M, Serra-Majem L . Worldwide variation of adherence to the Mediterranean diet, in 1961-1965 and 2000-2003. Public Health Nutr. 2009; 12(9A):1676-84. DOI: 10.1017/S1368980009990541. View

Andersen J, Rowland B, Gloster E, Willis D, Hernandez N, Felix H . Associations among Self-Reported Mental Health, Physical Activity, and Diet during the COVID-19 Pandemic. Nutr Health. 2022; 28(4):711-719. PMC: 8891903. DOI: 10.1177/02601060221082362. View

Vanstone M, Giacomini M, Smith A, Brundisini F, Dejean D, Winsor S . How diet modification challenges are magnified in vulnerable or marginalized people with diabetes and heart disease: a systematic review and qualitative meta-synthesis. Ont Health Technol Assess Ser. 2013; 13(14):1-40. PMC: 3817924. View

Wu I, Hsu K, Lee C, Sun C, Hsu H, Tsai C . p-Cresyl sulphate and indoxyl sulphate predict progression of chronic kidney disease. Nephrol Dial Transplant. 2010; 26(3):938-47. PMC: 3042976. DOI: 10.1093/ndt/gfq580. View

Menotti A, Puddu P . How the Seven Countries Study contributed to the definition and development of the Mediterranean diet concept: a 50-year journey. Nutr Metab Cardiovasc Dis. 2015; 25(3):245-52. DOI: 10.1016/j.numecd.2014.12.001. View

Lin C, Wu V, Wu P, Wu C . Meta-Analysis of the Associations of p-Cresyl Sulfate (PCS) and Indoxyl Sulfate (IS) with Cardiovascular Events and All-Cause Mortality in Patients with Chronic Renal Failure. PLoS One. 2015; 10(7):e0132589. PMC: 4501756. DOI: 10.1371/journal.pone.0132589. View

Dominguez L, Veronese N, Baiamonte E, Guarrera M, Parisi A, Ruffolo C . Healthy Aging and Dietary Patterns. Nutrients. 2022; 14(4). PMC: 8879056. DOI: 10.3390/nu14040889. View

10.

Ikizler T, Burrowes J, Byham-Gray L, Campbell K, Carrero J, Chan W . KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. Am J Kidney Dis. 2020; 76(3 Suppl 1):S1-S107. DOI: 10.1053/j.ajkd.2020.05.006. View

11.

Lichtenstein A, Appel L, Vadiveloo M, Hu F, Kris-Etherton P, Rebholz C . 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association. Circulation. 2021; 144(23):e472-e487. DOI: 10.1161/CIR.0000000000001031. View

12.

Filip R, Anchidin-Norocel L, Gheorghita R, Savage W, Dimian M . Changes in Dietary Patterns and Clinical Health Outcomes in Different Countries during the SARS-CoV-2 Pandemic. Nutrients. 2021; 13(10). PMC: 8539259. DOI: 10.3390/nu13103612. View

13.

Fidanza F, Alberti A, Lanti M, Menotti A . Mediterranean Adequacy Index: correlation with 25-year mortality from coronary heart disease in the Seven Countries Study. Nutr Metab Cardiovasc Dis. 2005; 14(5):254-8. DOI: 10.1016/s0939-4753(04)80052-8. View

14.

Gryp T, Vanholder R, Vaneechoutte M, Glorieux G . p-Cresyl Sulfate. Toxins (Basel). 2017; 9(2). PMC: 5331431. DOI: 10.3390/toxins9020052. View

15.

Menotti A, Alberti-Fidanza A, Fidanza F . The association of the Mediterranean Adequacy Index with fatal coronary events in an Italian middle-aged male population followed for 40 years. Nutr Metab Cardiovasc Dis. 2010; 22(4):369-75. DOI: 10.1016/j.numecd.2010.08.002. View

16.

Kouvari M, DCunha N, Travica N, Sergi D, Zec M, Marx W . Metabolic Syndrome, Cognitive Impairment and the Role of Diet: A Narrative Review. Nutrients. 2022; 14(2). PMC: 8780484. DOI: 10.3390/nu14020333. View

17.

di Giuseppe R, Bonanni A, Olivieri M, Di Castelnuovo A, Donati M, de Gaetano G . Adherence to Mediterranean diet and anthropometric and metabolic parameters in an observational study in the 'Alto Molise' region: the MOLI-SAL project. Nutr Metab Cardiovasc Dis. 2007; 18(6):415-21. DOI: 10.1016/j.numecd.2007.05.010. View

18.

Alberti-Fidanza A, Fidanza F . Mediterranean Adequacy Index of Italian diets. Public Health Nutr. 2004; 7(7):937-41. DOI: 10.1079/phn2004557. View

19.

Pan P, Yu J, Wang L . Colon Cancer: What We Eat. Surg Oncol Clin N Am. 2018; 27(2):243-267. PMC: 5836483. DOI: 10.1016/j.soc.2017.11.002. View

20.

Rysz J, Franczyk B, Cialkowska-Rysz A, Gluba-Brzozka A . The Effect of Diet on the Survival of Patients with Chronic Kidney Disease. Nutrients. 2017; 9(5). PMC: 5452225. DOI: 10.3390/nu9050495. View