The dietary index for gut microbiota, genetically predicted gut microbiome, and the risk of chronic kidney disease: a cohort study.

Background

the dietary index for gut microbiota (DI-GM) is a recently proposed index that reflects the diversity of the gut microbiota from the perspective of dietary intake. However, its association with chronic kidney disease (CKD) has not been widely studied.

Methods

this prospective cohort study included 166 865 participants free of CKD at baseline. The DI-GM was assessed through a 24 h dietary recall questionnaire. Incident CKD was ascertained using hospital inpatient records, death registry data, and primary care data. A genetic risk score for gut microbial abundance was constructed based on 19 variants. The Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for CKD incidence.

Results

during a median follow-up of 9.44 years, 3977 participants developed CKD. In the fully adjusted model, compared with the lowest group for the DI-GM (0-3 points), participants in higher DI-GM groups (4, 5, and ≥6 points) had a significantly lower risk of CKD. The adjusted HRs (95% CIs) for these groups were 0.81 (0.74, 0.88), 0.79 (0.72, 0.86), and 0.73 (0.67, 0.80), respectively (P for trend <0.0001). Significant multiplicative interactions were observed between genetically predicted gut microbial abundance and adherence to the DI-GM (P for interaction = 0.004).

Conclusion

adherence to the DI-GM was strongly linked to a reduced risk of incident CKD, particularly in individuals with high gut microbial abundance.