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Mediterranean diet as a strategy for preserving kidney function in patients with coronary heart disease with type 2 diabetes and obesity: a secondary analysis of CORDIOPREV randomized controlled trial

Alicia Podadera-Herreros, Antonio P. Arenas-de Larriva, F. Gutierrez-Mariscal, J. Alcalá-Díaz, Ana Ojeda-Rodríguez, F. Rodríguez-Cantalejo, M. Cardelo, Diego Rodriguez-Cano et al.

Nutrition & Diabetes, 2024

1,002 participants · 29 citations

Abstract

Background Type 2 diabetes mellitus (T2DM) is recognized an independent risk factor for chronic kidney disease (CKD). The precise contribution and differential response to treatment strategies to reduce kidney dysfunction, depending on whether obesity is present alongside T2DM or not, remain to be fully clarified. Our objective was to improve our understanding of how obesity contributes to kidney function in patients with T2DM and coronary heart disease (CHD), who are highly predisposed to CKD, to assign the most effective dietary approach to preserve kidney function. Methods 1002 patients with CHD and estimated glomerular filtration rate (eGFR)≥30 ml/min/1.73m^2, were randomized to consume a Mediterranean diet (35% fat, 22% MUFA, 55% carbohydrates). Patients were classified into four groups according to the presence of T2DM and/or obesity at baseline: Non-Obesity/Non-T2DM, Obesity/Non-T2DM, Non-Obesity/T2DM and Obesity/T2DM. We evaluated kidney function using serum creatinine-based estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (uACR) before and after 5-years of dietary intervention. Results Patients with Obesity/T2DM had the lowest baseline eGFR and the highest baseline uACR compared to non-diabetics ( p < 0.05). After dietary intervention, the Mediterranean diet induced a lower eGFR decline in patients with Obesity/T2DM, compared to a low-fat diet but not in the other groups ( p = 0.014). The Mediterranean diet, but not the low-fat…

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Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,002 participants or records.

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