Macro partitioning
High dietary carbohydrate density (defined as the percentage of energy from carbohydrates) is associated with an increased risk of incident chronic kidney disease (CKD) in non-diabetic subjects with normal baseline renal function.
If you do not have diabetes and have normal kidney function, be mindful of the proportion of carbohydrates in your diet. This study suggests that diets where carbohydrates make up a very high percentage of your total energy (e.g., >75% of calories) may be associated with a higher risk of developing chronic kidney disease over time compared to diets with moderate carbohydrate intake. You do not need to eliminate carbs, but balancing them with adequate protein and healthy fats may support long-term kidney health.
In non-DM subjects, the risk of CKD development was significantly higher in the third (71.9–75.8%; HR, 1.20; 95% CI, 1.01–1.43; P = 0.04) and fourth (>75.8%; HR, 1.35; 95% CI 1.13–1.60; P = 0.001) quartiles than in the first dietary carbohydrate density quartile (<67.8%).
Why this rating
Large sample size (n=6746 non-DM), long follow-up (median 140 months), and multivariate adjustment, but relies on observational FFQ data rather than RCT.
Source
Carbohydrate-Rich Diet Is Associated with Increased Risk of Incident Chronic Kidney Disease in Non-Diabetic Subjects
Ki Heon Nam et al. · Journal of Clinical Medicine · 2019
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