Novel approaches to assess diet and kidney health risk

Chronic kidney disease (CKD) is a global public health problem. CKD is ultimately resulting in kidney failure and is an important cause of premature mortality and cardiovascular morbidity. The diet plays an important role in the development and progression of CKD and kidney function decline. This thesis describes several new approaches to assess the association between diet and kidney health, taking into account the complexity of overall diet and dietary intake in real life. Through observational prospective Lifelines cohort studies, spatial differences in kidney function are observed in the Northern Netherlands, which may be related to the neighborhood-level dietary intake. Higher adherence to a high-quality diet underlying the 2015 Dutch Dietary Guidelines is associated with a lower risk of incident CKD or kidney function decline in the general population. Kidney-specific dietary patterns are identified and are strongly linked with kidney health risk, thus, they can be considered to design tailored and targeted measures to prevent kidney health risk in the general population and kidney transplant recipients. Ultra-processed foods as modern industrial products become increasingly prominent in the food supplies and dietary patterns. We found that they are associated with a higher kidney health risk. In conclusion, achieving healthier dietary habits is a main strategy for the prevention of CKD and its complications (including cardiovascular disease). Novel approaches, addressing the complexity of diet in daily life, provide important insights and opportunities to guide the prevention of CKD by dietary measures in the future.