San Diego—An international group of researchers, led by Camilo G. Sotomayor, conducted a prospective cohort study to examine the associations of consumption of fruits and vegetables following kidney transplantation and the risk of cardiovascular death. The study population included an extensively phenotyped cohort of renal transplant recipients with long-term follow-up. Results of the study were reported during a poster session at Kidney Week 2018 in a poster titled Fruit and Vegetable Consumption and Cardiovascular Mortality in Renal Transplant Recipients: A Prospective Cohort Study.
An item-specific food-frequency questionnaire was used to assess fruit and vegetable consumption. The risk of cardiovascular mortality was determined using multivariable-adjusted Cox proportional hazards regression analysis.
The total study population included 400 renal transplant recipients; mean age was 52 years and 54% were male. At a median follow-up of 7.2 years, 23% (n=93) of patients died; 49 of those due to cardiovascular causes.
There was no association between fruit consumption and risk of cardiovascular mortality. There was an inverse association between vegetable consumption and the risk of cardiovascular mortality. Independent of adjustment for several potential confounders, the association remained.
The association of fruit was significantly modified by renal function (Pint=.01) and proteinuria (Pint=.01). There were significant inverse associations between fruit consumption and risk of cardiovascular mortality in patients with estimated glomerular filtration rate (eGFR) >45 mL/min/1.73 m2 (hazard ratio [HR], 0.56; 95% confidence interval [CI], 0.35-0.92; P=.02) o absence of proteinuria (HR, 0.63; 95% CI, 0.41-0.92; P=.02).
In conclusion, the researchers said, “In renal transplant recipients, a relatively high vegetable consumption is independently and strongly associated with a lower risk of premature cardiovascular mortality. A relatively high fruit consumption is also associated with a lower risk of premature cardiovascular mortality, although particularly in renal transplant recipients with eGFR >45 mL/min/1.73 m2 or absence of proteinuria. Further studies are warranted to further investigate whether increasing fruit and vegetable consumption may open opportunities for interventional pathways to decrease the burden of cardiovascular mortality in renal transplant recipients.”