Dietary inflammatory index in patients with chronic kidney disease under conservative treatment at a university hospital in Rio de Janeiro, Brazil

Abstract

ABSTRACT Introduction: Chronic kidney disease (CKD) is associated with a chronic low-grade inflammatory state, which may be influenced by dietary patterns. The Dietary Inflammatory Index (DII) is a validated tool used to estimate the inflammatory potential of the diet. Objective: To evaluate the dietary inflammatory potential in patients with CKD undergoing conservative treatment and its association with anthropometric and cardiovascular risk markers. Methods: A cross-sectional observational study was conducted in adult patients diagnosed with stage 3–5 CKD under conservative management. Dietary intake was assessed using two non-consecutive 24-hour dietary recalls, and DII scores were calculated based on 36 dietary parameters. Anthropometric and cardiovascular risk indicators were evaluated, including body mass index (BMI), triceps skinfold thickness (TSFT), arm muscle area (AMA), waist-to-height ratio (WHtR), Castelli indices, and the conicity index (CI). Multivariate linear regression models were adjusted for age, sex, and estimated glomerular filtration rate (eGFR). Results: A total of 51 patients were included, with a median age of 71 years (IQR, 56–80), and 56.9% were female. The median DII score was 2.90 (IQR, 2.29–3.74), indicating a predominantly pro-inflammatory dietary profile. Higher DII scores were associated with higher conicity index values (β = 0.368; p = 0.010). No statistically significant associations were observed between the DII and other anthropometric, biochemical, or cardiovascular risk markers. Conclusion: Patients with CKD under conservative treatment exhibited predominantly pro-inflammatory dietary patterns. Higher DII scores were associated with greater central adiposity.