Korean J Fam Med. 2026 Oct 21. doi: 10.4082/kjfm.26.0060. Online ahead of print.
ABSTRACT
BACKGROUND: The prevalence and mortality of chronic kidney disease (CKD) are high. Systemic inflammation often occurs in patients with CKD and limits overall survival. The dietary inflammatory index (DII), developed to assess the inflammatory potential of diet, may be an underrecognized risk factor for CKD mortality.
METHODS: This study included 7,113 adult participants from the US National Health and Nutrition Examination Survey conducted between 2005 and 2018. Multivariable Cox regression analysis was used to assess the association between DII scores and mortality in patients with CKD, with hazard ratios (HRs) and 95% confidence intervals (CIs) reported. Restricted cubic spline (RCS) models were used to evaluate non-linear associations, whereas subgroup and mediation analyses explored potential effect modifications and mediation effects.
RESULTS: The all-cause mortality rate among patients with CKD was 19.3%. After full adjustment (model 3), the highest DII quartile showed a 23% higher mortality risk (HR, 1.23; 95% CI, 1.07-1.42; Ptrend<0.001) compared with the lowest quartile. RCS confirmed a linear dose-response relationship (Poverall<0.001, Pnon-linear=0.549). No associations were observed for cardiovascular or malignant tumor mortality. The effect of DII scores on all-cause mortality was more pronounced in patients with lower body weight.
CONCLUSION: Higher DII scores are associated with elevated all-cause mortality in patients with CKD, supporting the potential benefit of anti-inflammatory diets.
PMID:42902776 | DOI:10.4082/kjfm.26.0060