Co-occurrence of Modifiable Risk Factors for Kidney Disease with Minerals, Vitamins and Macronutrients Intake in Patients with Type 2 Diabetes Mellitus

AIM: To determine prevalence and co-occurrence of modifiable risk factors (MRF) for chronic kidney disease (CKD) regarding mineral, vitamin and macronutrient intake in patients with type 2 diabetes mellitus. METHODS. Cross-sectional study in 548 patients (31% with CKD). Nutrient intake assessed using 24-h food recall; adequate intake determined according with Clinical Practice Guideline for Nutrition in CKD and European Society for Clinical Nutrition and Metabolism. MRF considered: hypertension, hyperglycemia, dyslipidemia, overweight-obesity, higher waist circumference, and hyperuricemia. Kidney function evaluated according with KDIGO. RESULTS. A high frequency of MRF (with a co-occurrence of ≥5 MRF in >65%) and non-compliance with RDI for many macronutrients, minerals and vitamins were observed in the entire sample. In multivariate analysis of macronutrients, patients who did not meet carbohydrate RDI had increased risk [OR (95%CI), p ] for CKD [1.6 (1.0-2.6), 0.03], and those who did not meet RDI for cholesterol and total fiber had higher risk for increased urinary albumin/creatinine ratio [1.6 (1.1-2.5), 0.02, and 1.5 (1.0-2.3), 0.04, respectively]. For micronutrients, patients who did not meet RDI for phosphorus and vitamin K had lower risk [0.4 (0.2-0.8) 0.005 and 0.5 (0.2-0.9), 0.01,respectively] for lower glomerular filtration rate. Patients with co-ocurrence of ≥5MRF had higher risk for increased albuminuria and CKD [1.6 (1.1-2.5), 0.01, and 1.5 (1.1-2.3), 0.01, respectively]. CONCLUSIONS. Co-occurrence of ≥5 MRF was associated with higher albumin/creatinine rate and higher frequency of CKD. Non-compliance with RDI for carbohydrates, cholesterol and fiber increased the risk of decreased glomerular filtration rate and higher albuminuria.