Study Links Plant-Based Diets to Lower Mortality in Chronic Kidney Disease

A predominantly plant-based dietary pattern is associated with significantly lower all-cause and renal-related mortality among patients with chronic kidney disease (CKD), according to research presented at the 63rd ERA Congress.

Researchers analyzed data from 8,165 adults with CKD, utilizing the National Health and Nutrition Examination Survey (NHANES) and the Health Care and Nutrition Study (HCNS). CKD was defined as having an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m² and/or the presence of albuminuria.

The study compared adherence to four major dietary patterns: the Dietary Approaches to Stop Hypertension (DASH) diet, the Mediterranean diet, the Planetary Health Diet (PHD), and the Inverted Pyramid Diet. These diets vary in their focus on plant-based foods, sustainability, and the consumption of animal-derived and ultra-processed foods.

Over a follow-up period of approximately 7-8 years, 2,847 deaths were recorded, accounting for 34.9% of the participants, with 312 of those classified as renal-related deaths.

The PHD was found to have the strongest correlation with reduced mortality rates. Each standard deviation increase in adherence to this diet was linked to a 17% reduction in overall mortality risk (HR: 0.83; 95% CI: 0.78-0.89; p<0.001) and a 24% reduction in renal-related mortality risk (HR: 0.76; 95% CI: 0.64-0.90; p=0.001).

While both the DASH and Mediterranean diets also showed associations with lower all-cause mortality, their benefits were less significant. Conversely, higher adherence to the Inverted Pyramid Diet was correlated with a higher risk of mortality. Participants following this diet reported an 18% increase in all-cause mortality risk (HR: 1.18; 95% CI: 1.10-1.27; p<0.001) and a 32% increase in renal-related mortality risk (HR: 1.32; 95% CI: 1.12-1.56; p=0.001).

The study further identified that consuming ultra-processed foods comprising at least 30% of total energy intake raised mortality risk by 24%, while eating high amounts of red meat, defined as four or more servings weekly, was linked to a 19% increase in mortality risk.

The authors concluded that dietary quality is crucial in managing CKD, advocating for plant-forward diets that emphasize minimally processed foods and limit red meat and ultra-processed items to improve long-term health outcomes in this vulnerable population.

Reference: Gembillo G et al. Plant-based versus ultra-processed dietary patterns and mortality in chronic kidney disease: a multicohort analysis. Abstract 3961. ERA Congress, 3-6 June 2026.