Sex Differences in Diet Quality and Nutrient Intake in Adults Living With Chronic Kidney Disease

Abstract

\n \n \n Recognition is growing that sex impacts outcomes in kidney disease. Women tend to have slower kidney function decline and better controlled risk factors pre-dialysis but the same mortality rates as men once dialysis starts. In the general population, women tend to have higher diet quality scores. Little is known about how sex differences impact diet quality and how this may explain known sex differences in this population.\n \n \n \n Diet History Questionnaire-3 (DHQ3) was administered to adults attending the Grey Nuns Hospital in Edmonton Alberta pre-dialysis (CKD; n\xa0=\xa046) or Hemodialysis (HD; n\xa0=\xa065) clinics. Healthy Eating Index (HEI) was used to assess diet quality. Nutrient intake was assessed per kg of body weight and adjusted for energy intake (i.e., per 1000kcal).\xa0Outcomes\xa0were assessed with subjects divided into sex category and clinic (CKD vs HD). Two tailed t-tests were used to test for sex differences in parametric variables. HEI scores were compared to age-matched general population values and sorted into below or above the comparator. Chi-square test were used to test for statistical significance in categorical variables.\n \n \n \n 110 participants were included, 51 females and 60 males. There was no sex difference in mean HEI between females (61.2\xa0±\xa09.7)\xa0and males (59.9\xa0±\xa08.8;\xa0p\xa0=\xa00.464). 57% of females and 60% of males had HEI scores below mean age-matched HEI scores for the general population and no sex differences were observed. Pre-dialysis females had higher whole fruit composite scores vs pre-dialysis males (females 4.7\xa0±\xa00.7;\xa0males 3.8\xa0±\xa01.6,\xa0p\xa0=\xa00.015). Males consumed more total and mg/kg body weight protein, potassium, phosphorus and sodium than females (all p\xa0<\xa00.05); however, when intakes were adjusted for energy intake, there was no difference.\n \n \n \n In this cohort of patients with CKD there were no observed differences in diet quality score between males and females. The majority of CKD patients had lower diet quality scores than the general population which might explain, to some extent, the few sex differences observed in this population. However, the higher whole fruit composite scores in pre-dialysis women may to some degree explain sex differences observed in pre-dialysis kidney disease. Further studies exploring dietary intake and sex differences in this population appear warranted.\n \n \n \n None.\n