Relationship between dietary fiber and all-cause mortality, cardiovascular mortality, and cardiovascular disease in patients with chronic kidney disease: a systematic review and meta-analysis

Abstract

Background: The potential protective effects of dietary fiber against all-cause mortality, cardiovascular mortality, and cardiovascular disease in patients with chronic kidney disease have not been definitively established. To verify this relationship, a systematic review and a meta-analysis were undertaken. Methods: PubMed, The Cochrane Library, Web of Science, Embase, ProQuest, and CINAHL were used to systematically search for prospective cohort studies that investigate the association between dietary fiber and all-cause mortality, cardiovascular mortality, and cardiovascular disease in individuals with chronic kidney disease (CKD). This search was conducted up to and including March 2023. Results: The analysis included 10 cohort studies, with a total of 19,843 patients who were followed up for 1.5–10.1 y. The results indicated a significant negative correlation between dietary fiber and all-cause mortality among patients with CKD (HR 0.80, 95% CI 0.58–0.97, P < 0.001). Subgroup analysis further revealed that the study population and exposure factors were significantly associated with all-cause mortality (P < 0.001). Increased dietary fiber intake was associated with a reduced risk of cardiovascular mortality (HR 0.78; 95% CI 0.67–0.90) and a reduced incidence of cardiovascular disease (HR 0.87; 95% CI 0.80–0.95) among patients with CKD. Conclusions: The pooled results of our meta-analysis indicated an inverse association between dietary fiber intake and all-cause mortality, cardiovascular mortality, and cardiovascular disease. Graphical abstract: (Figure presented.)