Associations of proanthocyanidin intake with renal function and clinical outcomes in elderly women

PLoS One. 2013 Aug 5;8(8):e71166. doi: 10.1371/journal.pone.0071166. Print 2013.

Abstract

Background: Progression to chronic renal failure involves accelerated atherosclerosis and vascular calcification. Oxidative stress and endothelial dysfunction play a role in renal failure pathophysiology. In addition to improving vascular health and function, proanthocyanidins have been shown to exert renoprotective effects in animal models. Thus we hypothesize that proanthocyanidins may contribute to the maintenance of healthy renal function.

Objective: Determine the association of habitual proanthocyanidin intake with renal function and the risk of clinical renal outcomes in a population of elderly women.

Design: 948 women aged over 75 y, free of prevalent renal disease at baseline, were randomly selected from ambulant Caucasian women. Proanthocyanidin consumption was determined using a validated food frequency questionnaire and the United States Department of Agriculture proanthocyanidin food content database. Fasting serum cystatin C and creatinine were assessed at baseline. Renal failure hospitalisations and deaths were assessed over 5 years of follow-up through the Western Australia Data Linkage System.

Results: Compared to participants with low consumption, participants in the highest tertile of proanthocyanidin intake had a 9% lower cystatin C concentration (P<0.001). High proanthocyanidin consumers were at 50% lower risk of moderate chronic kidney insufficiency, and 65% lower risk of experiencing a 5-year renal disease event (P<0.05). These relationships remained significant following adjustment for renal disease risk factors and diet-related potential confounders.

Conclusion: Increased consumption of proanthocyanidins was associated with better renal function and substantially reduced renal associated events, which has been supported by mechanistic and animal model data. Proanthocyanidin intake should be further examined as a dietary contributor to better renal health.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged*
  • Aged, 80 and over
  • Eating
  • Feeding Behavior
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • Kidney / drug effects*
  • Kidney Failure, Chronic / epidemiology*
  • Proanthocyanidins / administration & dosage*
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Risk Factors

Substances

  • Proanthocyanidins
  • proanthocyanidin

Grant support

The study was supported by research grants from Kidney Health Australia grant S07 10, Healthway Health Promotion Foundation of Western Australia, Sir Charles Gairdner Hospital Research Advisory Committee and by the project grants 254627, 303169 and 572604 from the National Health and Medical Research Council of Australia. JRL is supported by a Raine Medical Research Foundation Priming Grant. None of these funding agencies had any input into any aspect of the design and management of this study.