Abstract

BACKGROUND We investigated the associations of fruit and vegetable (F&V) consumption after kidney transplantation with risk of CV mortality in an extensively phenotyped cohort of renal transplant recipients (RTR) with long-term follow-up. METHODS F&V consumption were assessed by means of an item-specific food-frequency questionnaire. Multivariable-adjusted Cox-proportional hazards regression analysis was performed to assess the risk of CV mortality. RESULTS We included 400 RTR (age 52±12 (SD) years old, 54% males). At a median follow-up of 7.2 [interquartile range, 6.7-7.6] years, 93 (23%) patients died, of which 49 (53%) were due to CV disease. Overall, fruit consumption was not associated with CV mortality, whereas vegetable consumption was inversely associated with risk of CV mortality (Table 1). This association remained independent of adjustment for several potential confounders. The association of fruit consumption with CV mortality was significantly modified by renal function (Pint=0.01) and proteinuria (Pint=0.01), with significant inverse associations in patients with estimated Glomerular Filtration Rate (eGFR)>45 mL/min/1.73m2 (HR, 0.56; 95% CI, 0.35-0.92; P=0.02) or absence of proteinuria (HR, 0.62; 95% CI, 0.41-0.92; P=0.02). CONCLUSION In RTR, a relatively high vegetable consumption is independently and strongly associated with lower risk of premature CV mortality. A relatively high fruit consumption is also associated with lower risk of premature CV mortality, although particularly in RTR with eGFR>45 mL/min/1.73m2 or absence of proteinuria. Further studies are warranted to investigate whether increasing F&V consumption may open opportunities for interventional pathways to decrease the burden of CV mortality in RTR.