Abstract
BACKGROUND: Previous studies have suggested that gut dysbacteriosis may promote the onset of chronic kidney disease (CKD). However, the relationship between consumption of live microorganisms and CKD remains unclear. This study aimed to evaluate the association between dietary consumption of live microorganisms and risk of CKD. METHODS: We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) spanning 2001 to 2018. Dietary intake was assessed through self-reported questionnaires, while CKD diagnosis was based on glomerular filtration rate and albumin-creatinine ratio measurements. RESULTS: After adjusting for potential confounders, participants with high live microbial intake had a significantly lower risk of CKD compared to those with low intake [odds ratio (OR): 0.79, 95% confidence interval (CI): 0.68-0.91, p = 0.001]. Similarly, those with moderate/high live microbial intake exhibited a reduced CKD risk compared to the low intake group (OR: 0.87, 95% CI: 0.78-0.97, p = 0.009). Subgroup analyses revealed a significant interaction between live microbial intake and CKD risk among participants with less than a high school education, as well as among Mexican Americans and other racial groups (including multiracial) (all P values for interaction < 0.05). A U-shaped dose-response relationship was identified between microbial intake and CKD risk, with significant non-linear associations observed for high consumption levels (P for non-linearity = 0.013). CONCLUSIONS: High dietary intake of live microorganisms is associated with a lower risk of CKD, highlighting the potential role of gut microbiota modulation in CKD prevention.