Chronic Kidney Disease (CKD) often progresses to End-Stage Renal Disease (ESRD), requiring dialysis or transplantation. This study aimed to examine the relationship between the Energy-Adjusted Dietary Inflammatory Index (E-DII) and metabolic parameters, including glycemic indices, lipid profiles, renal and hepatic functions, blood pressure, and anthropometric measurements, in hemodialysis patients. In this exploratory cross-sectional study, 300 hemodialysis patients from Ahvaz, Iran, were enrolled. Dietary intake was assessed using a 168-item Food Frequency Questionnaire (FFQ), and E-DII scores were calculated to assess dietary inflammation. Key metabolic parameters, including body mass index (BMI), waist circumference (WC), fasting blood sugar (FBS), lipid profiles, blood pressure, renal and hepatic function markers, and physical activity levels, were measured using standardized protocols. Statistical analyses were performed to evaluate the associations between E-DII scores and these outcomes. Higher E-DII scores, indicating diets with greater inflammatory potential, were significantly associated with increased post-dialysis BMI and WC ( P < 0.001); however, these measures may be influenced by fluid status in hemodialysis patients. higher fasting blood sugar ( P < 0.001), and dyslipidemia, including elevated triglycerides ( P < 0.001), total cholesterol ( P = 0.03), and LDL-c ( P = 0.02). Renal function was also affected, with higher plasma creatinine ( P = 0.01) and uric acid levels ( P < 0.001) in patients with higher E-DII scores. Blood pressure was significantly elevated across increasing E-DII quartiles ( P < 0.001). Physical activity levels were inversely associated with E-DII scores ( P < 0.001). Higher E-DII scores were associated with unfavorable metabolic outcomes in this exploratory cross-sectional sample of hemodialysis patients. Associations with anthropometric measures should be interpreted with caution, as post-dialysis body dimensions are influenced by fluid status. These findings suggest an association that supports the need for further longitudinal research to confirm these relationships and evaluate the potential benefits of anti-inflammatory dietary strategies. Given the exploratory nature of this analysis and the absence of adjustment for multiple comparisons, results should be interpreted with caution and require confirmation in independent cohorts. Further research using full DII components (including herbs and spices) and prospective designs is required to assess the benefits of anti-inflammatory diets in this population.
Karimi et al. (Tue,) studied this question.