坚果摄入、肾功能、慢性肾脏病与死亡率：一项系统综述。
完整摘要 · 中文译文
综述目的：本系统综述评估坚果摄入与肾脏健康结局之间的关联，包括肾功能标志物以及慢性肾脏病（CKD）的发病率、患病率和死亡率。鉴于坚果的营养益处和CKD日益加重的疾病负担，我们旨在评估坚果摄入是否与肾脏相关结局相关，并评估现有证据的强度和一致性。 近期发现：近期的观察性研究和队列分析提供了关于坚果摄入与肾脏结局之间关系的新兴但异质性的证据。较高的坚果摄入量以及用坚果替代红肉和加工肉类，在一些人群中与较低的CKD风险或患病率相关。然而，关于特定肾功能标志物（如估算肾小球滤过率和白蛋白尿）的研究结果在各研究之间仍不一致。坚果也已在植物性饮食指数和基于生物标志物的方法中进行了评估，产生了互补但不一致的结果。在已确诊CKD的个体或高危人群中的证据有限。总体而言，暴露定义、结局指标和研究人群的变异性导致关联强度和一致性存在不确定性。当前证据表明，坚果摄入，尤其是当坚果替代红肉和加工肉类时，可能在一些人群中与有利的肾脏相关结局相关。然而，证据主要为观察性研究，不能确立因果关系或最佳水 坚果摄入水平对肾脏健康的影响。研究设计和结局评估的异质性进一步限制了确定性结论的得出。未来研究应优先开展设计良好的前瞻性研究和随机对照试验，以确立因果关系、阐明剂量-反应关系，并确定坚果在慢性肾脏病（CKD）预防和管理的CKD特异性饮食建议中的作用。
完整摘要 · 英文原文
PURPOSE OF REVIEW: This systematic review evaluates the association between nut consumption and kidney health outcomes, including kidney function markers and chronic kidney disease (CKD) incidence, prevalence, and mortality. Given the nutritional benefits of nuts and the growing burden of CKD, we aimed to assess whether nut consumption is associated with kidney-related outcomes and to assess the strength and consistency of the available evidence. RECENT FINDINGS: Recent observational studies and cohort analyses provide emerging but heterogeneous evidence on the relationship between nut intake and kidney outcomes. Higher nut consumption and substitution of red and processed meat with nuts are associated with lower CKD risk or prevalence in some populations. However, findings for specific kidney function markers, such as estimated glomerular filtration rate and albuminuria, remain inconsistent across studies. Nuts have also been evaluated within plant-based dietary indices and through biomarker-based approaches, yielding complementary but non-uniform results. Evidence in individuals with established CKD or high-risk populations is limited. Overall, variability in exposure definitions, outcome measures, and study populations contributes to uncertainty in the strength and consistency of associations. Current evidence suggests that nut consumption, particularly when nuts replace red and processed meat, may be associated with favorable kidney-related outcomes in some populations. However, the evidence is predominantly observational and does not establish causality or an optimal level of nut consumption for kidney health. The heterogeneity in study design and outcome assessment further constrains definitive conclusions. Future research should prioritize well-designed prospective studies and randomized controlled trials to establish causality, clarify dose-response relationships, and determine the role of nuts in CKD-specific dietary recommendations for its prevention and management.