Identification of interactions between genetic risk scores and dietary patterns for personalized prevention of kidney dysfunction in a population-based cohort

Background & Aim: Chronic kidney disease (CKD) is heterogeneous in structure and function. This study investigated interactions between genetic factors and dietary patterns on kidney dysfunction in Korean adults. Methods: Baseline data from the Ansan and Ansung cohorts of the Korean Genome and Epidemiology Study included 8,230 adults aged 40–69 years. Kidney dysfunction was defined as eGFR < 90 mL/min/1.73 m². Genotyping (Affymetrix Genome-Wide Human SNP Array 5.0) and genome-wide association analysis (1,590,162 SNPs; generalized linear models) were conducted with significance threshold P < 5×10⁻⁸. Linkage disequilibrium clumping identified 94 significant SNPs. A genetic risk score (GRS) was computed; participants were grouped as low-GR (GRS > 0) and high-GR (GRS ≤ 0). Dietary intake (103-item FFQ) was reduced to dietary patterns via principal component analysis; factor scores were categorized into tertiles. Results: Three dietary patterns were identified: prudent; flour-based and animal food; and white rice. Higher adherence to the flour-based and animal food pattern was associated with higher kidney dysfunction prevalence in both GR groups (P for trend < 0.0001 in model 1; 0.0050 and 0.0065 in model 2 for low- and high-GR, respectively). Conclusions: The flour-based and animal food dietary pattern was associated with higher kidney dysfunction prevalence regardless of GR level. Findings support the potential for personalized nutritional interventions based on genetic risk profiles to prevent kidney dysfunction.