{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T16:21:08Z","timestamp":1788366068764,"version":"build-2803163510"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"abstract":"\n Background:<\/jats:title>\n Ultra-processed foods (UPFs) are associated with adverse health. Plant foods can be highly processed. It is not clear whether plant- and animal-sourced UPFs are associated chronic kidney disease (CKD) risk.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n Data came from the Cardiovascular Health Study, a prospective cohort of 2,661 older adults (\u226565 years). The exposure was UPF intake, classified as plant- or animal-sourced in servings\/day using the Nova framework from food frequency questionnaires (1989-1990, 1995-1996). The outcome was incident CKD (estimated glomerular filtration rate [eGFR] <60 mL\/min\/1.73 m\n 2<\/jats:sup>\n ) and absolute eGFR change (up to 18 years). Time-dependent Cox and linear models were used to examine the associations between total, plant-, and animal-sourced UPF, and minimally-processed food (MPF) intake with incident CKD and eGFR change.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n After a median 6.8 years follow-up and adjusting for demographics and health behaviors, those in the highest tertiles of total and animal-sourced UPF intake had 26% and 37% higher risk of incident CKD compared to the lowest tertile (Hazard Ratio (HR) 1.26; 95% CI 1.08, 1.47; p-trend=0.003 and HR 1.37; 95% CI 1.17, 1.60; p-trend<0.001, respectively). Per standard deviation higher plant-sourced UPF was associated with higher CKD risk (HR 1.07; 95% CI 1.01, 1.13) but not in categorical analyses (p-trend=0.12). Higher total MPF was associated with 20% lower risk of incident CKD (HR 0.80 for tertile 3 vs. 1; 95% CI 0.69, 0.95; p-trend = 0.008). Replacing three servings of total MPF with total UPF (HR 1.02; 95% CI 1.001, 1.03, p=0.04) and plant-sourced MPF with plant-sourced UPF (HR 1.02; 95% CI 1.002, 1.05, p=0.03) was weakly associated with elevated risks of CKD. No associations were observed for eGFR change. Competing risks analyses for mortality attenuated estimates.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Total, and animal-sourced UPF were associated with incident CKD and plant-sourced UPF was modestly associated. Health benefits of plant foods may be dampened by ultra-processing, but additional work is needed in younger populations.<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.0000001207","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T16:00:38Z","timestamp":1788364838000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Plant- and Animal-Sourced Ultra-Processed Foods and Incident CKD in the Cardiovascular Health Study"],"prefix":"10.2215","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6487-5258","authenticated-orcid":false,"given":"Courtney M.","family":"Hill","sequence":"first","affiliation":[{"name":"Department of Epidemiology, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Feinberg","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5442-8745","authenticated-orcid":false,"given":"Casey M.","family":"Rebholz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD"},{"name":"Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7038-1844","authenticated-orcid":false,"given":"Rozenn","family":"Lemaitre","sequence":"additional","affiliation":[{"name":"Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA"},{"name":"Department of Medicine, University of Washington, Seattle, Washington, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5358-2345","authenticated-orcid":false,"given":"Amanda M.","family":"Fretts","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Washington, Seattle, WA"},{"name":"Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2749-1279","authenticated-orcid":false,"given":"Kerri L.","family":"Wiggins","sequence":"additional","affiliation":[{"name":"Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2705-6237","authenticated-orcid":false,"given":"Nona","family":"Sotoodehnia","sequence":"additional","affiliation":[{"name":"Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA"},{"name":"Department of Medicine, University of Washington, Seattle, Washington, WA"},{"name":"Division of Cardiology, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S.","family":"Floyd","sequence":"additional","affiliation":[{"name":"Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA"},{"name":"Department of Medicine, University of Washington, Seattle, Washington, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0484-4385","authenticated-orcid":false,"given":"Benjamin","family":"Lidgard","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington, Seattle, Washington, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9583-8628","authenticated-orcid":false,"given":"Nisha","family":"Bansal","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington, Seattle, Washington, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce M.","family":"Psaty","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Washington, Seattle, WA"},{"name":"Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1707-7018","authenticated-orcid":false,"given":"Hyunju","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Washington, Seattle, WA"},{"name":"Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,2]]},"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.0000001207","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T16:00:38Z","timestamp":1788364838000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2215\/CJN.0000001207"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":0,"URL":"https:\/\/doi.org\/10.2215\/cjn.0000001207","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,2]]},"assertion":[{"value":"2026-05-08","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-28","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}