Higher consumption of sulfur microbial diet is associated with the increased risk of chronic kidney disease.

Background: Emerging evidence suggested that dietary patterns linked to sulfur-metabolizing bacteria in the stool may influence kidney health. We aimed to investigate the association between the sulfur microbial diet and chronic kidney disease (CKD). Methods: We included 192,282 participants from the UK Biobank. The sulfur microbial diet score was derived from a 24-h dietary assessment, calculated by summing the products of the Results: After a median follow-up of 12.17 years, 4,739 incident CKD cases were identified. The fully adjusted HR of CKD for participants in the highest quartile was 1.15 (95% CI: 1.06, 1.24) compared with those in the lowest quartile. Substituting one serving per day of low-calorie drinks or sweets and desserts with an equal amount of other vegetables was significantly associated with a 7% or 5% reduction in CKD risk. In the mediation analyses, metabolic disorder factors accounted for 1.27-23.13% of the association between the sulfur microbial diet and CKD, while BMI explained 23.13% of the association. Conclusion: Higher sulfur microbial diet intake was associated with an increased risk of CKD, which was partially mediated by metabolic disorders. Replacing low-calorie drinks or sweets and desserts with other vegetables was related to a significant reduction in CKD risk. These findings highlighted the role of sulfur-metabolizing bacteria in the relationship between diet and CKD.