Dietary acid load and chronic kidney disease among adults in the United States

被引:101
作者
Banerjee, Tanushree [1 ,8 ]
Crews, Deidra C. [2 ,3 ]
Wesson, Donald E. [4 ]
Tilea, Anca [5 ]
Saran, Rajiv [5 ,6 ]
Burrows, Nilka Rios [7 ]
Williams, Desmond E. [7 ]
Powe, Neil R. [1 ,8 ]
机构
[1] Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA
[2] Johns Hopkins Univ, Sch Med, Dept Med, Div Nephrol, Baltimore, MD 21205 USA
[3] Johns Hopkins Med Inst, Welch Ctr Prevent Epidemiol & Clin Res, Baltimore, MD 21205 USA
[4] Scott & White Healthcare, Temple, TX USA
[5] Univ Michigan, Kidney Epidemiol & Cost Ctr, Ann Arbor, MI 48109 USA
[6] Univ Michigan, Dept Med, Div Nephrol, Ann Arbor, MI 48109 USA
[7] Ctr Dis Control & Prevent, Atlanta, GA USA
[8] San Francisco Gen Hosp, Dept Med, San Francisco, CA 94110 USA
基金
美国国家卫生研究院;
关键词
Acidosis; Albuminuria; Chronic kidney disease; NHANES (National Health and Nutrition Examination Survey); Nutrition; GLOMERULAR-FILTRATION-RATE; NUTRITION EXAMINATION SURVEY; PLANT PROTEIN-INTAKE; METABOLIC-ACIDOSIS; NATIONAL-HEALTH; SERUM BICARBONATE; ENDOTHELIN; PROGRESSION; DECLINE; FOOD;
D O I
10.1186/1471-2369-15-137
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: Diet can markedly affect acid-base status and it significantly influences chronic kidney disease (CKD) and its progression. The relationship of dietary acid load (DAL) and CKD has not been assessed on a population level. We examined the association of estimated net acid excretion (NAE(es)) with CKD; and socio-demographic and clinical correlates of NAE(es). Methods: Among 12,293 U.S. adult participants aged > 20 years in the National Health and Nutrition Examination Survey 1999-2004, we assessed dietary acid by estimating NAE(es) from nutrient intake and body surface area; kidney damage by albuminuria; and kidney dysfunction by eGFR < 60 ml/min/1.73m(2) using the MDRD equation. We tested the association of NAE(es) with participant characteristics using median regression; while for albuminuria, eGFR, and stages of CKD we used logistic regression. Results: Median regression results (beta per quintile) indicated that adults aged 40-60 years (beta [95% CI] = 3.1 [0.3-5.8]), poverty (beta [95% CI] = 7.1 [4.01-10.22]), black race (beta [95% CI] = 13.8 [10.8-16.8]), and male sex (beta [95% CI] = 3.0 [0.7-5.2]) were significantly associated with an increasing level of NAE(es). Higher levels of NAE(es) compared with lower levels were associated with greater odds of albuminuria (OR [95% CI] = 1.57 [1.20-2.05]). We observed a trend toward greater NAE(es) being associated with higher risk of low eGFR, which persisted after adjustment for confounders. Conclusion: Higher NAE(es) is associated with albuminuria and low eGFR, and socio-demographic risk factors for CKD are associated with higher levels of NAE(es). DAL may be an important target for future interventions in populations at high risk for CKD.
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页数:12
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