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

BMC Nephrology

Neil R Powe¹  Desmond E Williams⁶  Nilka Rios Burrows⁶  Rajiv Saran²  Anca Tilea⁴  Donald E Wesson⁵  Deidra C Crews³  Tanushree Banerjee¹ 

[1] Department of Medicine, San Francisco General Hospital, San Francisco, CA, USA;Division of Nephrology, Department of Medicine and Kidney Epidemiology & Cost Center, University of Michigan, Ann Arbor, MI, USA;Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA;Kidney Epidemiology & Cost Center, University of Michigan, Ann Arbor, MI, USA;Texas A&M College of Medicine and Scott and White Healthcare, Texas, USA;Centers of Disease and Control and Prevention, Atlanta, GA, USA

关键词: Nutrition;    NHANES (National Health and Nutrition Examination Survey);    Chronic kidney disease;    Albuminuria;    Acidosis;   

Others  :  1082636
DOI  :  10.1186/1471-2369-15-137

 received in 2014-02-06, accepted in 2014-08-03,  发布年份 2014

【 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/1.73m² 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 (β per quintile) indicated that adults aged 40–60 years (β [95% CI] = 3.1 [0.3–5.8]), poverty (β [95% CI] = 7.1 [4.01–10.22]), black race (β [95% CI] = 13.8 [10.8–16.8]), and male sex (β [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.

【 授权许可】

   
2014 Banerjee et al.; licensee BioMed Central Ltd.

【 图 表 】

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