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Dietary acid load and chronic kidney disease among adults in the United States.
BMC Nephrol. 2014 Aug 24; 15:137.BN

Abstract

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/1.73 m(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 (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.

Authors+Show Affiliations

Department of Medicine, University of California, San Francisco, CA, USA. banerjeet@medsfgh.ucsf.edu.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

25151260

Citation

Banerjee, Tanushree, et al. "Dietary Acid Load and Chronic Kidney Disease Among Adults in the United States." BMC Nephrology, vol. 15, 2014, p. 137.
Banerjee T, Crews DC, Wesson DE, et al. Dietary acid load and chronic kidney disease among adults in the United States. BMC Nephrol. 2014;15:137.
Banerjee, T., Crews, D. C., Wesson, D. E., Tilea, A., Saran, R., Rios Burrows, N., Williams, D. E., & Powe, N. R. (2014). Dietary acid load and chronic kidney disease among adults in the United States. BMC Nephrology, 15, 137. https://doi.org/10.1186/1471-2369-15-137
Banerjee T, et al. Dietary Acid Load and Chronic Kidney Disease Among Adults in the United States. BMC Nephrol. 2014 Aug 24;15:137. PubMed PMID: 25151260.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary acid load and chronic kidney disease among adults in the United States. AU - Banerjee,Tanushree, AU - Crews,Deidra C, AU - Wesson,Donald E, AU - Tilea,Anca, AU - Saran,Rajiv, AU - Rios Burrows,Nilka, AU - Williams,Desmond E, AU - Powe,Neil R, AU - ,, Y1 - 2014/08/24/ PY - 2014/02/06/received PY - 2014/08/03/accepted PY - 2014/8/25/entrez PY - 2014/8/26/pubmed PY - 2015/3/31/medline SP - 137 EP - 137 JF - BMC nephrology JO - BMC Nephrol VL - 15 N2 - 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/1.73 m(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 (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. SN - 1471-2369 UR - https://www.unboundmedicine.com/medline/citation/25151260/Dietary_acid_load_and_chronic_kidney_disease_among_adults_in_the_United_States_ L2 - https://www.biomedcentral.com/1471-2369/15/137 DB - PRIME DP - Unbound Medicine ER -