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 (NAEes) with CKD; and socio-demographic and clinical correlates of NAEes.
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 NAEes from nutrient intake and body surface area; kidney damage by albuminuria; and kidney dysfunction by eGFR
We tested the association of NAEes 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 NAEes. Higher levels of NAEes 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 NAEes being associated with higher risk of low eGFR, which persisted after adjustment for confounders.
Conclusion:
Higher NAEes is associated with albuminuria and low eGFR, and socio-demographic risk factors for CKD are associated with higher levels of NAEes. DAL may be an important target for future interventions in populations at high risk for CKD.
Author: Tanushree BanerjeeDeidra C CrewsDonald E WessonAnca TileaRajiv SaranNilka Rios BurrowsDesmond E WilliamsNeil R Powe
Credits/Source: BMC Nephrology 2014, 15:137
Published on: 2014-08-24
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