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Dietary Acid Load and Incident Chronic Kidney Disease: Results from the ARIC Study.

TitleDietary Acid Load and Incident Chronic Kidney Disease: Results from the ARIC Study.
Publication TypeJournal Article
Year of Publication2015
AuthorsRebholz CM, Coresh JJ, Grams ME, Steffen LM, Anderson CAM, Appel LJ
Secondary AuthorsCrews DC
JournalAm J Nephrol
Volume42
Issue6
Pagination427-35
Date Published2015
ISSN1421-9670
KeywordsAcidosis, Acids, Adult, Aged, Diet, Dietary Proteins, Female, Follow-Up Studies, Glomerular Filtration Rate, Humans, Incidence, Kidney, Kidney Failure, Chronic, Magnesium, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, Registries, Renal Insufficiency, Chronic, Risk Factors, United States
Abstract

BACKGROUND: Higher dietary acid load can result in metabolic acidosis and is associated with faster kidney disease progression in patients with chronic kidney disease (CKD). However, the relationship between dietary acid load and incident CKD has not been evaluated.

METHODS: We conducted prospective analyses of the Atherosclerosis Risk in Communities study participants without CKD at baseline (1987-1989, n = 15,055). Dietary acid load was estimated using the equation for potential renal acid load by Remer and Manz, incorporating dietary intake data from a food frequency questionnaire. Incident CKD was assessed from baseline through 2010 and defined as estimated glomerular filtration rate (eGFR)

RESULTS: In the overall study population, 55% were female, 26% were African-American and mean age at baseline was 54 years. During a median follow-up of 21 years, there were 2,351 (15.6%) incident CKD cases. After adjusting for demographics (age, sex, race-center), established risk factors (diabetes status, hypertension status, overweight/obese status, smoking status, education level, physical activity), caloric intake and baseline eGFR, higher dietary acid load were associated with higher risk of incident CKD (hazard ratio [HR] for quartile 4 vs. 1: 1.13, 95% CI 1.01-1.28, p for trend = 0.02; HR per interquartile range increase: 1.06, 95% CI 1.00-1.11, p = 0.04).

CONCLUSION: Dietary acid load is associated with incident CKD in a population-based sample. These data suggest a potential avenue for CKD risk reduction through diet.

DOI10.1159/000443746
Alternate JournalAm J Nephrol
PubMed ID26789417
PubMed Central IDPMC4733508
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100009I / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
K23 DK097184 / DK / NIDDK NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
P30 DK072488 / DK / NIDDK NIH HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States
K08 DK092287 / DK / NIDDK NIH HHS / United States