Title | Dietary Acid Load and Incident Chronic Kidney Disease: Results from the ARIC Study. |
Publication Type | Journal Article |
Year of Publication | 2015 |
Authors | Rebholz CM, Coresh JJ, Grams ME, Steffen LM, Anderson CAM, Appel LJ |
Secondary Authors | Crews DC |
Journal | Am J Nephrol |
Volume | 42 |
Issue | 6 |
Pagination | 427-35 |
Date Published | 2015 |
ISSN | 1421-9670 |
Keywords | Acidosis, 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. |
DOI | 10.1159/000443746 |
Alternate Journal | Am J Nephrol |
PubMed ID | 26789417 |
PubMed Central ID | PMC4733508 |
Grant List | HHSN268201100012C / 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 |