Race/Ethnicity, Dietary Acid Load, and Risk of End-Stage Renal Disease among US Adults with Chronic Kidney Disease.
Race/Ethnicity, Dietary Acid Load, and Risk of End-Stage Renal Disease among US Adults with Chronic Kidney Disease.
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DOI：
10.1159/000487715
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发表时间：
2018
影响因子：
4.2
通讯作者：
Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance Team
中科院分区：
文献类型：
--
作者：
Crews DC;Banerjee T;Wesson DE;Morgenstern H;Saran R;Burrows NR;Williams DE;Powe NR;Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance Team
膳食酸负荷（DAL）赋予CKD和CKD进展的风险。我们试图确定DAL与CKD患者中ESRD风险的种族/民族差异之间的关系。在1123名非西班牙裔黑人（NHB）和白人（NHW）国民健康与营养调查III参与者中，估计肾小球滤过率为15-59 ml/min/1.73 m2，使用Remer和Manz净酸排泄（NAEes）公式和24小时饮食回忆来估计DAL。ESRD事件通过与医疗保险的联系来确定。使用竞争风险模型（考虑死亡）来估计治疗ESRD的风险比（HR），比较NHBs与NHWs，调整人口统计学、临床和营养因素（体表面积、总热量摄入、血清碳酸氢盐、蛋白质摄入）和naee。另外，测试了naee与ESRD风险的关系是否因种族/民族而异。基线时，nhb的nae （50.9 mEq/d vs. 44.2 mEq/d）高于nhw。22%的患者在平均7.5年的时间内发展为ESRD。NHBs与NHWs的未调整风险比为3.35[95%可信区间（CI）， 2.51-4.48]；调整后的HR（以上因素）：1.68 （CI 1.18-2.38）。NAE与ESRD风险的相关性在非裔美国人（NAE校正HR每mEq/d增加1.21,CI 1.12-1.31）中比在非裔美国人（HR 1.08, CI 0.96-1.20）中更强，种族/民族*NAE的p交互作用=0.004。在美国成年CKD患者中，DAL与进展为ESRD的相关性在nhb患者中强于nhw患者。DAL对不同种族/民族的肾脏预后的影响值得进一步研究。
Dietary acid load (DAL) confers risk for CKD and CKD progression. We sought to determine the relation of DAL to racial/ethnic differences in risk of ESRD among persons with CKD. Among 1123 non-Hispanic black (NHB) and white (NHW) National Health and Nutrition Examination Survey III participants with estimated glomerular filtration rate 15-59 ml/min/1.73 m2, DAL was estimated using the Remer and Manz net acid excretion (NAEes) formula and 24-hour dietary recall. ESRD events were ascertained via linkage with Medicare. A competing risk model (accounting for death) was used to estimate the hazard ratio (HR) for treated ESRD, comparing NHBs with NHWs, adjusting for demographic, clinical and nutritional factors (body surface area, total caloric intake, serum bicarbonate, protein intake), and NAEes. Separately, whether the relation of NAEes with ESRD risk varied by race/ethnicity was tested. At baseline, NHBs had greater NAEes (50.9 vs. 44.2 mEq/d) than NHWs. Fully, 22% developed ESRD over a median of 7.5 years. The unadjusted HR comparing NHBs to NHWs was 3.35 [95% confidence interval (CI), 2.51-4.48]; adjusted HR (for factors above): 1.68 (CI 1.18-2.38). A stronger association of NAE with risk of ESRD was observed among NHBs (adjusted HR per mEq/d increase in NAE 1.21, CI 1.12-1.31) than among NHWs (HR 1.08, CI 0.96-1.20), p interaction for race/ethnicity*NAEes=0.004. Among U.S. adults with CKD, the association of DAL with progression to ESRD is stronger among NHBs than NHWs. DAL is worthy of further investigation for its contribution to kidney outcomes across race/ethnic groups.
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DOI：
10.1053/j.jrn.2014.07.008
发表时间：
2015-03
期刊：
Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation
影响因子：
--
作者：
Crews DC;Kuczmarski MF;Miller ER 3rd;Zonderman AB;Evans MK;Powe NR
通讯作者：
Powe NR
DOI：
10.1126/science.1193032
发表时间：
2010-08-13
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Genovese G;Friedman DJ;Ross MD;Lecordier L;Uzureau P;Freedman BI;Bowden DW;Langefeld CD;Oleksyk TK;Uscinski Knob AL;Bernhardy AJ;Hicks PJ;Nelson GW;Vanhollebeke B;Winkler CA;Kopp JB;Pays E;Pollak MR
通讯作者：
Pollak MR
影响因子：
--
作者：
Mellen, Philip B.;Gao, Sue K.;Goff, David C.
通讯作者：
Goff, David C.
影响因子：
13.6
作者：
Grams, Morgan E.;Massie, Allan B.;Segev, Dorry L.
通讯作者：
Segev, Dorry L.
影响因子：
3.3
作者：
Beydoun MA;Poggi-Burke A;Zonderman AB;Rostant OS;Evans MK;Crews DC
通讯作者：
Crews DC