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Dietary Acid Intake and Kidney Disease Progression in the Elderly
- Source :
- American Journal of Nephrology. 39:145-152
- Publication Year :
- 2014
- Publisher :
- S. Karger AG, 2014.
-
Abstract
- Background/Aims: Non-volatile acid is produced by metabolism of organic sulfur in dietary protein, and promotes kidney damage. We investigated the role of dietary acid load, in terms of net endogenous acid production (NEAP), in chronic kidney disease (CKD) progression. Methods: 217 CKD patients on low-protein diet with a normal serum bicarbonate level were enrolled in this retrospective cohort study in Japan. The primary outcome was 25% decline in estimated glomerular filtration rate (eGFR) or start of dialysis. Their NEAP was measured every 3 months. The patients were categorized into four groups on the basis of quartiles of NEAP every 3 months. The groups were treated as time-dependent variables. Results: The average age (SD) was 70.6 (7.1) years; eGFR 23.5 (14.2) ml/min/1.73 m2. Analysis using extended Cox models for the NEAP groups adjusted for baseline characteristics (referring to group 1 showing the lowest NEAP) showed that high NEAP was associated with a high risk of CKD progression; group 2, adjusted hazard ratio (HR) 3.930 (95% confidence interval (CI) 1.914, 8.072); group 3, adjusted HR 4.740 (95% CI 2.196, 10.288); group 4, adjusted HR 4.303 (95% CI 2.103, 8.805). Logistic regression analysis adjusted for baseline characteristics showed that the occurrence of hypoalbuminemia or hyperkalemia was associated with low serum bicarbonate level and the presence of complications at baseline, but not with NEAP. Conclusion: In elderly CKD patients, our findings suggest that high NEAP is independently associated with CKD progression. The decrease in NEAP may be an effective kidney-protective therapy.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Renal function
Risk Assessment
Gastroenterology
Disease-Free Survival
Renal Dialysis
Internal medicine
Diet, Protein-Restricted
Humans
Medicine
Hypoalbuminemia
Renal Insufficiency, Chronic
Dialysis
Aged
Proportional Hazards Models
Retrospective Studies
business.industry
Proportional hazards model
Hazard ratio
Retrospective cohort study
Middle Aged
medicine.disease
Confidence interval
Bicarbonates
Endocrinology
Nephrology
Disease Progression
Female
Dietary Proteins
business
Acids
Glomerular Filtration Rate
Kidney disease
Subjects
Details
- ISSN :
- 14219670 and 02508095
- Volume :
- 39
- Database :
- OpenAIRE
- Journal :
- American Journal of Nephrology
- Accession number :
- edsair.doi.dedup.....ba6b04729bbb461fa652a0bafd1c2d07