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Food Insecurity, CKD, and Subsequent ESRD in US Adults
| Content Provider | Scilit |
|---|---|
| Author | O’Hare, Ann Banerjee, Tanushree Crews, Deidra C. Wesson, Donald E. Dharmarajan, Sai Saran, Rajiv Burrows, Nilka Ríos Saydah, Sharon Powe, Neil R. Hsu, Chi-Yuan Bibbins-Domingo, Kirsten McCulloch, Charles Grubbs, Vanessa Peralta, Carmen Shlipak, Michael Rubinsky, Anna Hsu, Raymond Coresh, Josef Tuot, Delphine Steffick, Diane Gillespie, Brenda Herman, William Port, Friedrich Robinson, Bruce Shahinian, Vahakn Yee, Jerry Young, Eric McClellan, William Fava, Melissa Tilea, Anca Williams, Desmond Eberhardt, Mark Flowers, Nicole Geiss, Linda Mondesire, Juanita Moore, Bernice Myers, Gary Pavkov, Meda Rolka, Deborah Schoolwerth, Anton Valdez, Rodolfo Waller, Larry |
| Copyright Year | 2017 |
| Description | Journal: American Journal of Kidney Diseases Background Poor access to food among low-income adults has been recognized as a risk factor for chronic kidney disease (CKD), but there are no data for the impact of food insecurity on progression to end-stage renal disease (ESRD). We hypothesized that food insecurity would be independently associated with risk for ESRD among persons with and without earlier stages of CKD. Study Design Longitudinal cohort study. Setting & Participants 2,320 adults (aged ≥ 20 years) with CKD and 10,448 adults with no CKD enrolled in NHANES III (1988-1994) with household income ≤ 400% of the federal poverty level linked to the Medicare ESRD Registry for a median follow-up of 12 years. Predictor Food insecurity, defined as an affirmative response to the food-insecurity screening question. Outcome Development of ESRD. Measurements Demographics, income, diabetes, hypertension, estimated glomerular filtration rate, and albuminuria. Dietary acid load was estimated from 24-hour dietary recall. We used a Fine-Gray competing-risk model to estimate the relative hazard (RH) for ESRD associated with food insecurity after adjusting for covariates. Results 4.5% of adults with CKD were food insecure. Food-insecure individuals were more likely to be younger and have diabetes (29.9%), hypertension (73.9%), or albuminuria (90.4%) as compared with their counterparts (P<0.05). Median dietary acid load in the food-secure versus food-insecure group was 51.2 mEq/d versus 55.6 mEq/d, respectively (P=0.05). Food-insecure adults were more likely to develop ESRD (RH, 1.38; 95% CI, 1.08-3.10) compared with food-secure adults after adjustment for demographics, income, diabetes, hypertension, estimated glomerular filtration rate, and albuminuria. In the non-CKD group, 5.7% were food insecure. We did not find a significant association between food insecurity and ESRD (RH, 0.77; 95% CI, 0.40-1.49). Limitations Use of single 24-hour diet recall; lack of laboratory follow-up data and measure of changes in food insecurity over time; follow-up of cohort ended 10 years ago. Conclusions Among adults with CKD, food insecurity was independently associated with a higher likelihood of developing ESRD. Innovative approaches to address food insecurity should be tested for their impact on CKD outcomes. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5765854/pdf http://www.ajkd.org/article/S0272638616306722/pdf |
| Ending Page | 47 |
| Page Count | 10 |
| Starting Page | 38 |
| ISSN | 02726386 |
| e-ISSN | 15236838 |
| DOI | 10.1053/j.ajkd.2016.10.035 |
| Journal | American Journal of Kidney Diseases |
| Issue Number | 1 |
| Volume Number | 70 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2017-07-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: American Journal of Kidney Diseases Endocrinology and Metabolism Food Insecurity Nutrient Intake Dietary Acid Load (dal) Dietary Patterns End-stage Renal Disease (esrd) Incident Esrd Kidney Disease Progression Disease Trajectory Modifiable Risk Factor Health Disparities Socioeconomic Status Food Deserts Chronic Kidney Disease (ckd) |
| Content Type | Text |
| Resource Type | Article |
| Subject | Nephrology |
