TY - JOUR
T1 - Americans' use of dietary supplements that are potentially harmful in CKD
AU - Grubbs, Vanessa
AU - Plantinga, Laura C.
AU - Tuot, Delphine S.
AU - Hedgeman, Elizabeth
AU - Saran, Rajiv
AU - Saydah, Sharon
AU - Rolka, Deborah
AU - Powe, Neil R.
N1 - Funding Information:
Support: This project was supported under a cooperative agreement from the CDC , grant 1U58DP003839-01 . The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC. Dr Powe was partially supported by grant R01 DK78124 from the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK). Dr Grubbs was also supported by the NIDDK through a Diversity Supplement to grant R01 DK70939 and by the Harold Amos Medical Faculty Development Program of the Robert Wood Johnson Foundation. Dr Tuot was supported by award number KL2RR024130 from the National Center for Research Resources .
PY - 2013/5
Y1 - 2013/5
N2 - Background: The prevalence in the United States of dietary supplement use that may be harmful to those with chronic kidney disease (CKD) is unknown. We sought to characterize potentially harmful supplement use by individual CKD status. Study Design: Cross-sectional national survey (National Health and Nutrition Examination Survey, 1999-2008). Setting & Participants: Community-based survey of 21,169 nonpregnant noninstitutionalized US civilian adults (aged ≥20 years). Predictor: CKD status (no CKD, at risk of CKD [presence of diabetes, hypertension, and/or cardiovascular disease], stages 1/2 [albuminuria only (albumin-creatinine ratio ≥30 mg/g)], or stages 3/4 [estimated glomerular filtration rate of 15-59 mL/min/1.73 m2]). Outcome: Self-reported use of dietary supplements containing any of 37 herbs the National Kidney Foundation identified as potentially harmful in the setting of CKD. Measurements: Albuminuria and estimated glomerular filtration rate assessed from urine and blood samples; demographics and comorbid conditions assessed by standardized questionnaire. Results: An estimated 8.0% of US adults reported potentially harmful supplement use within the last 30 days. A lower crude estimated prevalence of potentially harmful supplement use was associated with higher CKD severity (no CKD, 8.5%; at risk, 8.0%; stages 1/2, 6.1%; and stages 3/4, 6.2%; P < 0.001). However, after adjustment for confounders, those with or at risk of CKD were as likely to use a potentially harmful supplement as those without CKD: at-risk OR, 0.93 (95% CI, 0.79-1.09); stages 1/2 OR, 0.83 (95% CI, 0.64-1.08); and stages 3/4 OR, 0.87 (95% CI, 0.63-1.18); all versus no CKD. Limitations: Herb content was not available and the list of potentially harmful supplements examined is unlikely to be exhaustive. Conclusions: The use of dietary supplements potentially harmful to people with CKD is common regardless of CKD status. Health care providers should discuss the use and potential risks of supplements with patients with and at risk of CKD.
AB - Background: The prevalence in the United States of dietary supplement use that may be harmful to those with chronic kidney disease (CKD) is unknown. We sought to characterize potentially harmful supplement use by individual CKD status. Study Design: Cross-sectional national survey (National Health and Nutrition Examination Survey, 1999-2008). Setting & Participants: Community-based survey of 21,169 nonpregnant noninstitutionalized US civilian adults (aged ≥20 years). Predictor: CKD status (no CKD, at risk of CKD [presence of diabetes, hypertension, and/or cardiovascular disease], stages 1/2 [albuminuria only (albumin-creatinine ratio ≥30 mg/g)], or stages 3/4 [estimated glomerular filtration rate of 15-59 mL/min/1.73 m2]). Outcome: Self-reported use of dietary supplements containing any of 37 herbs the National Kidney Foundation identified as potentially harmful in the setting of CKD. Measurements: Albuminuria and estimated glomerular filtration rate assessed from urine and blood samples; demographics and comorbid conditions assessed by standardized questionnaire. Results: An estimated 8.0% of US adults reported potentially harmful supplement use within the last 30 days. A lower crude estimated prevalence of potentially harmful supplement use was associated with higher CKD severity (no CKD, 8.5%; at risk, 8.0%; stages 1/2, 6.1%; and stages 3/4, 6.2%; P < 0.001). However, after adjustment for confounders, those with or at risk of CKD were as likely to use a potentially harmful supplement as those without CKD: at-risk OR, 0.93 (95% CI, 0.79-1.09); stages 1/2 OR, 0.83 (95% CI, 0.64-1.08); and stages 3/4 OR, 0.87 (95% CI, 0.63-1.18); all versus no CKD. Limitations: Herb content was not available and the list of potentially harmful supplements examined is unlikely to be exhaustive. Conclusions: The use of dietary supplements potentially harmful to people with CKD is common regardless of CKD status. Health care providers should discuss the use and potential risks of supplements with patients with and at risk of CKD.
KW - Dietary supplements
KW - chronic kidney disease
KW - risk factor
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U2 - 10.1053/j.ajkd.2012.12.018
DO - 10.1053/j.ajkd.2012.12.018
M3 - Article
C2 - 23415417
AN - SCOPUS:84876297065
SN - 0272-6386
VL - 61
SP - 739
EP - 747
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 5
ER -