期刊
RENAL FAILURE
卷 45, 期 1, 页码 -出版社
TAYLOR & FRANCIS LTD
DOI: 10.1080/0886022X.2023.2205950
关键词
Dietary total antioxidant capacity; mortality; chronic kidney disease; NHANES; vitamin C equivalent antioxidant capacity; component dietary antioxidant index
This study analyzed data from two cohorts to investigate the association between dietary total antioxidant capacity (DTAC) and all-cause and CVD mortality risk in CKD patients. The results showed an L-shaped association between DTAC and all-cause mortality in CKD stages 1-2, with higher dietary total antioxidant intake associated with lower mortality risk. However, no similar benefits were observed for patients with CKD stages 3-5 or albuminuria.
Background The relationship between dietary total antioxidant capacity (DTAC) and death risk among CKD populations remains unclear. Methods Based on vitamin C equivalent antioxidant capacity (VCEAC) and the component dietary antioxidant index (CDAI) indices, we analyzed two cohorts to investigate the association of DTAC with all-cause and CVD mortality in CKD patients using data from National Health and Nutrition Examination Survey (2007-2018). VCEAC (n = 6330) and CDAI (n = 6300) cohorts with mortality follow-up data available through 2018 were included. Cox models with restricted cubic splines was used to model the nonlinear association between VCEAC/CDAI and outcomes in CKD patients. Results Our results showed L-shaped associations of DTAC with all-cause mortality among individuals with CKD stages 1-2 in both cohorts. Compared to the lowest quartile, higher dietary total antioxidant intake was associated with lower all-cause mortality risks among CKD stages 1-2 after adjustment for covariates, with HRs (95%CI) of 1.00, 0.91 (0.71,1.17), 0.69 (0.53,0.90), and 0.70 (0.54,0.91) in VCEAC, and similar respective estimate trends in CDAI. After sensitivity and subgroup analyses, there were no benefits for patients with stage 3-5 CKD or albuminuria. Mediation analysis revealed that the proportions mediated in both cohorts were less consistent. Conclusions Moderate dietary total antioxidants intake has potential benefits for early-stage CKD patients. However, further evidence is needed to confirm whether patients with worsening CKD can benefit in the long term.
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