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Americans’ Use of Dietary Supplements That Are Potentially Harmful in CKD
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Details:
  • Corporate Authors:
    Centers for Disease Control and Prevention CKD Surveillance Team
  • Pubmed ID:
    23415417
  • Pubmed Central ID:
    PMC3628413
  • Description:
    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 non-pregnant, non-institutionalized U.S. civilian adults (≥20 years)

    Predictor

    CKD status (no CKD, at risk for CKD [presence of diabetes, hypertension and/or cardiovascular disease], stage 1/2 [albuminuria only (albumin-creatinine ratio ≥30 mg/g)], or stage 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 U.S. adults reported potentially harmful supplement use within the last 30 days. Lower crude estimated prevalence of potentially harmful supplement use was associated with higher CKD severity (no CKD, 8.5%; at risk, 8.0%; stage 1/2, 6.1%; and stage 3/4, 6.2%; p<0.001). However, after adjustment for confounders, those with or at risk for 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); stage 1/2 OR, 0.83 (95% CI, 0.64 -1.08); stage 3/4 OR, 0.87 (95% CI, 0.63 -1.18); all vs. 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. Healthcare providers should discuss the use and potential risks of supplements with patients with and at risk for CKD.

  • Document Type:
  • Collection(s):
  • Funding:
    1U58DP003839-01/DP/NCCDPHP CDC HHS/United States
    K23 DK094850/DK/NIDDK NIH HHS/United States
    K24 DK002643/DK/NIDDK NIH HHS/United States
    KL2RR024130/RR/NCRR NIH HHS/United States
    R01 DK70939/DK/NIDDK NIH HHS/United States
    R01 DK78124/DK/NIDDK NIH HHS/United States
    T32 DK007219/DK/NIDDK NIH HHS/United States
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