Americans’ Use of Dietary Supplements That Are Potentially Harmful in CKD
Published Date:Feb 14 2013
Source:Am J Kidney Dis. 2013; 61(5):739-747.
Corporate Authors:Centers for Disease Control and Prevention CKD Surveillance Team
Pubmed Central ID:PMC3628413
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
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.
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)
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]).
Self-reported use of dietary supplements containing any of 37 herbs the National Kidney Foundation identified as potentially harmful in the setting of CKD.
Albuminuria and estimated glomerular filtration rate assessed from urine and blood samples; demographics and comorbid conditions assessed by standardized questionnaire.
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.
Herb content was not available and the list of potentially harmful supplements examined is unlikely to be exhaustive.
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.
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