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Clin J Am Soc Nephrol. 2017 Jan 6;12(1):79-86. doi: 10.2215/CJN.03390316. Epub 2016 Oct 26.

Diet Soda Consumption and Risk of Incident End Stage Renal Disease.

Author information

  • 1Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland; crebhol1@jhu.edu.
  • 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
  • 3Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland.
  • 4Divisions of Nephrology and.
  • 5Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota.
  • 6Division of Preventive Medicine, Department of Family Medicine and Public Health, University of California San Diego School of Medicine, San Diego, California; and.
  • 7Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
  • 8General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.

Abstract

BACKGROUND AND OBJECTIVES:

Diet soda consumption is common in the United States and is associated with impaired glucose metabolism, diabetes, and metabolic syndrome.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:

We prospectively analyzed diet soda consumption, assessed by food frequency questionnaire at baseline (1987-1989) and a follow-up examination (1993-1995), and incident ESRD through December 31, 2012 in the Atherosclerosis Risk in Communities study (n=15,368).

RESULTS:

Baseline mean age of participants was 54 years, 55% were female, and 27% were black. The majority of participants (43.5%) consumed <1 glass/wk of diet soda; 17.8% consumed 1-4 glasses/wk; 25.3% consumed 5-7 glasses/wk; and 13.5% consumed >7 glasses/wk. Over a median follow-up of 23 years, 357 incident ESRD cases were observed. Relative to <1 glass/wk of diet soda, consuming 1-4 glasses/wk, 5-7 glasses/wk, and >7 glasses/wk, respectively, was associated with 1.08-times (95% confidence interval [95% CI], 0.75 to 1.55), 1.33-times (95% CI, 1.01 to 1.75), and 1.83-times (95% CI, 1.01 to 2.52) higher risk of ESRD after adjusting for age, sex, race-center, education level, smoking status, physical activity, total caloric intake, eGFR, body mass index category, diabetes, systolic BP, and serum uric acid (P value for trend <0.001). Results were similar after additional adjustment for dietary acid load, diet quality, dietary sodium, dietary fructose, sugar-sweetened beverages, and dietary phosphorus. Risk estimates were similar by body mass index category (P value for interaction = 0.82), but the association between diet soda and ESRD was only significant for those who were overweight or obese at baseline. Sugar-sweetened beverage consumption was not significantly associated with ESRD in the fully adjusted model.

CONCLUSIONS:

Diet soda consumption was associated with higher ESRD risk in this general population sample. Further research is necessary to validate these findings in other study populations and to examine potential mechanisms through which diet soda could impact kidney disease.

KEYWORDS:

United States; atherosclerosis; beverages; blood pressure; body mass index; diabetes, mellitus; diet; energy intake; female; follow-up studies; fructose; glomerular filtration rate; glucose; kidney failure, chronic; metabolic syndrome X; motor activity; obesity; overweight; phosphorus, dietary; smoking; sodium, dietary; surveys and questionnaires; sweetening agents; uric acid

PMID:
27797893
PMCID:
PMC5220651
[Available on 2018-01-06]
DOI:
10.2215/CJN.03390316
[PubMed - in process]
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