ASSESSING THE RELATIONSHIP BETWEEN KIDNEY RISK FACTORS AND ESTIMATED GLOMERULAR FILTRATION RATE AMONG US ADULTS

Abstract

Chronic kidney disease (CKD) is a degenerative kidney condition that over time causes multiple complications and systemic disorders and eventually death. Early detection of kidney function decline is essential for reducing death. A cross-sectional study was conducted using data from two cycles of the NHANES, 2015-2018 (n=8875 US adults and 687 US adults with eGFR <60), to examine the interaction effect between high sensitivity c-reactive protein (hs-CRP), serum calcium, diet quality (DQ), and albuminuria on estimated glomerular filtration rate (eGFR) and to determine the effect of DQ and hs-CRP on US adults with eGFR < 60 mL/min/1.73m2. Data included laboratory values, 24-hour recalls and self-reported demographics and medical conditions. DQ was determined through the Healthy Eating Index (HEI)-2015. Results showed a significant effect of DQ and certain whole food components (fruits, vegetables, whole grains, refined grains, and seafood and plant protein) and added sugars on eGFR (p<0.01). Albuminuria had an interaction effect with hs-CRP on eGFR (p<0.01) but not with serum calcium (p=0.36). The interaction between hs-CRP and DQ was significant among the general population (p=0.02), but not in adults with eGFR< 60. Significance was observed with all co-variates except diabetes mellitus. An additional cross-sectional study was conducted to determine the relative validity of the developed 57-item Chronic Kidney Disease, Short Food Frequency Questionnaire, (CKD SFFQ) with two 24-hour recalls. Pearson correlations and Bland-Altman plots were conducted for agreement with statistical significance at p<0.05. Pearson correlation coefficients were considered adequate for validity (p = -0.39 to 0.60) and the Bland–Altman plots revealed generally good agreement. From the CKD SFFQ, participants consumed limited fruits, vegetables, grains, and plant proteins. Preventative programs that address both nutrition and risk factors for CKD is necessary to reduce the prevalence of this disease.