Nephrology and Renal Transplantation Department, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.
Nephrology Department, Hospital Garcia de Orta, Almada, Portugal.
Nephrol Dial Transplant. 2019 Jun 1;34(6):974-980. doi: 10.1093/ndt/gfy234.
An inverse relationship between coffee consumption and mortality has been reported in the general population. However, the association between caffeine consumption and mortality in patients with chronic kidney disease (CKD) remains uncertain.
We analysed 4863 non-institutionalized USA adults with CKD [defined by an estimated glomerular filtration rate (eGFR) of 15-60 mL/min/1.73 m2 and/or a urinary albumin:creatinine ratio >30 mg/g] in a nationwide study using the National Health and Nutrition Examination Survey (NHANES) 1999-2010. Caffeine consumption was evaluated by 24-h dietary recalls at baseline and all-cause, cardiovascular and cancer mortality were evaluated until 31 December 2011. We also performed an analysis of caffeine consumption according to its source (coffee, tea and soft drinks). Quartiles of caffeine consumption were <28.2 mg/day (Q1), 28.2-103.0 (Q2), 103.01-213.5 (Q3) and >213.5 (Q4).
During a median follow-up of 60 months, 1283 participants died. Comparing with Q1 of caffeine consumption, the adjusted hazard ratio for all-cause mortality was 0.74 [95% confidence interval (CI) 0.60-0.91] for Q2, 0.74 (95% CI 0.62-0.89) for Q3 and 0.78 (95% CI 0.62-0.98) for Q4 (P = 0.02 for trend across quartiles). There were no significant interactions between caffeine consumption quartiles and CKD stages or urinary albumin:creatinine ratio categories regarding all-cause mortality.
We detected an inverse association between caffeine consumption and all-cause mortality among participants with CKD.
在普通人群中，已报道咖啡摄入量与死亡率呈负相关。然而，在慢性肾脏病（CKD）患者中，咖啡因摄入量与死亡率之间的关系尚不确定。
我们分析了全国性研究中 4863 名非住院的美国 CKD 患者[通过估计肾小球滤过率（eGFR）为 15-60mL/min/1.73m2和/或尿白蛋白：肌酐比值>30mg/g 定义]的数据，该研究使用了国家健康和营养调查（NHANES）1999-2010 年的数据。在基线和所有原因、心血管和癌症死亡评估时，通过 24 小时膳食回顾评估咖啡因摄入量。我们还根据咖啡因的来源（咖啡、茶和软饮料）分析了咖啡因的摄入量。咖啡因摄入量的四分位数为<28.2mg/天（Q1）、28.2-103.0mg（Q2）、103.01-213.5mg（Q3）和>213.5mg（Q4）。
在中位数为 60 个月的随访期间，有 1283 名参与者死亡。与 Q1 的咖啡因摄入量相比，Q2 的全因死亡率的调整后的危险比为 0.74（95%置信区间为 0.60-0.91），Q3 为 0.74（95%置信区间为 0.62-0.89），Q4 为 0.78（95%置信区间为 0.62-0.98）（P<0.02 用于趋势检验）。在全因死亡率方面，咖啡因摄入量四分位数与 CKD 分期或尿白蛋白：肌酐比值类别之间没有显著的交互作用。
我们发现，在 CKD 患者中，咖啡因摄入量与全因死亡率呈负相关。
