长期饮水量与心血管高危人群肾功能的关系。

Long-term association between water intake and kidney function in a population at high cardiovascular risk.

机构信息

Consorcio Centro de Investigación Biomédica en Red, M.P. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnología, Alimentaciò, Nutrició, Desenvolupament i Salut Mental (ANUT-DSM), Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.

Consorcio Centro de Investigación Biomédica en Red, M.P. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria & Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas de Gran Canaria, Spain.

出版信息

J Nutr Health Aging. 2024 Sep;28(9):100327. doi: 10.1016/j.jnha.2024.100327. Epub 2024 Aug 12.

DOI:10.1016/j.jnha.2024.100327

PMID:39137622

Abstract

OBJECTIVES

The evidence on water intake in the prevention of kidney function decline is scarce at population level in well-being individuals at high cardiovascular risk. Therefore, we aimed to longitudinally evaluate the associations between total water intake and subtypes and kidney function, through estimated-Glomerular Filtration Rate (eGFR).

METHODS

Three-year prospective analysis conducted in 1986 older adults (aged 55-75 year) with overweight/obesity and metabolic syndrome from the PREDIMED-Plus study. Water intake was assessed using validated beverage and food frequency questionnaires. Serum creatinine-based eGFR (SCr-based eGFR; ml/min/1.73 m) was estimated using the CKD-EPI equation at baseline, one-year and 3-years of follow-up. Mixed-effects linear regression models were fitted to evaluate the associations between baseline total water intake and subtypes, and SCr-based eGFR over 3-years of follow-up.

RESULTS

Participants in the highest baseline tertile of total water intake, plain water and water from all fluids showed a lower decrease in SCr-based eGFR after 3-years of follow-up, compared to those in the lowest tertile. Participants with the highest tap water consumption showed a lower SCr-based eGFR decline after 1-year and 3-years of follow-up, in comparerd to participants in the lowest intake category (T3 vs. T1: β: 1.4 ml/min/1.73 m; 95%CI: 0.5-2.3, β: 1.0; 95%CI: 0.1-2.0, respectively).

CONCLUSIONS

Plain water rather than other water sources, and especially tap water, was associated with lower kidney function decline assessed through eGFR over 3-years of follow-up, in older individuals at high cardiovascular risk.

TRIAL REGISTRATION

ISRCTN89898870. Retrospectively registered on 24 July 2014.

摘要

目的

在心血管高危的健康人群中，关于水摄入在预防肾功能下降方面的证据在人群水平上相对较少。因此，我们旨在通过估算肾小球滤过率（eGFR），对总水摄入量和各亚型与肾功能之间的关系进行纵向评估。

方法

这是一项前瞻性的 3 年分析，研究对象为 PREDIMED-Plus 研究中的 1986 名超重/肥胖和代谢综合征的 55-75 岁老年人。使用经过验证的饮料和食物频率问卷评估水的摄入量。在基线、1 年和 3 年随访时，使用基于血清肌酐的 eGFR（SCr 基于 eGFR；ml/min/1.73 m）通过 CKD-EPI 方程进行估计。使用混合效应线性回归模型评估基线总水摄入量和各亚型与 3 年随访期间 SCr 基于 eGFR 之间的关系。

结果

与最低 tertile 相比，在最高 tertile 的基线总水摄入量、白开水和所有液体中的水摄入的参与者，在 3 年的随访中 SCr 基于 eGFR 的下降幅度较低。与最低摄入量组相比，最高自来水量摄入者在 1 年和 3 年随访时 SCr 基于 eGFR 的下降幅度较低（T3 与 T1：β：1.4 ml/min/1.73 m；95%CI：0.5-2.3，β：1.0；95%CI：0.1-2.0）。