美国国家健康与营养检查调查（NHANES）I流行病学随访研究中老年人的饮食、肾脏疾病指标及后期死亡率
Diet, indicators of kidney disease, and later mortality among older persons in the NHANES I Epidemiologic Follow-Up Study.
作者信息
Dwyer J T, Madans J H, Turnbull B, Cornoni-Huntley J, Dresser C, Everett D F, Perrone R D
机构信息
Tufts University Medical School, Boston, Mass.
出版信息
Am J Public Health. 1994 Aug;84(8):1299-303. doi: 10.2105/ajph.84.8.1299.
OBJECTIVES
The purpose of this study was to determine whether diet adversely affected survival among 2572 older persons with indicators of kidney disease in a population-based cohort. Average follow-up time for survivors, of whom 1453 (57%) had died at analysis, was 14.5 years.
METHODS
Kidney disease indicators were a "yes" response to "Has a doctor ever told you that you have kidney disease or renal stones?" and/or trace or greater amounts of protein in urine. Dietary protein intakes were calculated from 24-hour recalls.
RESULTS
Cox proportional hazards models were used, stratified by sex, with age, body mass index, blood pressure, education, smoking status, total caloric intake, and diabetes mellitus as covariates. Relative risk of total mortality with an additional 15 g of protein per day was 1.25 (95% confidence interval [CI] = 1.09, 1.42) among White men with kidney disease indicators, vs 1.00 (95% CI = 0.95, 1.06) among those without them; relative risks of renal-related mortality were 1.32 (95% CI = 0.97, 1.79) and 0.95 (95% CI = 0.81, 1.11), respectively. No significant differences were found for White women.
CONCLUSIONS
Once chronic renal disease is present, diet may be associated with earlier mortality in White males.
目的
本研究旨在确定在一个基于人群的队列中，饮食是否会对2572名有肾脏疾病指标的老年人的生存产生不利影响。在分析时，1453名（57%）幸存者的平均随访时间为14.5年。
方法
肾脏疾病指标为对“医生是否曾告诉你患有肾脏疾病或肾结石？”回答“是”，和/或尿中蛋白质含量为微量或更高。饮食蛋白质摄入量通过24小时回顾法计算。
结果
使用Cox比例风险模型，按性别分层，将年龄、体重指数、血压、教育程度、吸烟状况、总热量摄入和糖尿病作为协变量。在有肾脏疾病指标的白人男性中，每天额外摄入15克蛋白质的全因死亡率相对风险为1.25（95%置信区间[CI]=1.09，1.42），而在没有这些指标的男性中为1.00（95%CI=0.95，1.06）；肾脏相关死亡率的相对风险分别为1.32（95%CI=0.97，1.79）和0.95（95%CI=0.81，1.11）。白人女性未发现显著差异。
结论
一旦出现慢性肾脏疾病，饮食可能与白人男性的早死有关。
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