Grubbs V, Plantinga L, Tuot D, et al. Prevalent use of dietary supplements potentially harmful in chronic kidney disease in the United States. American Society of Nephrology (ASN) meeting (ASN) 2011. Abstract TH-PO267.
http://www.asn-online.org/education_and_meetings/kidneyweek/archives/KW1...
+++++
TH-PO267
Prevalent Use of Dietary Supplements Potentially Harmful in Chronic Kidney Disease in the United States
Vanessa Grubbs,1,2 Laura C. Plantinga,1 Delphine S. Tuot,1 Elizabeth Hedgeman,3 Rajiv Saran,3 Sharon Saydah,4 Deborah Rolka,4 Neil R. Powe.1,2 1University of California, San Francisco; 2San Francisco General Hospital; 3University of Michigan; 4Centers for Disease Control and Prevention.
Background: The National Kidney Foundation (NKF) identifies 39 herbs that may be harmful in the setting of chronic kidney disease (CKD) (http://www.kidney.org/atoz/ content/herbalsupp.cfm), but the prevalent use of such herbs in the U.S. by CKD status is unknown.
Methods: Using 1999-2008 National Health and Nutrition Examination Survey data, we examined the reported use of dietary supplements in the past 30 days among 21,169 non- pregnant adults (age 20+ years). CKD stage 1/2 was defined by urinary albumin:creatinine ratio of ≥30 mg/g with eGFR ≥60 ml/min/1.73 m2 and CKD stage 3/4 by eGFR 15-59 ml/ min/1.73 m2. Any dietary supplement containing at least one NKF-identified herb was defined as potentially harmful. The prevalence and odds of taking a potentially harmful supplement by CKD status were estimated via multivariable logistic regression weighted to the U.S. population.
Results: While an estimated 52.4% of participants reported taking any dietary supplement, the supplement was potentially harmful among 15.3%. The crude estimated prevalence of those taking a any dietary supplement increased with greater CKD severity (no CKD 51.4%; CKD stage 1/2 49.1%; CKD stage 3/4 65.8%, p<0.001), but decreased among those taking a potentially harmful supplement (16.1%, 13.0%, and 10.0%, respectively, p<0.001). However, after adjustment for demographics, co-morbid disease, and healthcare visits, CKD status was not a significant determinant of taking any supplement (stage 1/2 0.95, 0.82-1.10; stage 3/4 OR 1.07, 0.93-1.23, vs. no CKD) or a potentially harmful supplement (stage 1/2: OR 0.97, 0.73-1.28; stage 3/4: OR 0.90, 0.67-1.21, vs. no CKD).
Conclusions: The use of dietary supplements potentially harmful in CKD is common and, as use is not statistically different by CKD status, patients with CKD may be unaware of risk. Health care providers, too, may be unaware of potentially harmful supplements and that patients with CKD are taking them. Further research and education are warranted.
Funding: NIDDK Support, Other U.S. Government Support