Abstract P022: MS #279 - Use Of Dietary Supplements And Risk Of Chronic Kidney Disease In The Hispanic Community Health Study/Study Of Latinos (HCHS/SOL)

Abstract

Background: Dietary supplements (DS) are often used for their perceived health-promoting and therapeutic properties. Certain supplements can be nephrotoxic, especially among individuals at risk for chronic kidney disease (CKD). Hispanic/Latino populations are users of DS (30-70%) and have a high prevalence of conditions predisposing CKD. The potential contribution of DS use to risk of CKD in this population has not been studied. Objective: To assess whether DS use is associated with higher prevalence and incidence of CKD in Hispanic/Latinos. Methods: DS use was assessed in 16,279 of 16,415 Hispanic/Latinos enrolled in HCHS/SOL in 24-hour recall and 30-day medications inventory. Users of any DS were compared to those reporting no DS use. Prevalent CKD was defined with estimated glomerular filtration rate (eGFR) using the serum creatinine-cystatin C equation or urine albumin-to-creatinine ratio (ACR) ≥ 30 mg/g at baseline. Incident low eGFR and incident albuminuria at follow-up were defined as <60 mL/min/1.73 m 2 and ACR ≥ 30 mg/g, respectively. Incident CKD was defined as no prevalent CKD and incident low eGFR with eGFR decline ≥1ml/min/1.73 m 2 /year or incident albuminuria. We used multivariable logistic regression to estimate odds ratios (OR) for prevalence and Poisson regression for incidence rate ratios (IRR). Analyses accounted for HCHS/SOL complex sampling design. Results: DS users were older (median age 45 vs 35 years) and more likely to be female (57 vs 48%), have health insurance (54 vs 48%) and be born in the United States (26 vs 19%). Of DS users, 13% had prevalent CKD while 12% of non-DS users had prevalent CKD (adjusted OR 0.77 (95% CI 0.66, 0.91)). IRRs for incident CKD, low eGFR and albuminuria between users and non-users of DS were 1.0 (95% CI 0.84, 1.3), 0.87 (95% CI 0.61, 1.3), and 1.2 (95% CI 0.88, 1.6), respectively. Conclusions: DS use was associated with lower prevalent CKD at visit 1 and not associated with incident CKD, low eGFR or albuminuria at visit 2. DS use may be a proxy for health-seeking behavior in this population.