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PubMed ID:
38164661
Public Release Type:
Journal
Publication Year: 2024
Affiliation: 1 Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology; Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou 510515, China
DOI:
https://doi.org/10.1039/d3fo03927g
Authors:
Liu M,
Ye Z,
Yang S,
Zhang Y,
Zhang Y,
He P,
Zhou C,
Fan Hou F,
Qin X
Request IDs:
23553
Studies:
Chronic Renal Insufficiency Cohort Study
,
The Chronic Kidney Disease in Children Cohort Study
Objective: To evaluate the association of dietary intake of food folate (natural folate) and synthetic folic acid intake from fortified foods with the risk of all-cause mortality and end-stage kidney disease (ESKD) among chronic kidney disease (CKD) population in regions with folic acid fortification. Methods: 4028 individuals with established CKD in Chronic Renal Insufficiency Cohort (CRIC) were included. Diet was assessed by a validated Diet History Questionnaire at baseline, year 2, and year 4, and nutrient intakes, including food folate and folic acid from fortified foods, were estimated using the national nutrient database. The outcomes were all-cause mortality and ESKD. 7332 CKD participants in National Health and Nutrition Examination Surveys (NHANES) were used to validate the association for all-cause mortality. Results: During a median follow-up of 11.1 years, 1155 deaths and 938 ESKD occurred. Compared with the first quartile of food folate intake, the third (HR:0.74; 95%CI: 0.62, 0.90) and fourth (HR:0.79; 95%CI: 0.63, 0.98) quartiles had a lower risk of all-cause mortality; and the second (HR:0.77; 95%CI: 0.63, 0.93), third (HR: 0.70; 95%CI: 0.57, 0.87), and fourth (HR: 0.80; 95%CI: 0.62, 1.02) quartiles had a lower risk of ESKD. Nevertheless, there was no significant association of synthetic folic acid intake from fortified foods with outcomes. Consistently, in NHANES, food folate intake, but not folic acid, was inversely associated with all-cause mortality. Conclusion: Higher intake of dietary natural folate, but not synthetic folic acid from fortified foods, was associated with lower risks of all-cause mortality and ESKD among CKD participants.
