title: Dietary polyunsaturated fatty acids and incidence of end-stage renal disease in the Southern Community Cohort Study.
abstract: Whether polyunsaturated fatty acids (PUFA) are associated with end-stage renal disease (ESRD) in populations with a high burden of risk factors for kidney disease is unknown. We sought to determine whether PUFA intake is associated with ESRD.
  
  
  
  We conducted a nested case-control study of ESRD within the Southern Community Cohort Study (SCCS), a prospective cohort of low-income blacks and whites in the southeastern US (2002-2009). Through 2012, 1,074 incident ESRD cases were identified by linkage with the United States Renal Data System and matched to 3,230 controls by age, sex and race. Dietary intake of total, n-3 or n-6 PUFA was assessed from a validated food frequency questionnaire administered at baseline. Odds ratios (ORs) and 95 % confidence intervals (CIs) were computed from logistic regression models that included matching variables, body mass index, smoking, diabetes, hypertension, education, income, total energy intake and percent energy from protein and saturated fat.
  
  
  
  The mean (SD) age of participants was 55 (9) years. Most participants were women (55 %), black (87 %), with hypertension (67 %) and on average obtained 8 % of their energy from PUFA. Higher PUFA intake was marginally associated with a lower risk of ESRD in adjusted analyses. The adjusted odds ratios (95 % confidence intervals) for ESRD for the 5thvs. 1stquintile of PUFA were 0.79 (0.60-1.05; Ptrend= 0.06) for total PUFA, 0.81 (0.61-1.06; Ptrend= 0.04) for n-6 PUFA and 0.93 (0.71-1.21; Ptrend= 0.45) for n-3 PUFA.
  
  
  
  We observed a marginally significant inverse trend between dietary PUFA intake and ESRD incidence, mainly driven by n-6 fatty acid intake. Our findings require replication but suggest that a diet rich in n-6 PUFA may prevent ESRD development in a population with a high burden of kidney disease risk factors.
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.|Present address: Division of Nephrology and Hypertension, University of California San Diego, San Diego, CA, 92161, USA.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Malhotra
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.|Vanderbilt Center for Kidney Disease, Nashville, TN, 37232, USA.
authors.forename: Kerri L
authors.initials: KL
authors.lastname: Cavanaugh
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, 2525 West End Ave, Suite 800, Nashville, TN, 37203, USA.|International Epidemiology Institute, Rockville, MD, 20850, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Blot
authors.affiliation: Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA.|Vanderbilt Center for Kidney Disease, Nashville, TN, 37232, USA.
authors.forename: T Alp
authors.initials: TA
authors.lastname: Ikizler
authors.affiliation: Vanderbilt Center for Kidney Disease, Nashville, TN, 37232, USA. loren.lipworth@vanderbilt.edu.|Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, 2525 West End Ave, Suite 800, Nashville, TN, 37203, USA. loren.lipworth@vanderbilt.edu.
authors.forename: Loren
authors.initials: L
authors.lastname: Lipworth
authors.affiliation: Vanderbilt Center for Kidney Disease, Nashville, TN, 37232, USA.|Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, 2525 West End Ave, Suite 800, Nashville, TN, 37203, USA.
authors.forename: Edmond K
authors.initials: EK
authors.lastname: Kabagambe
mesh_terms: D000328:Adult; D000368:Aged; D015930:Diet Records; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D043371:Fatty Acids, Omega-6 / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D015144:Southeastern United States / Q000453:epidemiology
chemical_list: D004042:Dietary Fats, Unsaturated; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6
keywords: End-stage renal disease; Polyunsaturated fatty acids