ABSTRACT
AIMS: To examine the association between wine consumption and the prevalence of chronic kidney disease (CKD) and cardiovascular disease (CVD). DATA SYNTHESIS: We performed a cross-sectional logistic regression analysis of National Health and Nutrition Examination Survey (NHANES) in participants 21 years of age or older from 2003 to 2006 in a large representative study of the U.S. POPULATION: Wine consumption was categorized as none (0 glass per day), light (<1 glass per day), or moderate (≥1 glasses per day). Prevalent CKD was defined as a urine albumin/creatinine ratio (UACR) ≥30 mg/g or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2. CVD was defined as history of CVD including angina, myocardial infarction, or stroke. Only 27 (0.5%) individuals reported moderate wine consumption, whereas 57.5% and 42% reported abstinence and light wine consumption, respectively. Light wine consumption was associated with a lower prevalence of CKD as opposed to abstinence in unadjusted analysis. After adjusting for demographics and CVD risk factors light wine consumption was associated with lower prevalence of CKD defined as UACR ≥30 mg/g but not with low eGFR. Furthermore, light wine consumption was associated with significantly lower rates of CVD in the general population and in subjects with CKD. The adjusted odd of CVD for those with light wine consumption was 0.72 (CI 0.52-0.99, p = 0.046) for the subjects with CKD. CONCLUSION: These data suggest that light wine consumption (compared to abstinence) is associated with lower prevalence of CKD and a lower odd of CVD in those with CKD in the U.S.
Subject(s)
Alcohol Drinking/epidemiology , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/prevention & control , Renal Insufficiency, Chronic/epidemiology , Wine , Adult , Albuminuria/epidemiology , Albuminuria/physiopathology , Albuminuria/prevention & control , Alcohol Abstinence , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/physiopathology , Cross-Sectional Studies , Female , Glomerular Filtration Rate , Humans , Kidney/physiopathology , Male , Middle Aged , Nutrition Surveys , Prevalence , Prognosis , Protective Factors , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/physiopathology , Renal Insufficiency, Chronic/prevention & control , Risk Assessment , Risk Factors , Time Factors , United States/epidemiology , Young AdultABSTRACT
BACKGROUND/AIMS: Calciphylaxis is a rare condition with dismal prognosis that affects patients with ESRD. Sodium thiosulfate (STS) may play a therapeutic role but its proposed efficacy is based on case reports and thus subject to publication bias. METHODS: We identified all patients who received STS for any indication over a 5-year period through pharmacy records of 4 hospitals, retrospectively reviewing medical records for risk factors, laboratory values, the response of skin lesions to STS, and mortality. RESULTS: 14 patients received STS for calciphylaxis over 5 years. Following STS administration, pain decreased in 71% of patients, and 70% had an improvement in their lesions. Those who did not improve or stabilize their skin lesions tended to have more advanced skin lesions, were on renal replacement therapy longer, were more obese and received less total dose of STS. However, despite STS, there was a 71% mortality rate, with 50% of subjects dying within 6 months. CONCLUSION: We conclude in this study of all subjects who received STS at our Institution that STS is an effective treatment for the pain and skin lesions of calciphylaxis if given in the early stages of disease and for a consistent period of time. However, there is little impact on overall mortality compared to historical published cohorts.
