Dietary niacin may have a mortality benefit in patients with chronic kidney disease

1. Higher dietary niacin intake was associated with lower all-cause mortality risk in patients with chronic kidney disease.

Evidence Rating Level: 2 (Good)

Chronic kidney disease (CKD), characterized by a progressive decline in renal function, involves chronic inflammation and is associated with an increased risk of cardiovascular disease. Previous research suggests that dietary niacin (vitamin B3) intake contains anti-inflammatory properties and may help improve cardiovascular outcomes. However, the relationship between niacin intake and CKD prognosis remains unclear. This retrospective cohort study thus examined the association between dietary niacin intake and all-cause mortality in CKD patients. Data was obtained from the National Health and Nutrition Examinations Survey (NHANES) and included US adults aged >18 years with CKD. Dietary niacin intake data were based on the 24-hour dietary recall interviews. In total, 4,659 CKD patients were included in the study (mean [SD] age, 58.03 [0.42] years; 2,502 females [58.45%]), of whom 1,325 (28.44%) died during a mean (SD) follow-up of 73.92 (1.14) months. Compared to lower niacin intake (≤19mg), higher niacin intake (>33 mg) was associated with lower all-cause mortality risk (Hazard ratio (HR) = 0.74, 95%CI: 0.59–0.93), even after adjusting for covariates. Subgroup analyses also found higher niacin intake to be associated with lower all-cause mortality risk in those age ≥65 years old (HR = 0.68, 95%CI: 0.53–0.88), males (HR = 0.68, 95%CI: 0.51–0.92), BMI < 25 kg/m2 (HR = 0.70, 95%CI: 0.39–0.99), smoking (HR = 0.68, 95%CI: 0.49–0.94), dyslipidemia (HR = 0.71, 95%CI: 0.56–0.91), and non-hyperphosphatemia (HR = 0.73, 95%CI: 0.58–0.91). Overall, this study found higher dietary niacin intake to be associated with lower all-cause mortality risk in CKD patients, suggesting a potentially beneficial role of niacin in the CKD prognosis. Future studies are needed to confirm these findings.

Click to read the study in PLOSONE

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