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In patients with CKD, caffeine intake may be inversely associated with all-cause mortality

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Among patients with chronic kidney disease, caffeine intake appears to be negatively correlated with all-cause mortality, according to recently published findings.
“An inverse relationship between coffee consumption and mortality has been reported in the general population,” study co-author Miguel Bigotte Vieira, MD, told Healio.com/Nephrology. “However, the association between caffeine consumption and mortality in patients with CKD remains unclear.”

In the nationwide study, researchers evaluated 4,863 community-dwelling U.S. adults with CKD (defined by an eGFR of 15 to 60 mL/min/1.73 and/or urinary albumin/creatinine ratio greater than 30 mg/g) using 1999 to 2010 data from the National Health and Nutrition Examination Survey (NHANES). At baseline, 24-hour dietary recalls were used to document caffeine consumption. The 24-hour recalls chronicled all food items and amounts consumed during the 24 hours prior to the interviews.

Researchers reviewed NHANES-linked national death index files to determine mortality status and cause of mortality through Dec. 31, 2011. An assessment of caffeine consumption based on its specific source (coffee, tea or soft drinks) was also conducted. The following quartiles of caffeine consumption were established: less than 28.2 mg/day (Q1); 28.2 to 103 mg/day (Q2); 103.01 to 213.5 mg/day (Q3); and more than 213.5 mg/day (Q4). Time to death was defined as the primary outcome, and time to cardiovascular mortality and time to death by cancer were secondary outcomes.
During the course of a median 60-month follow-up, 1,283 deaths occurred in the study population. Of these, 368 deaths resulted from cardiovascular events and 226 were related to cancer. Neither the univariate nor the multivariable analyses found a significant correlation between caffeine consumption and cardiovascular or cancer death.

In an analysis comparing with Q1 of caffeine consumption, the adjusted hazard ratio for all-cause death was 0.74 for Q2; was 0.74 for Q3; and was 0.78 for Q4. No significant interactions were seen between quartiles of caffeine intake and CKD stages or urinary albumin creatinine ratio categories pertaining to all-cause mortality.

A negative correlation was seen between caffeine consumption from soft drinks and all-cause mortality in patients with CKD, but no such association was seen for cardiovascular or cancer mortality. Consumption of tea was not found to be significantly associated with all-cause, cardiovascular or cancer death.

“Our study showed a protective effect of caffeine consumption among patients with chronic kidney disease. The reduction in mortality was present even after considering other factors such as age, gender, race smoking, other diseases and diet,” Vieira said. “However, our observational study cannot prove that caffeine reduces the risk of death, but only suggests the possibility of such a protective effect. This would represent a simple, clinically beneficial and inexpensive option, though this benefit should ideally be confirmed in a randomized clinical trial.” – by Jennifer Byrne

Disclosure s : The authors report no relevant financial disclosures.