We prospectively analyzed diet soda consumption, assessed by food frequency questionnaire at baseline (1987-1989) and a follow-up examination (1993-1995), and incident
ESRD through December 31, 2012 in the
Atherosclerosis Risk in Communities study (n=15,368).
RESULTS: Baseline mean age of participants was 54 years, 55% were female, and 27% were black. The majority of participants (43.5%) consumed <1 glass/wk of diet soda; 17.8% consumed 1-4 glasses/wk; 25.3% consumed 5-7 glasses/wk; and 13.5% consumed >7 glasses/wk. Over a median follow-up of 23 years, 357 incident
ESRD cases were observed. Relative to <1 glass/wk of diet soda, consuming 1-4 glasses/wk, 5-7 glasses/wk, and >7 glasses/wk, respectively, was associated with 1.08-times (95% confidence interval [95% CI], 0.75 to 1.55), 1.33-times (95% CI, 1.01 to 1.75), and 1.83-times (95% CI, 1.01 to 2.52) higher risk of
ESRD after adjusting for age, sex, race-center, education level, smoking status, physical activity, total caloric intake, eGFR, body mass index category, diabetes, systolic BP, and serum
uric acid (P value for trend <0.001). Results were similar after additional adjustment for dietary
acid load, diet quality,
dietary sodium, dietary
fructose, sugar-sweetened beverages, and
dietary phosphorus. Risk estimates were similar by body mass index category (P value for interaction = 0.82), but the association between diet soda and
ESRD was only significant for those who were
overweight or obese at baseline. Sugar-sweetened beverage consumption was not significantly associated with
ESRD in the fully adjusted model.
CONCLUSIONS: