Patterns of Beverages Consumed and Risk of Incident Kidney Disease

Clin J Am Soc Nephrol. 2019 Jan 7;14(1):49-56. doi: 10.2215/CJN.06380518. Epub 2018 Dec 27.


Background and objectives: Selected beverages, such as sugar-sweetened beverages, have been reported to influence kidney disease risk, although previous studies have been inconsistent. Further research is necessary to comprehensively evaluate all types of beverages in association with CKD risk to better inform dietary guidelines.

Design, setting, participants, & measurements: We conducted a prospective analysis in the Jackson Heart Study, a cohort of black men and women in Jackson, Mississippi. Beverage intake was assessed using a food frequency questionnaire administered at baseline (2000-2004). Incident CKD was defined as onset of eGFR<60 ml/min per 1.73 m2 and ≥30% eGFR decline at follow-up (2009-13) relative to baseline among those with baseline eGFR ≥60 ml/min per 1.73 m2. Logistic regression was used to estimate the association between the consumption of each individual beverage, beverage patterns, and incident CKD. Beverage patterns were empirically derived using principal components analysis, in which components were created on the basis of the linear combinations of beverages consumed.

Results: Among 3003 participants, 185 (6%) developed incident CKD over a median follow-up of 8 years. At baseline, mean age was 54 (SD 12) years, 64% were women, and mean eGFR was 98 (SD 18) ml/min per 1.73 m2. After adjusting for total energy intake, age, sex, education, body mass index, smoking, physical activity, hypertension, diabetes, HDL cholesterol, LDL cholesterol, history of cardiovascular disease, and baseline eGFR, a principal components analysis-derived beverage pattern consisting of higher consumption of soda, sweetened fruit drinks, and water was associated with significantly greater odds of incident CKD (odds ratio tertile 3 versus 1 =1.61; 95% confidence interval, 1.07 to 2.41).

Conclusions: Higher consumption of sugar-sweetened beverages was associated with an elevated risk of subsequent CKD in this community-based cohort of black Americans.

Keywords: Beverages; Body Mass Index; Cardiovascular Diseases; Cholesterol; Chronic; Energy Intake; Epidemiology and outcomes; Exercise; Fruit; HDL; LDL; Logistic Models; Nutrition Policy; Prospective; Renal Insufficiency; Sex Education; Smoking; Studies; Sugars; Sweetening Agents; Water; chronic kidney disease; diabetes mellitus; glomerular filtration; hypertension; kidney; nutrition; rate.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • African Americans / statistics & numerical data*
  • Aged
  • Carbonated Beverages / statistics & numerical data*
  • Drinking Behavior*
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Mississippi / epidemiology
  • Principal Component Analysis
  • Prospective Studies
  • Renal Insufficiency, Chronic / epidemiology*
  • Risk Factors
  • Sugar-Sweetened Beverages / statistics & numerical data*
  • Surveys and Questionnaires
  • Water*


  • Water