Association of Dietary Niacin Intake with All-cause and Cardiovascular Mortality in Patients with Chronic Kidney Disease

Background Niacin, also known as vitamin B3 or nicotinic acid (NA), exhibits beneficial effects on factors influencing the decline of kidney function. In chronic kidney disease (CKD) patients, the relationship between dietary niacin and mortality prognosis remains unclear. Methods The study involved 2,962 CKD patients from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 and followed for survival through December 31, 2019. Cox proportional hazards models were utilized to explore the association between dietary niacin intake and both all-cause mortality and cardiovascular disease (CVD) mortality. Additionally, restricted cubic splines and subgroup analyses were performed. Results During a median follow-up of 5.7 years, 631 deaths including 229 CVD deaths were recorded. In multivariable-adjusted Cox models, highest quartile of niacin intake compared with lowest quartile was associated with lower mortality risk. Hazard ratios were 0.71 (95% confidence interval [CI], 0.53–0.97) for all-cause mortality (P = 0.044 for trend) and 0.61 (95% CI, 0.41–0.91) for CVD mortality (P = 0.020 for trend). Conclusions The findings of this cohort study indicate a potential association between increased dietary niacin intake and reduced all-cause and cardiovascular mortality among patients with CKD.