Format

Send to

Choose Destination
J Am Soc Nephrol. 2018 Jun;29(6):1741-1751. doi: 10.1681/ASN.2018010008. Epub 2018 Apr 25.

The Association of Mediterranean and DASH Diets with Mortality in Adults on Hemodialysis: The DIET-HD Multinational Cohort Study.

Author information

1
Sydney School of Public Health, University of Sydney, Sydney, Australia; vsag1982@gmail.com.
2
Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden.
3
Sydney School of Public Health, University of Sydney, Sydney, Australia.
4
Centre for Kidney Research, Children's Hospital at Westmead, Westmead, Australia.
5
Department of Renal Medicine, Westmead Hospital, Westmead, Australia.
6
Division of Nephrology and Transplantation, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy.
7
Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand.
8
Department of Nutrition and Dietetics and.
9
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
10
Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
11
Department of Medical Epidemiology and Biostatistics and.
12
Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
13
Division of Medicine, Department of Nephrology, University of Queensland at the Princess Alexandra Hospital, Woolloongabba, Australia.
14
Translational Research Institute, University of Queensland, Woolloongabba, Australia.
15
Cumming School of Medicine, Health Sciences Centre, University of Calgary, Calgary, Alberta, Canada.
16
Faculty of Medicine, Medical University of Lublin, Lublin, Poland.
17
School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.
18
Nefrología e dialisi, Presidio Ospedaliero Penne, Unità Sanitaria Locale Pescara, Pescara, Italy; and.
19
Diaverum Academy, Diaverum, Bari, Italy.

Abstract

Background Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets associate with lower cardiovascular and all-cause mortality in the general population, but the benefits for patients on hemodialysis are uncertain.Methods Mediterranean and DASH diet scores were derived from the GA2LEN Food Frequency Questionnaire within the DIET-HD Study, a multinational cohort study of 9757 adults on hemodialysis. We conducted adjusted Cox regression analyses clustered by country to evaluate the association between diet score tertiles and all-cause and cardiovascular mortality (the lowest tertile was the reference category).Results During the median 2.7-year follow-up, 2087 deaths (829 cardiovascular deaths) occurred. The adjusted hazard ratios (95% confidence intervals) for the middle and highest Mediterranean diet score tertiles were 1.20 (1.01 to 1.41) and 1.14 (0.90 to 1.43), respectively, for cardiovascular mortality and 1.10 (0.99 to 1.22) and 1.01 (0.88 to 1.17), respectively, for all-cause mortality. Corresponding estimates for the same DASH diet score tertiles were 1.01 (0.85 to 1.21) and 1.19 (0.99 to 1.43), respectively, for cardiovascular mortality and 1.03 (0.92 to 1.15) and 1.00 (0.89 to 1.12), respectively, for all-cause mortality. The association between DASH diet score and all-cause death was modified by age (P=0.03); adjusted hazard ratios for the middle and highest DASH diet score tertiles were 1.02 (0.81 to 1.29) and 0.70 (0.53 to 0.94), respectively, for younger patients (≤60 years old) and 1.05 (0.93 to 1.19) and 1.08 (0.95 to 1.23), respectively, for older patients.Conclusions Mediterranean and DASH diets did not associate with cardiovascular or total mortality in hemodialysis.

KEYWORDS:

DASH diet; Dietary patterns; Mediterranean diet; end-stage kidney disease; hemodialysis; mortality

PMID:
29695436
PMCID:
PMC6054330
[Available on 2019-06-01]
DOI:
10.1681/ASN.2018010008

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center