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DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease.
Am J Kidney Dis. 2016 Dec; 68(6):853-861.AJ

Abstract

BACKGROUND

There are established guidelines for recommended dietary intake for hypertension treatment and cardiovascular disease prevention. Evidence is lacking for effective dietary patterns for kidney disease prevention.

STUDY DESIGN

Prospective cohort study.

SETTING & PARTICIPANTS

Atherosclerosis Risk in Communities (ARIC) Study participants with baseline estimated glomerular filtration rate (eGFR) ≥ 60mL/min/1.73m2 (N=14,882).

PREDICTOR

The Dietary Approaches to Stop Hypertension (DASH) diet score was calculated based on self-reported dietary intake of red and processed meat, sweetened beverages, sodium, fruits, vegetables, whole grains, nuts and legumes, and low-fat dairy products, averaged over 2 visits.

OUTCOMES

Cases were ascertained based on the development of eGFRs<60mL/min/1.73m2 accompanied by ≥25% eGFR decline from baseline, an International Classification of Diseases, Ninth/Tenth Revision code for a kidney disease-related hospitalization or death, or end-stage renal disease from baseline through 2012.

RESULTS

3,720 participants developed kidney disease during a median follow-up of 23 years. Participants with a DASH diet score in the lowest tertile were 16% more likely to develop kidney disease than those with the highest score tertile (HR, 1.16; 95% CI, 1.07-1.26; P for trend < 0.001), after adjusting for sociodemographics, smoking status, physical activity, total caloric intake, baseline eGFR, overweight/obese status, diabetes status, hypertension status, systolic blood pressure, and antihypertensive medication use. Of the individual components of the DASH diet score, high red and processed meat intake was adversely associated with kidney disease and high nuts, legumes, and low-fat dairy products intake was associated with reduced risk for kidney disease.

LIMITATIONS

Potential measurement error due to self-reported dietary intake and lack of data for albuminuria.

CONCLUSIONS

Consuming a DASH-style diet was associated with lower risk for kidney disease independent of demographic characteristics, established kidney risk factors, and baseline kidney function. Healthful dietary patterns such as the DASH diet may be beneficial for kidney disease prevention.

Authors+Show Affiliations

Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Electronic address: crebhol1@jhu.edu.Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Division of Nephrology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Division of Nephrology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN.William B. Schwartz Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, MA.Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27519166

Citation

Rebholz, Casey M., et al. "DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 68, no. 6, 2016, pp. 853-861.
Rebholz CM, Crews DC, Grams ME, et al. DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease. Am J Kidney Dis. 2016;68(6):853-861.
Rebholz, C. M., Crews, D. C., Grams, M. E., Steffen, L. M., Levey, A. S., Miller, E. R., Appel, L. J., & Coresh, J. (2016). DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 68(6), 853-861. https://doi.org/10.1053/j.ajkd.2016.05.019
Rebholz CM, et al. DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease. Am J Kidney Dis. 2016;68(6):853-861. PubMed PMID: 27519166.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease. AU - Rebholz,Casey M, AU - Crews,Deidra C, AU - Grams,Morgan E, AU - Steffen,Lyn M, AU - Levey,Andrew S, AU - Miller,Edgar R,3rd AU - Appel,Lawrence J, AU - Coresh,Josef, Y1 - 2016/08/09/ PY - 2016/01/29/received PY - 2016/05/13/accepted PY - 2016/8/16/pubmed PY - 2017/6/1/medline PY - 2016/8/14/entrez KW - Chronic kidney disease (CKD) KW - DASH diet score KW - diet KW - dietary acid load KW - dietary protein KW - disease progression KW - food frequency questionnaire KW - health promotion KW - incident kidney disease KW - kidney disease prevention KW - modifiable risk factor KW - renal function SP - 853 EP - 861 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am J Kidney Dis VL - 68 IS - 6 N2 - BACKGROUND: There are established guidelines for recommended dietary intake for hypertension treatment and cardiovascular disease prevention. Evidence is lacking for effective dietary patterns for kidney disease prevention. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: Atherosclerosis Risk in Communities (ARIC) Study participants with baseline estimated glomerular filtration rate (eGFR) ≥ 60mL/min/1.73m2 (N=14,882). PREDICTOR: The Dietary Approaches to Stop Hypertension (DASH) diet score was calculated based on self-reported dietary intake of red and processed meat, sweetened beverages, sodium, fruits, vegetables, whole grains, nuts and legumes, and low-fat dairy products, averaged over 2 visits. OUTCOMES: Cases were ascertained based on the development of eGFRs<60mL/min/1.73m2 accompanied by ≥25% eGFR decline from baseline, an International Classification of Diseases, Ninth/Tenth Revision code for a kidney disease-related hospitalization or death, or end-stage renal disease from baseline through 2012. RESULTS: 3,720 participants developed kidney disease during a median follow-up of 23 years. Participants with a DASH diet score in the lowest tertile were 16% more likely to develop kidney disease than those with the highest score tertile (HR, 1.16; 95% CI, 1.07-1.26; P for trend < 0.001), after adjusting for sociodemographics, smoking status, physical activity, total caloric intake, baseline eGFR, overweight/obese status, diabetes status, hypertension status, systolic blood pressure, and antihypertensive medication use. Of the individual components of the DASH diet score, high red and processed meat intake was adversely associated with kidney disease and high nuts, legumes, and low-fat dairy products intake was associated with reduced risk for kidney disease. LIMITATIONS: Potential measurement error due to self-reported dietary intake and lack of data for albuminuria. CONCLUSIONS: Consuming a DASH-style diet was associated with lower risk for kidney disease independent of demographic characteristics, established kidney risk factors, and baseline kidney function. Healthful dietary patterns such as the DASH diet may be beneficial for kidney disease prevention. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/27519166/DASH__Dietary_Approaches_to_Stop_Hypertension__Diet_and_Risk_of_Subsequent_Kidney_Disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(16)30257-8 DB - PRIME DP - Unbound Medicine ER -