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Dietary Patterns and Clinical Outcomes in Chronic Kidney Disease: The CKD.QLD Nutrition Study.
J Ren Nutr 2017; 27(3):175-182JR

Abstract

OBJECTIVE

Emerging evidence suggests that dietary patterns are associated with survival in people with chronic kidney disease (CKD). This study evaluated the relationship between dietary habits and renal-related clinical outcomes in an established CKD cohort.

DESIGN

Prospective cohort study.

SETTING

Three outpatient nephrology clinics in Queensland, Australia.

SUBJECTS

A total of 145 adult patients with Stage 3 or 4 CKD (estimated glomerular filtration rate 15-59 mL/minute/1.73 m2).

INTERVENTION

Dietary intake was measured using 24-hour recall and the HeartWise Dietary Habits Questionnaire (DHQ), which evaluates 10 components of dietary patterns in relation to cooking habits and intake of food groups.

MAIN OUTCOME MEASURE

The primary outcome was a composite end point of all-cause mortality, commencement of dialysis, and doubling of serum creatinine. Secondary outcome was all-cause mortality alone. Multivariate cox regression analyses calculated hazard ratios (HRs) for associations between DHQ domains and occurrence of composite outcome and adjusted for confounders, including comorbidities and renal function.

RESULTS

Over a median follow-up of 36 months, 32% (n = 47) reached the composite end point, of which 21% died (n = 30). Increasing DHQ score was associated with a lower risk of the composite end point with increasing intake of fruits and vegetables (HR: 0.61; 95% CI, 0.39-0.94) and limiting alcohol consumption (HR, 0.79; 95% CI: 0.65-0.96). For the secondary outcome of all-cause mortality, there was a significant association with adequate intake of fruits and vegetables (HR: 0.35; 95% CI, 0.15-0.83).

CONCLUSION

Healthy dietary patterns consisting of adequate fruits and vegetables and limited alcohol consumption are associated with a delay in CKD progression and improved survival in patients with Stage 3 or 4 CKD.

Authors+Show Affiliations

Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia.Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia; School of Medicine, University of Queensland, Brisbane, Queensland, Australia.Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; School of Medicine, University of Queensland, Brisbane, Queensland, Australia; Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia. Electronic address: kcampbel@bond.edu.au.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27939593

Citation

Wai, Shu Ning, et al. "Dietary Patterns and Clinical Outcomes in Chronic Kidney Disease: the CKD.QLD Nutrition Study." Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 27, no. 3, 2017, pp. 175-182.
Wai SN, Kelly JT, Johnson DW, et al. Dietary Patterns and Clinical Outcomes in Chronic Kidney Disease: The CKD.QLD Nutrition Study. J Ren Nutr. 2017;27(3):175-182.
Wai, S. N., Kelly, J. T., Johnson, D. W., & Campbell, K. L. (2017). Dietary Patterns and Clinical Outcomes in Chronic Kidney Disease: The CKD.QLD Nutrition Study. Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 27(3), pp. 175-182. doi:10.1053/j.jrn.2016.10.005.
Wai SN, et al. Dietary Patterns and Clinical Outcomes in Chronic Kidney Disease: the CKD.QLD Nutrition Study. J Ren Nutr. 2017;27(3):175-182. PubMed PMID: 27939593.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary Patterns and Clinical Outcomes in Chronic Kidney Disease: The CKD.QLD Nutrition Study. AU - Wai,Shu Ning, AU - Kelly,Jaimon T, AU - Johnson,David W, AU - Campbell,Katrina L, Y1 - 2016/12/08/ PY - 2016/08/15/received PY - 2016/10/09/revised PY - 2016/10/19/accepted PY - 2016/12/13/pubmed PY - 2017/10/4/medline PY - 2016/12/13/entrez SP - 175 EP - 182 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 27 IS - 3 N2 - OBJECTIVE: Emerging evidence suggests that dietary patterns are associated with survival in people with chronic kidney disease (CKD). This study evaluated the relationship between dietary habits and renal-related clinical outcomes in an established CKD cohort. DESIGN: Prospective cohort study. SETTING: Three outpatient nephrology clinics in Queensland, Australia. SUBJECTS: A total of 145 adult patients with Stage 3 or 4 CKD (estimated glomerular filtration rate 15-59 mL/minute/1.73 m2). INTERVENTION: Dietary intake was measured using 24-hour recall and the HeartWise Dietary Habits Questionnaire (DHQ), which evaluates 10 components of dietary patterns in relation to cooking habits and intake of food groups. MAIN OUTCOME MEASURE: The primary outcome was a composite end point of all-cause mortality, commencement of dialysis, and doubling of serum creatinine. Secondary outcome was all-cause mortality alone. Multivariate cox regression analyses calculated hazard ratios (HRs) for associations between DHQ domains and occurrence of composite outcome and adjusted for confounders, including comorbidities and renal function. RESULTS: Over a median follow-up of 36 months, 32% (n = 47) reached the composite end point, of which 21% died (n = 30). Increasing DHQ score was associated with a lower risk of the composite end point with increasing intake of fruits and vegetables (HR: 0.61; 95% CI, 0.39-0.94) and limiting alcohol consumption (HR, 0.79; 95% CI: 0.65-0.96). For the secondary outcome of all-cause mortality, there was a significant association with adequate intake of fruits and vegetables (HR: 0.35; 95% CI, 0.15-0.83). CONCLUSION: Healthy dietary patterns consisting of adequate fruits and vegetables and limited alcohol consumption are associated with a delay in CKD progression and improved survival in patients with Stage 3 or 4 CKD. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/27939593/Dietary_Patterns_and_Clinical_Outcomes_in_Chronic_Kidney_Disease:_The_CKD_QLD_Nutrition_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-2276(16)30157-1 DB - PRIME DP - Unbound Medicine ER -