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The Association of Mediterranean and DASH Diets with Mortality in Adults on Hemodialysis: The DIET-HD Multinational Cohort Study.
J Am Soc Nephrol. 2018 06; 29(6):1741-1751.JA

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.

Authors+Show Affiliations

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

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29695436

Citation

Saglimbene, Valeria M., et al. "The Association of Mediterranean and DASH Diets With Mortality in Adults On Hemodialysis: the DIET-HD Multinational Cohort Study." Journal of the American Society of Nephrology : JASN, vol. 29, no. 6, 2018, pp. 1741-1751.
Saglimbene VM, Wong G, Craig JC, et al. The Association of Mediterranean and DASH Diets with Mortality in Adults on Hemodialysis: The DIET-HD Multinational Cohort Study. J Am Soc Nephrol. 2018;29(6):1741-1751.
Saglimbene, V. M., Wong, G., Craig, J. C., Ruospo, M., Palmer, S. C., Campbell, K., Garcia-Larsen, V., Natale, P., Teixeira-Pinto, A., Carrero, J. J., Stenvinkel, P., Gargano, L., Murgo, A. M., Johnson, D. W., Tonelli, M., Gelfman, R., Celia, E., Ecder, T., Bernat, A. G., ... Strippoli, G. F. M. (2018). The Association of Mediterranean and DASH Diets with Mortality in Adults on Hemodialysis: The DIET-HD Multinational Cohort Study. Journal of the American Society of Nephrology : JASN, 29(6), 1741-1751. https://doi.org/10.1681/ASN.2018010008
Saglimbene VM, et al. The Association of Mediterranean and DASH Diets With Mortality in Adults On Hemodialysis: the DIET-HD Multinational Cohort Study. J Am Soc Nephrol. 2018;29(6):1741-1751. PubMed PMID: 29695436.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Association of Mediterranean and DASH Diets with Mortality in Adults on Hemodialysis: The DIET-HD Multinational Cohort Study. AU - Saglimbene,Valeria M, AU - Wong,Germaine, AU - Craig,Jonathan C, AU - Ruospo,Marinella, AU - Palmer,Suetonia C, AU - Campbell,Katrina, AU - Garcia-Larsen,Vanessa, AU - Natale,Patrizia, AU - Teixeira-Pinto,Armando, AU - Carrero,Juan-Jesus, AU - Stenvinkel,Peter, AU - Gargano,Letizia, AU - Murgo,Angelo M, AU - Johnson,David W, AU - Tonelli,Marcello, AU - Gelfman,Rubén, AU - Celia,Eduardo, AU - Ecder,Tevfik, AU - Bernat,Amparo G, AU - Del Castillo,Domingo, AU - Timofte,Delia, AU - Török,Marietta, AU - Bednarek-Skublewska,Anna, AU - Duława,Jan, AU - Stroumza,Paul, AU - Hoischen,Susanne, AU - Hansis,Martin, AU - Fabricius,Elisabeth, AU - Felaco,Paolo, AU - Wollheim,Charlotta, AU - Hegbrant,Jörgen, AU - Strippoli,Giovanni F M, Y1 - 2018/04/25/ PY - 2018/01/03/received PY - 2018/03/28/accepted PY - 2018/4/27/pubmed PY - 2019/9/10/medline PY - 2018/4/27/entrez KW - DASH diet KW - Dietary patterns KW - Mediterranean diet KW - end-stage kidney disease KW - hemodialysis KW - mortality SP - 1741 EP - 1751 JF - Journal of the American Society of Nephrology : JASN JO - J Am Soc Nephrol VL - 29 IS - 6 N2 - 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. SN - 1533-3450 UR - https://www.unboundmedicine.com/medline/citation/29695436/The_Association_of_Mediterranean_and_DASH_Diets_with_Mortality_in_Adults_on_Hemodialysis:_The_DIET_HD_Multinational_Cohort_Study_ L2 - https://jasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=29695436 DB - PRIME DP - Unbound Medicine ER -