Poor accordance to a DASH dietary pattern is associated with higher risk of ESRD among adults with moderate chronic kidney disease and hypertension

被引：56

作者：

Banerjee, Tanushree ^{[1
,10
]}

Crews, Deidra C. ^{[2
,3
]}

Tuot, Delphine S. ^{[4
]}

Pavkov, Meda E. ^{[5
]}

Burrows, Nilka Rios ^{[5
,12
]}

Stack, Austin G. ^{[6
]}

Saran, Rajiv ^{[7
,8
,11
]}

Bragg-Gresham, Jennifer ^{[7
,11
]}

Powe, Neil R. ^{[1
,9
]}

Powe, Neil ^{[10
]}

Tuot, Delphine ^{[10
]}

Hsu, Chi-yuan ^{[10
]}

McCulloch, Charles ^{[10
]}

Crews, Deidra ^{[10
]}

Hsu, Raymond ^{[10
]}

Grubbs, Vanessa ^{[10
]}

Bibbins-Domingo, Kirsten ^{[10
]}

Shlipak, Michael ^{[10
]}

Peralta, Carmen ^{[10
]}

Rubinsky, Anna ^{[10
]}

Coresh, Josef ^{[10
]}

Shahinian, Vahakn ^{[11
]}

Gillespie, Brenda ^{[11
]}

Morgenstern, Hal ^{[11
]}

Heung, Michael ^{[11
]}

Herman, William ^{[11
]}

McClellan, William ^{[11
]}

Steffick, Diane ^{[11
]}

Tilea, Anca ^{[11
]}

Yin, Maggie ^{[11
]}

Robinson, Ian ^{[11
]}

Zivin, Kara ^{[11
]}

Kurtz, Vivian ^{[11
]}

Wyncott, April ^{[11
]}

Eberhardt, Mark ^{[12
]}

Geiss, Linda ^{[12
]}

Mondesire, Juanita ^{[12
]}

Moore, Bernice ^{[12
]}

Patel, Priti ^{[12
]}

Pavkov, Meda ^{[12
]}

Rolka, Deborah ^{[12
]}

Saydah, Sharon ^{[12
]}

Shrestha, Sundar ^{[12
]}

Waller, Larry ^{[12
]}

机构：

[1] Univ Calif San Francisco, Dept Med, Div Gen Internal Med, San Francisco, CA USA

[2] Johns Hopkins Univ, Sch Med, Dept Med, Div Nephrol, Baltimore, MD 21205 USA

[3] Johns Hopkins Med Inst, Welch Ctr Prevent Epidemiol & Clin Res, Baltimore, MD 21205 USA

[4] Univ Calif San Francisco, Dept Med, Div Nephrol, San Francisco, CA USA

[5] Ctr Dis & Control & Prevent, Div Diabet Translat, Atlanta, GA USA

[6] Univ Hosp Limerick, Dept Nephrol & Internal Med, Limerick, Ireland

[7] Univ Michigan, Kidney Epidemiol & Cost Ctr, Ann Arbor, MI 48109 USA

[8] Univ Michigan, Dept Med, Div Nephrol, Ann Arbor, MI 48109 USA

[9] Zuckerberg San Francisco Gen Hosp, Dept Med, San Francisco, CA USA

[10] Univ Calif San Francisco, San Francisco, CA 94143 USA

[11] Univ Michigan, Ann Arbor, MI 48109 USA

[12] Ctr Dis Control & Prevent, Atlanta, GA USA

来源：

KIDNEY INTERNATIONAL | 2019年 / 95卷 / 06期

关键词：

CKD; diet; diabetes; ESRD; GLOMERULAR-FILTRATION-RATE; NET ACID EXCRETION; MORTALITY; HEALTHY; DECLINE; LOAD; BICARBONATE; PROGRESSION; VEGETABLES; REDUCTION;

D O I：

10.1016/j.kint.2018.12.027

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

The Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure, an important risk factor for chronic kidney disease (CKD) and end-stage renal disease (ESRD). However, it is unclear whether adherence to a DASH diet confers protection against future ESRD, especially among those with pre-existing CKD and hypertension. We examined whether a DASH diet is associated with lower risk of ESRD among 1,110 adults aged >= 20 years with hypertension and CKD (estimated glomerular filtration rate, eGFR 30-59 ml/min/1.73 m(2)) enrolled in the National Health and Nutrition Examination Survey (1988-1994). Baseline DASH diet accordance score was assessed using a 24-hour dietary recall questionnaire. ESRD was ascertained by linkage to the U.S. Renal Data System registry. We used the Fine-Gray competing risks method to estimate the relative hazard (RH) for ESRD after adjusting for sociodemographics, clinical and nutritional factors, eGFR, and albuminuria. Over a median follow-up of 7.8 years, 18.4% of subjects developed ESRD. Compared to the highest quintile of DASH diet accordance, there was a greater risk of ESRD among subjects in quintiles 1 (RH =1.7; 95% CI 1.1-2.7) and 2 (RH 2.2; 95% CI 1.1-4.1). Significant interactions were observed with diabetes status and race/ ethnicity, with the strongest association between DASH diet adherence and ESRD risk observed in individuals with diabetes and in non-Hispanic blacks. Low accordance to a DASH diet is associated with greater risk of ESRD in adults with moderate CKD and hypertension, particularly in non-Hispanic blacks and persons with diabetes.

引用

页码：1433 / 1442

页数：10

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