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:63
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
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
收藏
页码:1433 / 1442
页数:10
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