Dietary Patterns and Clinical Outcomes in Hemodialysis Patients in Japan: A Cohort Study

被引:16
作者
Tsuruya, Kazuhiko [1 ]
Fukuma, Shingo [2 ,3 ]
Wakita, Takafumi [4 ]
Ninomiya, Toshiharu [5 ]
Nagata, Masaharu [6 ]
Yoshida, Hisako [1 ]
Fujimi, Satoru [7 ]
Kiyohara, Yutaka [8 ]
Kitazono, Takanari [5 ]
Uchida, Kazuhiro [9 ]
Shirota, Tomoko [9 ]
Akizawa, Tadao [10 ]
Akiba, Takashi [11 ]
Saito, Akira [12 ,13 ]
Fukuhara, Shunichi [2 ,14 ]
机构
[1] Kyushu Univ, Grad Sch Med Sci, Dept Integrated Therapy Chron Kidney Dis, Fukuoka 812, Japan
[2] Kyoto Univ, Grad Sch Med & Publ Hlth, Dept Healthcare Epidemiol, Kyoto, Japan
[3] Inst Hlth Outcomes & Proc Evaluat Res iHope Int, Tokyo, Japan
[4] Kansai Univ, Fac Sociol, Osaka, Japan
[5] Kyushu Univ, Grad Sch Med Sci, Dept Med & Clin Sci, Fukuoka 812, Japan
[6] Kyushu Univ, Grad Sch Med Sci, Commun Med Educ Unit, Fukuoka 812, Japan
[7] Fukuoka Renal Clin, Fukuoka, Japan
[8] Kyushu Univ, Grad Sch Med Sci, Dept Environm Med, Fukuoka 812, Japan
[9] Nakamura Gakuen Univ, Sch Hlth & Nutr Sci, Dept Hlth Promot, Fukuoka, Japan
[10] Showa Univ, Sch Med, Dept Med, Div Nephrol, Tokyo 142, Japan
[11] Tokyo Womens Med Univ, Kidney Ctr, Dept Blood Purificat & Internal Med, Tokyo, Japan
[12] Shonantobu Gen Hosp, Div Nephrol, Kanagawa, Japan
[13] Shonantobu Gen Hosp, Dialysis Ctr, Kanagawa, Japan
[14] Fukushima Med Univ, Ctr Innovat Res Commun & Clin Excellence, Fukushima, Japan
来源
PLOS ONE | 2015年 / 10卷 / 01期
关键词
CHRONIC KIDNEY-DISEASE; CARDIOVASCULAR-DISEASE; COLORECTAL-CANCER; DIALYSIS PATIENTS; HISTORY QUESTIONNAIRES; CLUSTER-ANALYSIS; MORTALITY; HISAYAMA; METAANALYSIS; GUIDELINES;
D O I
10.1371/journal.pone.0116677
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background & Objectives Little is known about actual dietary patterns and their associations with clinical outcomes in hemodialysis patients. We identified dietary patterns in hemodialysis patients in Japan and examined associations between dietary patterns and clinical outcomes. Design, setting, participants, measurements We used data from 3,080 general-population participants in the Hisayama study (year 2007), and data from 1,355 hemodialysis patients in the Japan Dialysis Outcomes and Practice Patterns Study (JDOPPS: years 2005-2007). Food intake was measured using a brief self-administered diet-history questionnaire (BDHQ). To identify food groups with the Hisayama population data, we used principal components analysis with Promax rotation. We adjusted the resulting food groups for total daily energy intake, and then we used those adjusted food-group scores to identify dietary patterns in the JDOPPS patients by cluster analysis (Ward's method). We then used Cox regression to examine the association between dietary patterns and a composite of adverse clinical outcomes: hospitalization due to cardiovascular disease or death due to any cause. Results We identified three food groups: meat, fish, and vegetables. Using those groups we then identified three dietary patterns: well-balanced, unbalanced, and other. After adjusting for potential confounders, we found an association between an unbalanced diet and important clinical events (hazard ratio 1.90, 95% C.I. 1.19-3.04). Conclusions Hemodialysis patients whose diet was unbalanced were more likely to have adverse clinical outcomes. Thus hemodialysis patients might benefit not only from portion control, but also from a diet that is well-balanced diet with regard to the food groups identified here as meat, fish, and vegetables.
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页数:10
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