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Rebholz CM, Crews DC, Grams ME, et al. DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease. Am J Kidney Dis. 2016;68(6):853-861doi: 10.1053/j.ajkd.2016.05.019.
Rebholz, C. M., Crews, D. C., Grams, M. E., Steffen, L. M., Levey, A. S., Miller, E. R., Appel, L. J., & Coresh, J. (2016). DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease. American journal of kidney diseases : the official journal of the National Kidney Foundation, 68(6), 853-861. https://doi.org/10.1053/j.ajkd.2016.05.019
Rebholz, Casey M, et al. "DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease." American journal of kidney diseases : the official journal of the National Kidney Foundation vol. 68,6 (2016): 853-861. doi: https://doi.org/10.1053/j.ajkd.2016.05.019
Rebholz CM, Crews DC, Grams ME, Steffen LM, Levey AS, Miller ER, Appel LJ, Coresh J. DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease. Am J Kidney Dis. 2016 Dec;68(6):853-861. doi: 10.1053/j.ajkd.2016.05.019. Epub 2016 Aug 09. PMID: 27519166; PMCID: PMC5123940.
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Am J Kidney Dis. 2016 Dec;68(6):853-861. doi: 10.1053/j.ajkd.2016.05.019. Epub 2016 Aug 09.

DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease.

American journal of kidney diseases : the official journal of the National Kidney Foundation

Casey M Rebholz, Deidra C Crews, Morgan E Grams, Lyn M Steffen, Andrew S Levey, Edgar R Miller, Lawrence J Appel, Josef Coresh

Affiliations

  1. Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Electronic address: [email protected].
  2. Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Division of Nephrology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
  3. Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Division of Nephrology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
  4. Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN.
  5. William B. Schwartz Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, MA.
  6. Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
  7. Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.

PMID: 27519166 PMCID: PMC5123940 DOI: 10.1053/j.ajkd.2016.05.019

Abstract

BACKGROUND: There are established guidelines for recommended dietary intake for hypertension treatment and cardiovascular disease prevention. Evidence is lacking for effective dietary patterns for kidney disease prevention.

STUDY DESIGN: Prospective cohort study.

SETTING & PARTICIPANTS: Atherosclerosis Risk in Communities (ARIC) Study participants with baseline estimated glomerular filtration rate (eGFR) ≥ 60mL/min/1.73m

PREDICTOR: The Dietary Approaches to Stop Hypertension (DASH) diet score was calculated based on self-reported dietary intake of red and processed meat, sweetened beverages, sodium, fruits, vegetables, whole grains, nuts and legumes, and low-fat dairy products, averaged over 2 visits.

OUTCOMES: Cases were ascertained based on the development of eGFRs<60mL/min/1.73m

RESULTS: 3,720 participants developed kidney disease during a median follow-up of 23 years. Participants with a DASH diet score in the lowest tertile were 16% more likely to develop kidney disease than those with the highest score tertile (HR, 1.16; 95% CI, 1.07-1.26; P for trend < 0.001), after adjusting for sociodemographics, smoking status, physical activity, total caloric intake, baseline eGFR, overweight/obese status, diabetes status, hypertension status, systolic blood pressure, and antihypertensive medication use. Of the individual components of the DASH diet score, high red and processed meat intake was adversely associated with kidney disease and high nuts, legumes, and low-fat dairy products intake was associated with reduced risk for kidney disease.

LIMITATIONS: Potential measurement error due to self-reported dietary intake and lack of data for albuminuria.

CONCLUSIONS: Consuming a DASH-style diet was associated with lower risk for kidney disease independent of demographic characteristics, established kidney risk factors, and baseline kidney function. Healthful dietary patterns such as the DASH diet may be beneficial for kidney disease prevention.

Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Keywords: Chronic kidney disease (CKD); DASH diet score; diet; dietary acid load; dietary protein; disease progression; food frequency questionnaire; health promotion; incident kidney disease; kidney disease prevention; modifiable risk factor; renal function

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