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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 May 10, 2018

Saglimbene VM, et al. - Researchers investigated the association of Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets with mortality in patients on hemodialysis. They found no association of Mediterranean and DASH diets with cardiovascular or total mortality in hemodialysis.

Methods

  • In a multinational cohort study of 9757 adults on hemodialysis (the DIET-HD Study), the GA2LEN Food Frequency Questionnaire was used to derive Mediterranean and DASH diet scores.
  • In adjusted Cox regression analyses clustered by country, researchers assessed the link between diet score tertiles and all-cause and cardiovascular mortality (the lowest tertile was the reference category).

Results

  • A total of 2087 deaths (829 cardiovascular deaths) were reported during the median 2.7-year follow-up.
  • Data showed that 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.
  • For cardiovascular mortality, the observed 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; 1.03 (0.92 to 1.15) and 1.00 (0.89 to 1.12), respectively, for all-cause mortality.
  • Age was found to have a modifying impact on the link between DASH diet score and all-cause death (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.

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