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Adherence to the DASH Diet and Risk of Incident Chronic Kidney Disease: the Atherosclerosis Risk in Communities (ARIC) Study
Author(s) -
Rebholz Casey,
Crews Deidra,
Grams Morgan,
Levey Andrew,
Miller Edgar,
Appel Lawrence,
Coresh Josef
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.119.1
Subject(s) - medicine , dash , kidney disease , dash diet , renal function , prospective cohort study , incidence (geometry) , diabetes mellitus , endocrinology , blood pressure , computer science , operating system , physics , optics
Introduction There are established guidelines for optimal dietary intake for the prevention of hypertension and cardiovascular disease. Evidence is lacking for effective dietary patterns for the prevention of chronic kidney disease (CKD). Methods We conducted prospective analyses of ARIC study participants without CKD at baseline (1987‐89, N=15,100). A score was created to assess adherence to the Dietary Approaches to Stop Hypertension (DASH) diet. Incident CKD was defined as an ICD‐9/10 code for a CKD‐related hospitalization or death, end‐stage renal disease, or decreased kidney function [estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m 2 or 蠅25% eGFR decline from baseline] from baseline through 2011. Results There were a total of 2,351 incident CKD cases during a median follow‐up of 21 years. Participants with a DASH diet adherence score in the lowest tertile were at an increased risk of CKD ( Table ). Of the individual components of the DASH diet adherence score, low intake of magnesium and calcium and high intake of sodium were strongly associated with increased risk of CKD.Table. Risk of Incident Chronic Kidney Disease According to Tertile of DASH Diet ScoreLow AdherenceTertile 1 Moderate AdherenceTertile 3 High AdherenceTertile 3 P‐value for trend % (n) ‐‐ 39% (6,017) 36% (5,500) 25% (3,911) ‐‐ IR (95% CI) ‐‐ 9.29 (8.72, 9.90) 8.51 (7.95, 9.11) 8.48 (7.82, 9.19) 0.01 HR (95% CI) Model 1 1.14 (1.02, 1.27) 1.02 (0.91, 1.13) 1 [Reference] 0.002 HR (95% CI) Model 2 1.13 (1.01, 1.26) 1.01 (0.91, 1.13) 1 [Reference] 0.003Conclusions Higher adherence to the DASH diet may be associated with lower risk for developing CKD, independent of demographic characteristics, caloric intake, hypertension, diabetes, and kidney function. Further study is required to determine whether following a diet that is high in fruits, vegetables, and low‐fat dairy, and low in sodium, which has been shown to prevent hypertension and cardiovascular disease, might also prevent the development of CKD.