DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease.
DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease.
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DOI：
10.1053/j.ajkd.2016.05.019
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发表时间：
2016-12
期刊：
影响因子：
--
通讯作者：
Coresh J
中科院分区：
文献类型：
--
作者：
Rebholz CM;Crews DC;Grams ME;Steffen LM;Levey AS;Miller ER 3rd;Appel LJ;Coresh J
对于高血压治疗和心血管疾病预防，已有推荐的膳食摄入指南。但缺乏预防肾脏疾病的有效膳食模式的证据。
前瞻性队列研究
社区动脉粥样硬化风险（ARIC）研究中，基线估计肾小球滤过率（eGFR）≥60 mL/min/1.73 m²的参与者（N = 14882）
根据两次随访中自我报告的红肉和加工肉类、含糖饮料、钠、水果、蔬菜、全谷物、坚果和豆类以及低脂乳制品的膳食摄入情况，计算出得舒饮食（DASH）评分。
病例的确定依据是从基线开始eGFR＜60 mL/min/1.73 m²且较基线下降≥25%，有与肾脏疾病相关的住院或死亡的国际疾病分类第9版/第10版编码，或者从基线到2012年出现终末期肾病。
在中位随访23年期间，共有3720名参与者患上肾脏疾病。在对社会人口统计学特征、吸烟状况、体力活动、总热量摄入、基线eGFR、超重/肥胖状况、糖尿病状况、高血压状况、收缩压以及抗高血压药物使用情况进行调整后，得舒饮食评分处于最低三分位数的参与者患肾脏疾病的可能性比处于最高三分位数的参与者高16%（风险比，1.16；95%置信区间，1.07 - 1.26；趋势p＜0.001）。在得舒饮食评分的各个组成部分中，红肉和加工肉类的高摄入量与肾脏疾病呈负相关，坚果、豆类和低脂乳制品的高摄入量与肾脏疾病风险降低相关。
由于自我报告的膳食摄入可能存在测量误差以及缺乏关于蛋白尿的数据
遵循得舒饮食模式与较低的肾脏疾病风险相关，且与人口统计学特征、已确定的肾脏风险因素以及基线肾功能无关。健康的膳食模式，如得舒饮食，可能对预防肾脏疾病有益。
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. Prospective cohort study Atherosclerosis Risk in Communities (ARIC) study participants with baseline estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 (N=14,882) 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 two visits. Cases were ascertained based on development of eGFR <60 mL/min/1.73 m2 accompanied by ≥25% eGFR decline from baseline, an ICD-9/10 code for a kidney disease–related hospitalization or death, or end-stage renal disease from baseline through 2012. A total of 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 socio-demographics, smoking status, physical activity, total caloric intake, baseline eGFR, overweight/obese status, diabetes status, hypertension status, systolic blood pressure, and anti-hypertensive medication use. Of the individual components of the DASH diet score, high intake of red and processed meat was adversely associated with kidney disease and high intake of nuts, legumes, and low-fat dairy products was associated with reduced risk of kidney disease. Potential measurement error due to self-reported dietary intake and lack of data on albuminuria 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.
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DOI：
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发表时间：
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期刊：
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影响因子：
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