Abstract: FR-PO857

Mediterranean and Dietary Approaches to Stop Hypertension (DASH) Diets and Cardiovascular and All-Cause Mortality in Adults on Hemodialysis: The DIET-HD Multinational Cohort Study

Session Information

Category: Dialysis

  • 606 Dialysis: Epidemiology, Outcomes, Clinical Trials - Cardiovascular

Authors

  • Saglimbene, Valeria Maria, University of Sydney, Sydney, Australia
  • Wong, Germaine, University of Sydney, Sydney, New South Wales, Australia
  • Craig, Jonathan C., University of Sydney/Children's Hospital, Sydney, New South Wales, Australia
  • Hegbrant, Jorgen BA, Diaverum Medical Scientific Office, Lund, Sweden
  • Strippoli, Giovanni F.M., University of Bari, Bari, Italy
  • Ruospo, Marinella, Diaverum, Bari, Italy

Group or Team Name

  • For DIET-HD investigators
Background

Mediterranean and DASH diets are associated with reduced cardiovascular and all-cause mortality in the general population, but these benefits may not be transferable in patients on hemodialysis due to the high content of potassium and phosphate in these diets.

Methods

Mediterranean and DASH diet scores were measured from the GA2LEN food frequency questionnaire within the DIET-HD study, a prospective cohort study (January 2014-January 2016) of 9757 adults treated with hemodialysis in Europe and South America. Adjusted cox regression analyses clustered by country were conducted to evaluate the association between Mediterranean or DASH scores and cardiovascular and all-cause mortality.

Results

During a median follow up of 1.5 years (8108 person-years), there were 1214 deaths of which 515 were attributable to cardiovascular causes. The mean (standard deviation) Mediterranean and DASH scores were 4.0 (1.5) (scale 0 to 8) and 20.4 (3.7) (scale 0 to 34), respectively. Compared with the lowest Mediterranean score quartile (0-3), the adjusted hazard ratios (95% confidence intervals) for cardiovascular mortality in the second (3-4), third (4-5) and fourth (>5) quartile were 0.92 (0.72-1.17), 1.12 (0.87-1.43) and 1.05 (0.78-1.41), respectively; the adjusted hazard ratios for all-cause mortality were 1.05 (0.90-1.23), 1.16 (0.99-1.37) and 1.15 (0.95-1.40), respectively. Compared with the lowest DASH score quartile (0-18), the adjusted hazard ratios for cardiovascular mortality in the second (18-20), third (20-23) and fourth (>23) quartile were 0.95 (0.72-1.24), 1.28 (1.00-1.64) and 1.14 (0.85-1.52), respectively; the adjusted hazard ratios for all-cause mortality were 0.98 (0.83-1.16), 1.04 (0.89-1.23) and 0.95 (0.78-1.14), respectively.

Conclusion

Mediterranean or DASH dietary patterns were not associated with cardiovascular and all-cause mortality for patients on hemodialysis.