Dietary Patterns and Mortality in a Multinational Cohort of Adults Receiving Hemodialysis.

Autor:	Saglimbene VM; Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, Australia; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden. Electronic address: vsag1982@gmail.com., Wong G; Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, Australia; Centre for Kidney Research, Children's Hospital at Westmead, Westmead, Australia; Department of Renal Medicine, Westmead Hospital, Westmead, Australia., Teixeira-Pinto A; Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, Australia; Centre for Kidney Research, Children's Hospital at Westmead, Westmead, Australia., Ruospo M; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden., Garcia-Larsen V; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD., Palmer SC; Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand., Natale P; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden; Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy., Campbell K; Department of Nutrition and Dietetics, University of Queensland at Princess Alexandra Hospital, Woolloongabba, Queensland, Australia., Carrero JJ; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden., Stenvinkel P; Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden., Gargano L; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden., Murgo AM; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden., Johnson DW; Division of Medicine, Department of Nephrology, University of Queensland at the Princess Alexandra Hospital, Woolloongabba, Australia; Translational Research Institute, University of Queensland, Woolloongabba, Australia., Tonelli M; Cumming School of Medicine, Health Sciences Centre, University of Calgary, Calgary, Alberta, Canada., Gelfman R; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden., Celia E; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden., Ecder T; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden., Bernat AG; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden., Del Castillo D; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden., Timofte D; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden., Török M; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden., Bednarek-Skublewska A; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden; Medical University of Lublin, Lublin., Duława J; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden; Medical University of Silesia, Katowice, Poland., Stroumza P; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden., Hansis M; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden., Fabricius E; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden., Felaco P; Nephrology and dialysis Presidio Ospedaliero Penne, Unita' Sanitaria Locale Pescara., Wollheim C; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden., Hegbrant J; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden., Craig JC; College of Medicine and Public Health, Flinders University, Adelaide, Australia., Strippoli GFM; Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Sydney, Australia; Diaverum Medical-Scientific Office, Diaverum, Lund, Sweden; Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy; Diaverum Academy, Diaverum, Bari, Italy.
Jazyk:	angličtina
Zdroj:	American journal of kidney diseases : the official journal of the National Kidney Foundation [Am J Kidney Dis] 2020 Mar; Vol. 75 (3), pp. 361-372. Date of Electronic Publication: 2019 Sep 09.
DOI:	10.1053/j.ajkd.2019.05.028
Abstrakt:	Rationale & Objective: Clinical practice guidelines for dietary intake in hemodialysis focus on individual nutrients. Little is known about associations of dietary patterns with survival. We evaluated the associations of dietary patterns with cardiovascular and all-cause mortality among adults treated by hemodialysis. Study Design: Prospective cohort study. Setting & Participants: 8,110 of 9,757 consecutive adults on hemodialysis (January 2014 to June 2017) treated in a multinational private dialysis network and with analyzable dietary data. Exposures: Data-driven dietary patterns based on the GA 2 LEN food frequency questionnaire. Participants received a score for each identified pattern, with higher scores indicating closer resemblance of their diet to the identified pattern. Quartiles of standardized pattern scores were used as primary exposures. Outcomes: Cardiovascular and all-cause mortality. Analytical Approach: Principal components analysis with varimax rotation to identify common dietary patterns. Adjusted proportional hazards regression analyses with country as a random effect to estimate the associations between dietary pattern scores and mortality. Associations were expressed as adjusted HRs with 95% CIs, using the lowest quartile score as reference. Results: During a median follow-up of 2.7 years (18,666 person-years), there were 2,087 deaths (958 cardiovascular). 2 dietary patterns, "fruit and vegetable" and "Western," were identified. For the fruit and vegetable dietary pattern score, adjusted HRs, in ascending quartiles, were 0.94 (95% CI, 0.76-1.15), 0.83 (95% CI, 0.66-1.06), and 0.91 (95% CI, 0.69-1.21) for cardiovascular mortality and 0.95 (95% CI, 0.83-1.09), 0.84 (95% CI, 0.71-0.99), and 0.87 (95% CI, 0.72-1.05) for all-cause mortality. For the Western dietary pattern score, the corresponding estimates were 1.10 (95% CI, 0.90-1.35), 1.11 (95% CI, 0.87-1.41), and 1.09 (95% CI, 0.80-1.49) for cardiovascular mortality and 1.01 (95% CI, 0.88-1.16), 1.00 (95% CI, 0.85-1.18), and 1.14 (95% CI, 0.93-1.41) for all-cause mortality. Limitations: Self-reported food frequency questionnaire, data-driven approach. Conclusions: These findings did not confirm an association between mortality among patients receiving long-term hemodialysis and the extent to which dietary patterns were either high in fruit and vegetables or consistent with a Western diet. (Copyright © 2019 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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