title: Association of fish intake and survival in a cohort of incident dialysis patients.
abstract: Multiple studies in the general population have shown cardioprotective and survival benefits associated with dietary fish intake, but little is known about outcomes associated with dietary fish intake in patients with chronic renal failure. We investigated fish consumption and survival in 216 incident dialysis patients. Fish consumption was identified in a 24-hour dietary recall and a 3-day food diary collected at baseline (near treatment start) and a 3-day food diary collected 1 year later. Patients who reported fish intake had higher average serum albumin levels at baseline than patients who did not report fish intake. Patient survival was followed up for an average of 3 years from baseline. In univariate Cox regression models, younger age, black race, peritoneal dialysis rather than hemodialysis as initial treatment modality, absence of cardiovascular comorbidity, higher self-assessed physical functioning, and fish consumption were significantly associated with patient survival. A multivariable Cox proportional hazards regression analysis showed that dietary fish consumption independently predicted patient survival, controlling for all other variables in the model. In multivariable analysis, patients who were younger, black, and had higher mental health scores at baseline also had a significantly decreased mortality risk. Patients who reported fish consumption were approximately 50% less likely to die during the study interval. Health outcomes associated with fish consumption merit continued study in patients with chronic renal failure.
authors.affiliation: Department of Rehabilitation Medicine, School of Medicine, Emory University, Atlanta, GA 30322, USA. nkutner@emory.edu
authors.forename: Nancy G
authors.initials: NG
authors.lastname: Kutner
authors.forename: Patricia Ward
authors.initials: PW
authors.lastname: Clow
authors.forename: Rebecca
authors.initials: R
authors.lastname: Zhang
authors.forename: Xavier
authors.initials: X
authors.lastname: Aviles
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D015331:Cohort Studies; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D004032:Diet; D005260:Female; D005399:Fishes / Q000378:metabolism*; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000379:methods / Q000401:mortality