title: Nutrition and dietary intake and their association with mortality and hospitalisation in adults with chronic kidney disease treated with haemodialysis: protocol for DIET-HD, a prospective multinational cohort study.
abstract: BACKGROUND
  Adults with end-stage kidney disease (ESKD) treated with haemodialysis experience mortality of between 15% and 20% each year. Effective interventions that improve health outcomes for long-term dialysis patients remain unproven. Novel and testable determinants of health in dialysis are needed. Nutrition and dietary patterns are potential factors influencing health in other health settings that warrant exploration in multinational studies in men and women treated with dialysis. We report the protocol of the "DIETary intake, death and hospitalisation in adults with end-stage kidney disease treated with HaemoDialysis (DIET-HD) study," a multinational prospective cohort study. DIET-HD will describe associations of nutrition and dietary patterns with major health outcomes for adults treated with dialysis in several countries.
  
  
  METHODS
  DIET-HD will recruit approximately 10,000 adults who have ESKD treated by clinics administered by a single dialysis provider in Argentina, France, Germany, Hungary, Italy, Poland, Portugal, Romania, Spain, Sweden and Turkey. Recruitment will take place between March 2014 and June 2015. The study has currently recruited 8000 participants who have completed baseline data. Nutritional intake and dietary patterns will be measured using the Global Allergy and Asthma European Network (GA(2)LEN) food frequency questionnaire. The primary dietary exposures will be n-3 and n-6 polyunsaturated fatty acid consumption. The primary outcome will be cardiovascular mortality and secondary outcomes will be all-cause mortality, infection-related mortality and hospitalisation.
  
  
  BACKGROUND
  The study is approved by the relevant Ethics Committees in participating countries. All participants will provide written informed consent and be free to withdraw their data at any time. The findings of the study will be disseminated through peer-reviewed journals, conference presentations and to participants via regular newsletters. We expect that the DIET-HD study will inform large pragmatic trials of nutrition or dietary interventions in the setting of advanced kidney disease.
authors: Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand.
authors: Suetonia C
authors: SC
authors: Palmer
authors: Diaverum Medical Scientific Office, Lund, Sweden Division of Nephrology and Transplantation, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy.
authors: Marinella
authors: M
authors: Ruospo
authors: Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
authors: Katrina L
authors: KL
authors: Campbell
authors: Faculty of Medicine, National Health and Lung Institute, Imperial College of Science, Technology, and Medicine, Royal Brompton campus, London, UK.
authors: Vanessa
authors: V
authors: Garcia Larsen
authors: Diaverum Medical Scientific Office, Lund, Sweden.
authors: Valeria
authors: V
authors: Saglimbene
authors: Diaverum Medical Scientific Office, Lund, Sweden.
authors: Patrizia
authors: P
authors: Natale
authors: Diaverum Medical Scientific Office, Lund, Sweden.
authors: Letizia
authors: L
authors: Gargano
authors: Sydney School of Public Health, Edward Ford Building, University of Sydney, Sydney, New South Wales, Australia.
authors: Jonathan C
authors: JC
authors: Craig
authors: Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
authors: David W
authors: DW
authors: Johnson
authors: Cumming School of Medicine, University of Calgary, 2500 University Drive Northwest, Calgary, Alberta, Canada.
authors: Marcello
authors: M
authors: Tonelli
authors: The George Institute for Global Health, Sydney, New South Wales, Australia.
authors: John
authors: J
authors: Knight
authors: Diaverum Medical Scientific Office, Lund, Sweden Department of Nephrology, Medical University of Lublin, Lublin, Poland.
authors: Anna
authors: A
authors: Bednarek-Skublewska
authors: Diaverum Medical Scientific Office, Lund, Sweden.
authors: Eduardo
authors: E
authors: Celia
authors: Diaverum Medical Scientific Office, Lund, Sweden.
authors: Domingo
authors: D
authors: Del Castillo
authors: Diaverum Medical Scientific Office, Lund, Sweden Department of Internal Medicine, Metabolic Diseases, Medical University of Silesia, Katowice, Poland.
authors: Jan
authors: J
authors: Dulawa
authors: Diaverum Medical Scientific Office, Lund, Sweden.
authors: Tevfik
authors: T
authors: Ecder
authors: Diaverum Medical Scientific Office, Lund, Sweden.
authors: Elisabeth
authors: E
authors: Fabricius
authors: Diaverum Medical Scientific Office, Lund, Sweden Nephrology and Infectiology Research and Development Group, INEB, and School of Medicine, Porto University, Porto, Portugal.
authors: João Miguel
authors: JM
authors: Frazão
authors: Diaverum Medical Scientific Office, Lund, Sweden.
authors: Ruben
authors: R
authors: Gelfman
authors: Diaverum Medical Scientific Office, Lund, Sweden.
authors: Susanne Hildegard
authors: SH
authors: Hoischen
authors: Diaverum Medical Scientific Office, Lund, Sweden.
authors: Staffan
authors: S
authors: Schön
authors: Diaverum Medical Scientific Office, Lund, Sweden.
authors: Paul
authors: P
authors: Stroumza
authors: Diaverum Medical Scientific Office, Lund, Sweden.
authors: Delia
authors: D
authors: Timofte
authors: Diaverum Medical Scientific Office, Lund, Sweden.
authors: Marietta
authors: M
authors: Török
authors: Diaverum Medical Scientific Office, Lund, Sweden.
authors: Jörgen
authors: J
authors: Hegbrant
authors: Diaverum Medical Scientific Office, Lund, Sweden.
authors: Charlotta
authors: C
authors: Wollheim
authors: Diaverum Medical Scientific Office, Lund, Sweden.
authors: Luc
authors: L
authors: Frantzen
authors: Diaverum Medical Scientific Office, Lund, Sweden Sydney School of Public Health, Edward Ford Building, University of Sydney, Sydney, New South Wales, Australia Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy Diaverum Academy, Bari, Italy.
authors: G F M
authors: GF
authors: Strippoli
mesh_terms: D000293:Adolescent; D000328:Adult; D001118:Argentina / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D002149:Energy Intake; D005060:Europe / Q000453:epidemiology; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D005260:Female; D005502:Food; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007239:Infections / Q000401:mortality; D007676:Kidney Failure, Chronic / Q000401:mortality* / Q000628:therapy*; D008297:Male; D009752:Nutritional Status; D011446:Prospective Studies; D006435:Renal Dialysis; D012107:Research Design; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6
keywords: EPIDEMIOLOGY; NUTRITION & DIETETICS