title: Impact of Kidney Function on Effects of the Dietary Approaches to Stop Hypertension (Dash) Diet.
abstract: OBJECTIVE
  Although the Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure in adults with hypertension, how kidney function impacts this effect is not known. We evaluated whether Estimated Glomerular Filtration Rate (eGFR) modifies the effect of the DASH diet on blood pressure, markers of mineral metabolism, and markers of kidney function.
  
  
  METHODS
  Secondary analysis of the DASH-Sodium trial, a multicenter, randomized, controlled human feeding study that evaluated the blood pressure lowering effect of the DASH diet at three levels of sodium intake. Data from 92 participants with pre-hypertension or stage 1 hypertension during the 3450 mg /day sodium diet assignment contributed to this analysis. Stored frozen plasma and urine specimens were used to measure kidney related laboratory outcomes.
  
  
  RESULTS
  Effects of the DASH diet on blood pressure, phosphorus, intact parathyroid hormone, creatinine, and albuminuria were not modified by baseline eGFR (mean 84.5 ± 18.0 ml/min/1.73 m2, range 44.1 to 138.6 ml/min/1.73 m2) or the presence of chronic kidney disease (N=13%).
  
  
  CONCLUSIONS
  The impact of the DASH diet on blood pressure, markers of mineral metabolism, and markers of kidney function does not appear to be modified by eGFR in this small subset of DASH-Sodium trial participants with relatively preserved kidney function. Whether greater reduction in eGFR modifies the effects of DASH on kidney related measures is yet to be determined. A larger study in individuals with more advanced kidney disease is needed to establish the efficacy and safety of the DASH diet in this patient population.
authors.affiliation: Department of Medicine, Division of Nephrology, Duke University Medical Center, Durham, NC, USA ; Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, NC, USA ; Duke Hypertension Center, Duke University Medical Center, Durham, NC, USA.
authors.forename: Crystal C
authors.initials: CC
authors.lastname: Tyson
authors.affiliation: Department of Biostatistics & Bioinformatics, Duke University Medical Center, Durham, NC, USA.
authors.forename: Maragatha
authors.initials: M
authors.lastname: Kuchibhatla
authors.affiliation: Department of Medicine, Division of Nephrology, Duke University Medical Center, Durham, NC, USA.
authors.forename: Uptal D
authors.initials: UD
authors.lastname: Patel
authors.affiliation: Department of Medicine, Division of Nephrology, Duke University Medical Center, Durham, NC, USA.
authors.forename: Patrick H
authors.initials: PH
authors.lastname: Pun
authors.affiliation: Division of Nephrology, Johns Hopkins University, Baltimore, USA ; Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, USA.
authors.forename: Alex
authors.initials: A
authors.lastname: Chang
authors.affiliation: Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, NC, USA ; Duke Hypertension Center, Duke University Medical Center, Durham, NC, USA.
authors.forename: Chinazo
authors.initials: C
authors.lastname: Nwankwo
authors.affiliation: Department of Epidemiology and Biostatistics, SUNY Downstate Medical Center, New York, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Joseph
authors.affiliation: Department of Medicine, Division of Nephrology, Duke University Medical Center, Durham, NC, USA ; Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, NC, USA ; Duke Hypertension Center, Duke University Medical Center, Durham, NC, USA.
authors.forename: Laura P
authors.initials: LP
authors.lastname: Svetkey
keywords: Blood pressure; Diet; Hypertension; Kidney disease