title: Short-term effects of the DASH diet in adults with moderate chronic kidney disease: a pilot feeding study.
abstract: BACKGROUND
  Although the Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP) for adults with normal kidney function, evidence is lacking regarding its safety and efficacy in chronic kidney disease (CKD). We aimed to test the effects of the DASH diet on serum electrolytes and BP in adults with moderate CKD.
  
  
  METHODS
  In a prospective before-after feeding study, 11 adults with an estimated glomerular filtration rate of 30-59 mL/min/1.73 m(2) and medication-treated hypertension were provided a reduced-sodium, run-in diet for 1 week followed by a reduced-sodium, DASH diet for 2 weeks. Changes in serum electrolytes and BP were compared pre-post DASH.
  
  
  RESULTS
  Eleven participants underwent feeding; 1 completed 1 week and 10 completed 2 weeks of DASH. Compared with baseline, DASH modestly increased serum potassium at 1 week (mean ± standard deviation, +0.28 ± 0.4 mg/dL; P = 0.043) but had no significant effect on potassium at 2 weeks (+0.15 ± 0.28 mg/dL; P = 0.13). Serum bicarbonate was reduced (-2.5 ± 3.0 mg/dL; P = 0.03) at 2 weeks. Neither incident hyperkalemia nor new onset metabolic acidosis was observed. Clinic BP and mean 24-h ambulatory BP was unchanged. DASH significantly reduced mean nighttime BP (-5.3 ± 5.8 mmHg; P = 0.018), and enhanced percent declines in both nocturnal systolic BP (-2.1% to -5.1%; P = 0.004) and diastolic BP (-3.7% to -10.0%; P = 0.008).
  
  
  CONCLUSIONS
  These pilot data suggest that a reduced-sodium DASH dietary pattern does not cause acute metabolic events in adults with moderate CKD and may improve nocturnal BP. Definitive studies are needed to determine long-term effects of DASH in CKD.
authors.affiliation: Department of Medicine , Duke University , Durham, NC , USA.
authors.forename: Crystal C
authors.initials: CC
authors.lastname: Tyson
authors.affiliation: Department of Medicine, Duke University, Durham, NC, USA; Sarah W. Stedman Nutrition & Metabolism Center, Duke University Medical Center, Durham, NC, USA.
authors.forename: Pao-Hwa
authors.initials: PH
authors.lastname: Lin
authors.affiliation: Department of Medicine , Duke University , Durham, NC , USA.
authors.forename: Leonor
authors.initials: L
authors.lastname: Corsino
authors.affiliation: Department of Medicine , Duke University , Durham, NC , USA.
authors.forename: Bryan C
authors.initials: BC
authors.lastname: Batch
authors.affiliation: Sarah W. Stedman Nutrition & Metabolism Center , Duke University Medical Center , Durham, NC , USA.
authors.forename: Jenifer
authors.initials: J
authors.lastname: Allen
authors.affiliation: Duke Clinical Research Institute , Durham, NC , USA.
authors.forename: Shelly
authors.initials: S
authors.lastname: Sapp
authors.affiliation: Duke Clinical Research Institute , Durham, NC , USA.
authors.forename: Huiman
authors.initials: H
authors.lastname: Barnhart
authors.affiliation: Sarah W. Stedman Nutrition & Metabolism Center , Duke University Medical Center , Durham, NC , USA.
authors.forename: Chinazo
authors.initials: C
authors.lastname: Nwankwo
authors.affiliation: Sarah W. Stedman Nutrition & Metabolism Center , Duke University Medical Center , Durham, NC , USA.
authors.forename: Jasmine
authors.initials: J
authors.lastname: Burroughs
authors.affiliation: Department of Medicine, Duke University, Durham, NC, USA; Sarah W. Stedman Nutrition & Metabolism Center, Duke University Medical Center, Durham, NC, USA.
authors.forename: Laura P
authors.initials: LP
authors.lastname: Svetkey
keywords: DASH diet; blood pressure; kidney disease; metabolic side effects