title: DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease.
abstract: BACKGROUND
  There are established guidelines for recommended dietary intake for hypertension treatment and cardiovascular disease prevention. Evidence is lacking for effective dietary patterns for kidney disease prevention.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Atherosclerosis Risk in Communities (ARIC) Study participants with baseline estimated glomerular filtration rate (eGFR) ≥ 60mL/min/1.73m2(N=14,882).
  
  
  METHODS
  The Dietary Approaches to Stop Hypertension (DASH) diet score was calculated based on self-reported dietary intake of red and processed meat, sweetened beverages, sodium, fruits, vegetables, whole grains, nuts and legumes, and low-fat dairy products, averaged over 2 visits.
  
  
  RESULTS
  Cases were ascertained based on the development of eGFRs<60mL/min/1.73m2accompanied by ≥25% eGFR decline from baseline, an International Classification of Diseases, Ninth/Tenth Revision code for a kidney disease-related hospitalization or death, or end-stage renal disease from baseline through 2012.
  
  
  RESULTS
  3,720 participants developed kidney disease during a median follow-up of 23 years. Participants with a DASH diet score in the lowest tertile were 16% more likely to develop kidney disease than those with the highest score tertile (HR, 1.16; 95% CI, 1.07-1.26; P for trend < 0.001), after adjusting for sociodemographics, smoking status, physical activity, total caloric intake, baseline eGFR, overweight/obese status, diabetes status, hypertension status, systolic blood pressure, and antihypertensive medication use. Of the individual components of the DASH diet score, high red and processed meat intake was adversely associated with kidney disease and high nuts, legumes, and low-fat dairy products intake was associated with reduced risk for kidney disease.
  
  
  CONCLUSIONS
  Potential measurement error due to self-reported dietary intake and lack of data for albuminuria.
  
  
  CONCLUSIONS
  Consuming a DASH-style diet was associated with lower risk for kidney disease independent of demographic characteristics, established kidney risk factors, and baseline kidney function. Healthful dietary patterns such as the DASH diet may be beneficial for kidney disease prevention.
authors: Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Electronic address: crebhol1@jhu.edu.
authors: Casey M
authors: CM
authors: Rebholz
authors: Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Division of Nephrology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
authors: Deidra C
authors: DC
authors: Crews
authors: Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Division of Nephrology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
authors: Morgan E
authors: ME
authors: Grams
authors: Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN.
authors: Lyn M
authors: LM
authors: Steffen
authors: William B. Schwartz Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, MA.
authors: Andrew S
authors: AS
authors: Levey
authors: Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
authors: Edgar R
authors: ER
authors: Miller
authors: Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
authors: Lawrence J
authors: LJ
authors: Appel
authors: Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Division of General Internal Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
authors: Josef
authors: J
authors: Coresh
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000178:diet therapy*; D007674:Kidney Diseases / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
keywords: Chronic kidney disease (CKD); DASH diet score; diet; dietary acid load; dietary protein; disease progression; food frequency questionnaire; health promotion; incident kidney disease; kidney disease prevention; modifiable risk factor; renal function