Dietary Approach to Stop Hypertension (DASH) diet and risk of renal function decline and all-cause mortality in renal transplant recipients

M.C.J. Osté, A.W. Gomes Neto, E. Corpeleijn, R.O.B. Gans, M.H. de Borst, E. van den Berg, S.S. Soedamah-Muthu, D. Kromhout, G.J. Navis, S.J.L. Bakker

Thursday 15 march 2018

15:25 - 15:30h at Willem Burger Foyer

Categories: Clinical, Session (poster)

Parallel session: Poster session 3: Clinical

Aim

Renal transplant recipients (RTR) are at risk of progressive decline of graft function and premature mortality, with high blood pressure as an important risk factor for both. The aim of this study is to investigate whether a dietary pattern resembling the Dietary Approach to Stop Hypertension (DASH) diet is associated with these adverse events in RTR.

Methods

In this prospective cohort study, we included adult RTR with a functioning graft for > 1 year. Dietary data was collected using a validated 177-item food frequency questionnaire. For each of the 8 dietary components of the DASH diet, a score was attributed to each subject according to sex-specific quintiles of dietary intake. The 8 component scores were summed up to calculate the overall DASH-score. Cox regression models were used to study associations of the DASH-score in tertiles with renal function loss, defined as death-censored graft failure and/or doubling of serum creatinine, and all-cause mortality.

Results

We included 632 stable RTR (mean ± SD age: 53.0 ± 12.7 y, 57% men). Mean DASH score was 23.8±4.7. During median follow-up of 5.3 (IQR, 4.1-6.0) y, 119 (18.8%) RTR had renal function decline and 128 (20.3%) died. In Cox-regression analyses, RTR in the highest tertile of the DASH score had a lower risk of both renal function decline (HR: 0.57; 95% CI: 0.33-0.96, p = 0.03) and all-cause mortality (HR: 0.52; 95% CI: 0.32-0.83, p = 0.006) when compared to the lowest tertile, independent of potential confounders including age, sex, kidney function parameters (eGFR, urinary protein excretion, time between transplantation and baseline, primary renal disease), and transplant characteristics (acute rejection, pre-emptive transplantation, donor type).

Conclusions

High adherence to a DASH-style diet is associated with a lower risk of both renal function decline and all-cause mortality. This study suggests the necessity of a healthful diet in renal transplant recipients, however, randomized controlled trials are required.