Sp386mediterranean Diet and Mortality Ιν Chronic Kidney Disease (Ckd) Stage 5d (Dialysis) Patients

Giannikouris, Ioannis Emmanouil; Georgoulidou, Anastasia; Dermitzaki, Elefteria; Korovesi, Anastasia; Kokkalis, Apostolos C.; Stavroulopoulos, Aristeidis; Perakis, Kostas; Theodoridis, Marios; Passadakis, Ploumis; Dounousi, Evangelia; Markaki, Anastasia; Kyriazis, Periklis; Tsotsorou, Ourania; Katsoudas, Spyros; Bacharaki, Dimitra; Vlahakos, Demetrios

doi:10.1093/ndt/gfz103.sp386

Cited by 4 publications

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“…Seventeen studies were further excluded as they either did not report outcomes of interest, excluded dialysis patients, did not evaluate the diet of interest, or had no separate analysis of ESKD outcomes. The final analysis included seven articles [ 14 , 15 , 16 , 17 , 18 , 19 , 20 ], consisting of 9400 ESKD patients, from which 8395 were HD patients and 1005 were peritoneal dialysis (PD) patients. The literature retrieval, review, and selection process are demonstrated in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“… Forest plots of the included studies assessing outcomes defined as DASH and Mediterranean and all-cause mortality [ 15 , 20 ]. …”

Section: Figurementioning

confidence: 99%

“…A recent systematic review also showed that each one-point-higher adherence to the Mediterranean diet was associated with a 10% reduction of progression of CKD [ 13 ]. However, the effects of the DASH diet on clinical outcomes among ESKD patients are inconsistent, and it remains unclear if it has any beneficial effect in this population [ 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. Current dietary guidelines for ESKD patients usually recommend the restriction of specific nutrients (sodium, potassium, phosphorus, etc.)…”

Section: Introductionmentioning

confidence: 99%

“…However, there is limited evidence showing the clinical benefits of restricted nutrients in ESKD patients. The literature has been inconsistent regarding the benefits of a DASH diet in the chronic kidney disease population, and only a small number of studies are available in ESKD patients [ 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. In this systematic review, we evaluated the impact of a DASH, Mediterranean, or plant-based diet on clinical outcomes, including all-cause and cardiovascular mortality, left ventricular hypertrophy (LVH), and hyperkalemia in ESKD patients.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Mediterranean Diet, DASH Diet, and Plant-Based Diet on Outcomes among End Stage Kidney Disease Patients: A Systematic Review and Meta-Analysis

Charkviani

Tangpanithandee

Krisanapan

et al. 2022

Clinics and Practice

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Background: The Mediterranean, Dietary Approach to Stop Hypertension (DASH), and plant-based diets may provide cardiovascular benefit to the general population. However, data on their effect on end stage kidney disease (ESKD) patients are limited. This systematic review aims to assess the impact of Mediterranean, DASH, and plant-based diets on outcomes among ESKD patients. Methods: A literature review was conducted in EMBASE, MEDLINE, and Cochrane databases from inception through September 2022 to identify studies that assess the clinical outcomes of Mediterranean, DASH, or plant-based diets on ESKD patients on hemodialysis (HD) or peritoneal dialysis (PD). Effect estimates from the individual studies were derived utilizing the random-effect, generic inverse variance approach of DerSimonian and Laird. Results: Seven studies with 9400 ESKD patients (8395 HD and 1005 PD) met the eligibility criteria and were included in the data analysis. Pooled odds ratios (ORs) of mortality for ESKD patients who adhered to the Mediterranean versus plant-based diet were 0.49 (95% CI: 0.07–3.54; two studies, I2 = 67%) and 0.87 (95% CI: 0.75–1.01; two studies, I2 = 0%), respectively. Data on mortality for ESKD patients on a DASH diet were limited to one study with an OR of 1.00 (95% CI: 0.89–1.12). The pooled OR of cardiovascular mortality among ESKD patients who adhered to a plant-based diet was 0.86 (95% CI: 0.68–1.08; two studies, I2 = 0%), compared to those who did not. Data on cardiovascular mortality among those with Mediterranean and DASH diet were limited to one study with ORs of 1.14 (95% CI: 0.90–1.43) and 1.19 (95% CI: 0.99–1.43), respectively. Mediterranean diet adherence was found to be associated with reduced risk of left ventricular hypertrophy (LVH) with an OR of 0.82 (95% CI: 0.68–0.99) in a study including 127 ESKD patients. The risk of hyperkalemia was not significant among those with a plant-based diet with an OR of 1.00 (95% CI: 0.94–1.07) in a study including 150 ESKD patients. Conclusions: While our systematic review demonstrated no significant associations of Mediterranean, DASH, and plant-based diets with reduced all-cause mortality or cardiovascular mortality, there was also no evidence that suggested harmful effects of these diets to ESKD patients.

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Section: Resultsmentioning

confidence: 99%

“… Forest plots of the included studies assessing outcomes defined as DASH and Mediterranean and all-cause mortality [ 15 , 20 ]. …”

Section: Figurementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of Mediterranean Diet, DASH Diet, and Plant-Based Diet on Outcomes among End Stage Kidney Disease Patients: A Systematic Review and Meta-Analysis

Charkviani

Tangpanithandee

Krisanapan

et al. 2022

Clinics and Practice

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show abstract

“…Another neglected tool is the Mediterranean diet, a magic poly-weapon against all traditional and non-traditional CV risk factors[ 41 ]. Although the Mediterranean diet is associated with beneficial surrogate goals (Ph load, oxidative stress, inflammation, metabolic acidosis, blood pressure control, lipid control), cardiac parameters[ 42 ] and possibly even mortality[ 43 ], it is not a goal strongly implemented in clinical practice.…”

Section: Present Examples Of Guideline-driven Clinical Practicementioning

confidence: 99%

Emperor’s syndrome in the COVID-19 era: Time for patient-centered nephrology?

Bacharaki¹,

Diamandopoulos²

2021

WJN

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The coronavirus disease-19 (COVID-19) pandemic has been a wake-up call in which has forced us to react worldwide. Health policies and practices have attracted particular attention in terms of human and financial cost. Before COVID-19, chronic kidney disease was already considered a risk multiplier in patients with diabetes and hypertension, the two now being the major risk factors for COVID-19 infection and adverse outcome. In contrast to the urgent need for action, the nephrology field is considered to be in a state of stagnation regarding the management of chronic kidney disease patients who still experience unacceptably high morbidity and mortality. Ironically and paradoxically in a field lacking robust clinical trials, clinical practice is driven by guidelines-based medicine on weak evidence. The Emperor’s syndrome, referring to Hans Christian Andersen’s fairy tale, has been described in medicine as voluntary blindness to an obvious truth, being a weak evidence-based therapeutic intervention or weak health care. A promising positive example of improving heart and kidney outcomes is the emerging treatment with sodium-glucose cotransporter 2 inhibitors. COVID-19 could boost actions for patient-centered care as a positive shift in nephrology care.

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Association between dietary intake and nutritional status in Eastern Mediterranean patients receiving hemodialysis

Markaki

Psylinakis

Theodoridis

et al. 2020

MNM

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BACKGROUND: Studies on hemodialysis (HD) patients reveal suboptimal dietary intakes, which have been linked to protein-energy wasting and its detrimental consequences. OBJECTIVE: Given the paucity of data regarding nutrient intakes of Eastern Mediterranean HD patients, we conducted a pilot study on HD patients at Heraklion, Crete, Greece to assess adequacy of dietary intakes and to determine their relationship with nutritional status. METHODS: Nutritional status of 36 patients aged 61.8 ± 15.0 years was evaluated by three 24-hour dietary recalls, anthropometry and blood biochemical markers. RESULTS:The mean dietary energy and protein intakes were 34.4 ± 2.1 kcal/kg and 1.25 ± 0.067 g/kg, respectively. The anthropometric results were indicative of a well-maintained somatic status. 30.6% of the patients had adequate weight (BMI 18.5-24.9 kg/m 2 ) and 69.4% were overweight or obese (BMI ≥ 25 kg/m 2 ). Patients had arm anthropometrics higher than the 25th percentile. Mean predialysis serum levels of urea and creatinine, were within the expected range, phosphorus was borderline high, while albumin and cholesterol were at the optimum level for HD patients. In univariate linear regression, a positive relation was observed between ideal weight-adjusted energy (wEI) and protein (wPI) intakes with anthropometric and biochemical indices. However, in the multivariate model, only the associations between dietary intakes of energy and protein with anthropometric indices remained significant. CONCLUSIONS: 24-hour derived-dietary intakes reached recommended targets and adequately reflected the nutritional status of the patients, according to anthropometric and biochemical indices. Additionally, the 24-hour recall method should be part of the routine care for HD patients, in order to identify patients at nutritional risk before objective parameters of wasting are documented.

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Sp386mediterranean Diet and Mortality Ιν Chronic Kidney Disease (Ckd) Stage 5d (Dialysis) Patients

Cited by 4 publications

References 0 publications

Effects of Mediterranean Diet, DASH Diet, and Plant-Based Diet on Outcomes among End Stage Kidney Disease Patients: A Systematic Review and Meta-Analysis

Effects of Mediterranean Diet, DASH Diet, and Plant-Based Diet on Outcomes among End Stage Kidney Disease Patients: A Systematic Review and Meta-Analysis

Emperor’s syndrome in the COVID-19 era: Time for patient-centered nephrology?

Association between dietary intake and nutritional status in Eastern Mediterranean patients receiving hemodialysis

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