Adherence to low-sodium Dietary Approaches to Stop Hypertension-style diet may decrease the risk of incident chronic kidney disease among high-risk patients: a secondary prevention in prospective cohort study

Nephrol Dial Transplant. 2018 Jul 1;33(7):1159-1168. doi: 10.1093/ndt/gfx352.


Background: Considering the fact that subjects with dysglycemia, dyslipidemia or high blood pressure are at high risk for chronic kidney disease (CKD), long-term adherence to the Dietary Approaches to Stop Hypertension (DASH)-style diet may contribute to the prevention of CKD. This study, examined the association between adherence to the low-sodium DASH-style diet and incident CKD among high-risk adults over 3 years of follow-up.

Methods: In this prospective cohort study (followed up for 3 years, 2012-15), we selected 1100 subjects with dysglycemia, 2715 with dyslipidemia and 2089 with high blood pressure, all of whom were free of CKD at baseline (2009-11) in a subgroup of the Tehran Lipid and Glucose Study. The low-sodium DASH-style diet was designed based on eight foods and nutrients using a food frequency questionnaire. Estimated glomerular filtration rate (eGFR) was calculated and CKD was defined as eGFR <60 mL/min/1.73 m2.

Results: After 3 years of follow-up, among subjects with dysglycemia, dyslipidemia or high blood pressure, the rate of incident CKD was ∼16%. In multivariable-adjusted analyses for participants in the highest compared with the lowest quartile of the low-sodium DASH-style diet score, the odds ratio was 0.58 [95% confidence interval (CI) 0.36-0.92] for subjects with dysglycemia, 0.64 (95% CI 0.48-0.87) for subjects with dyslipidemia and 0.62 (95% CI 0.44-0.87) for subjects with high blood pressure.

Conclusions: Higher adherence to the low-sodium DASH-style diet might be associated with a lower risk of incident CKD among high-risk adults, highlighting the importance of adherence to the low-sodium DASH-style diet in substantially reducing both the occurrence of CKD and the burden imposed by it in the future.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Diet, Sodium-Restricted / methods*
  • Dietary Approaches To Stop Hypertension / methods*
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • Hypertension / epidemiology
  • Hypertension / etiology
  • Hypertension / prevention & control*
  • Incidence
  • Iran / epidemiology
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Compliance*
  • Prospective Studies
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / drug therapy
  • Risk Assessment / methods*
  • Risk Factors
  • Secondary Prevention / methods*