FP662
THE ASSOCIATION OF MEDITERRANEAN AND DASH DIETS WITH MORTALITY IN ADULTS ON HEMODIALYSIS: THE DIET-HD MULTINATIONAL COHORT STUDY Free

INTRODUCTION AND AIMS: Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets are associated with lower cardiovascular and all-cause mortality for the general population, but their benefits for patients on hemodialysis are uncertain. We evaluated the association between these dietary patterns and mortality in adults on hemodialysis.

METHODS: Dietary scores reflecting Mediterranean and DASH dietary patterns were derived from the GA²LEN food frequency questionnaire within the DIET-HD study, a multinational cohort study of 9757 adults on hemodialysis. Adjusted Cox regression analyses clustered by country were conducted to evaluate the association of dietary scores with all-cause and cardiovascular mortality. Estimates were expressed as an adjusted hazard ratio (HR) with 95% confidence interval (CI), using the lowest tertile of dietary score as the reference category.

RESULTS: During a median follow up of 2.7 years (18,666 person-years), there were 2087 deaths (829 cardiovascular deaths). The adjusted HR (CI) for the middle and highest Mediterranean diet score tertiles were 1.20 (1.01-1.41) and 1.13 (0.90-1.43) for cardiovascular mortality, and 1.10 (0.99-1.22) and 1.01 (0.87-1.16) for all-cause mortality. Similar findings were observed for the DASH diet score and cardiovascular mortality. There was evidence of an interaction between the DASH diet score and age (p=0.03) for all-cause mortality, with a lower risk of death observed among younger patients (≤60 years) reporting higher DASH diet scores. The adjusted HR for all-cause mortality for the middle and highest DASH diet score tertiles were 1.03 (0.81-1.29) and 0.70 (0.53-0.94) for younger patients (≤60 years) and 1.04 (0.92-1.18) and 1.07 (0.94-1.22) for older participants (>60 years).

CONCLUSIONS: Overall, there was no association between Mediterranean and DASH diets with cardiovascular mortality or all-cause mortality. A DASH diet may be associated with lower all-cause mortality among younger hemodialysis patients.