Am J Kidney Dis:防止高血压的膳食能预防肾脏疾病吗?

2016-11-26 haofan MedSci原创

DASH饮食习惯与降低的肾脏疾病低风险有关,并且独立于人口学特征、已经明确的肾脏的危险因素和肾脏基础功能。健康的饮食模式,如DASH饮食可能有利于肾脏疾病的预防。

已有指南推荐通过饮食摄入来进行高血压治疗和心血管疾病预防,但是缺乏证据表明有效的饮食模式可以预防肾脏疾病。最近,肾脏病领域权威杂志Am J Kidney Dis上发表了一篇来自巴尔的摩预防流行病学和临床研究中心的Casey M.Rebholz博士以及研究团队针对这一问题进行的一项前瞻性队列研究文章。

该研究的参与者来自于社区动脉粥样硬化风险(ARIC)研究,并且在研究之初这些研究对象(N=14,882)的估计肾小球滤过率(eGFR)≥60mL/min/1.73 m2 。研究人员根据参与者自我报告的各类饮食如红色和加工肉类、含糖饮料、钠、水果、蔬菜、全谷物、坚果和豆类以及低脂肪乳制品的摄入量来计算得出通过饮食方法防止高血压(DASH)的饮食评分,并对2次随访的饮食评分取平均值。

肾脏病患者根据eGFRs<60 mL/min/1.73 m2并伴有eGFR从基础水平下降≥25%来进行确定,按照国际疾病分类第九或第十修订版中的代码来确定从研究之初到2012年期间发生的肾脏病相关的住院或死亡,或终末期肾脏疾病。

在中位随访时间为23年的随访期间共有3720名受试者出现肾脏疾病。对社会人口统计、吸烟、体力活动、总热量的摄入、eGFR基础水平、超重/肥胖状态、糖尿病、高血压状态、收缩压和降压治疗等因素进行调整后,研究人员发现相比于DASH饮食评分位于最高三分位数范围的参与者,DASH饮食评分位于最低三分位数范围的参与者有16%的研究对象很可能患肾脏疾病(风险比为1.16;95%可信区间为1.07-1.26;P趋势<0.001)。饮食评分的个别组成元素,如红色和加工肉类的大量摄入与肾脏疾病成负相关;而坚果、豆类和低脂肪乳制品的大量摄入量与降低的肾脏疾病风险有关。

由此可见,DASH饮食习惯与降低的肾脏疾病低风险有关,并且独立于人口学特征、已经明确的肾脏的危险因素和肾脏基础功能。健康的饮食模式,如DASH饮食可能有利于肾脏疾病的预防。

原始出处:

Casey M.Rebholz,et al. DASH (Dietary Approaches to Stop Hypertension) Diet and Risk of Subsequent Kidney Disease. Am J Kidney Dis.2016 Dec;68(6):853-861.


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    2016-11-28 zhaojie88
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    2016-11-28 gwc389