April, 2018
Julie Hannah, Louise M. Wells and Colin H. Jones
Abstract
Hypertension control is fundamental in the treatment of Chronic Kidney Disease (CKD). The Dietary Approaches to Stop Hypertension (DASH) diet is recommended as part of the management of hypertension in the general population, but there are concerns about its safety for people with CKD.
We conducted a feasibility study to investigate the safety and acceptability of the DASH diet in free living, non-diabetic, hypertensive patients with stage 3 CKD.
Thirty-two participants completed the intervention (22 male, mean age was 69.9 years, range 43-87). Mean eGFR was 48.2 ± 8 ml/min/1.73m2 (range 31-59).
Subjects self-selected the DASH diet for 5 weeks.
Serum urea, creatinine, potassium, sodium, bicarbonate, calcium and phosphate, estimated GFR, urinary sodium, potassium and urea, body weight, height and sitting blood pressure were measured.
Total body water and extracellular fluid were estimated by multifrequency bioimpedance. Serum sodium decreased significantly (139.7 ± 2.6 to 138.9 ± 2.6 mEq/L, p=0.03). Urine sodium was significantly reduced (p<0.02). Total fat consumption decreased (p<0.001) contributing to a reduction in overall energy intake (p<0.001).
Protein and carbohydrate intake did not change. Sodium intake decreased (2784.9 mg to 1583.4 mg per day, p<0.001). Mean weight (81.4 ± 16.1 kg to 79 ± 5.4 kg, p<0.001) and extracellular fluid volume decreased (ECF) (18.3 ± 3.2 L to 17.9 ± 3.2 L, p=0.002), as did systolic and diastolic blood pressure (by 9.5 mmHg (p<0.009) and 5.3 mmHg (p<0.006) respectively).
