Dietary patterns and clinical outcomes in hemodialysis patients in Japan: A cohort study

Kazuhiko Tsuruya, Shingo Fukuma, Takafumi Wakita, Toshiharu Ninomiya, Masaharu Nagata, Hisako Yoshida, Satoru Fujimi, Yutaka Kiyohara, Takanari Kitazono, Kazuhiro Uchida, Tomoko Shirota, Tadao Akizawa, Takashi Akiba, Akira Saito, Shunichi Fukuhara

Research output: Contribution to journalArticle

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Abstract

Background & Objectives: Little is known about actual dietary patterns and their associations with clinical outcomes in hemodialysis patients. We identified dietary patterns in hemodialysis patients in Japan and examined associations between dietary patterns and clinical outcomes. Design, setting, participants, measurements: We used data from 3,080 general-population participants in the Hisayama study (year 2007), and data from 1,355 hemodialysis patients in the Japan Dialysis Outcomes and Practice Patterns Study (JDOPPS: years 2005-2007). Food intake was measured using a brief self-administered diet-history questionnaire (BDHQ). To identify food groups with the Hisayama population data, we used principal components analysis with Promax rotation. We adjusted the resulting food groups for total daily energy intake, and then we used those adjusted food-group scores to identify dietary patterns in the JDOPPS patients by cluster analysis (Ward's method). We then used Cox regression to examine the association between dietary patterns and a composite of adverse clinical outcomes: hospitalization due to cardiovascular disease or death due to any cause. Results: We identified three food groups: meat, fish, and vegetables. Using those groups we then identified three dietary patterns: well-balanced, unbalanced, and other. After adjusting for potential confounders, we found an association between an unbalanced diet and important clinical events (hazard ratio 1.90, 95% C.I. 1.19-3.04). Conclusions: Hemodialysis patients whose diet was unbalanced were more likely to have adverse clinical outcomes. Thus hemodialysis patients might benefit not only from portion control, but also from a diet that is well-balanced diet with regard to the food groups identified here as meat, fish, and vegetables.

Original languageEnglish
Article numbere0116677
JournalPloS one
Volume10
Issue number1
DOIs
Publication statusPublished - Jan 21 2015

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hemodialysis
cohort studies
eating habits
food groups
Renal Dialysis
Nutrition
Japan
Cohort Studies
Diet
Food
Meats
Vegetables
diet
Meat
Fish
Fishes
vegetables
meat
portion size
diet history

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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Tsuruya, K., Fukuma, S., Wakita, T., Ninomiya, T., Nagata, M., Yoshida, H., ... Fukuhara, S. (2015). Dietary patterns and clinical outcomes in hemodialysis patients in Japan: A cohort study. PloS one, 10(1), [e0116677]. https://doi.org/10.1371/journal.pone.0116677

Dietary patterns and clinical outcomes in hemodialysis patients in Japan : A cohort study. / Tsuruya, Kazuhiko; Fukuma, Shingo; Wakita, Takafumi; Ninomiya, Toshiharu; Nagata, Masaharu; Yoshida, Hisako; Fujimi, Satoru; Kiyohara, Yutaka; Kitazono, Takanari; Uchida, Kazuhiro; Shirota, Tomoko; Akizawa, Tadao; Akiba, Takashi; Saito, Akira; Fukuhara, Shunichi.

In: PloS one, Vol. 10, No. 1, e0116677, 21.01.2015.

Research output: Contribution to journalArticle

Tsuruya, K, Fukuma, S, Wakita, T, Ninomiya, T, Nagata, M, Yoshida, H, Fujimi, S, Kiyohara, Y, Kitazono, T, Uchida, K, Shirota, T, Akizawa, T, Akiba, T, Saito, A & Fukuhara, S 2015, 'Dietary patterns and clinical outcomes in hemodialysis patients in Japan: A cohort study', PloS one, vol. 10, no. 1, e0116677. https://doi.org/10.1371/journal.pone.0116677
Tsuruya, Kazuhiko ; Fukuma, Shingo ; Wakita, Takafumi ; Ninomiya, Toshiharu ; Nagata, Masaharu ; Yoshida, Hisako ; Fujimi, Satoru ; Kiyohara, Yutaka ; Kitazono, Takanari ; Uchida, Kazuhiro ; Shirota, Tomoko ; Akizawa, Tadao ; Akiba, Takashi ; Saito, Akira ; Fukuhara, Shunichi. / Dietary patterns and clinical outcomes in hemodialysis patients in Japan : A cohort study. In: PloS one. 2015 ; Vol. 10, No. 1.
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AU - Shirota, Tomoko

AU - Akizawa, Tadao

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AU - Saito, Akira

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N2 - Background & Objectives: Little is known about actual dietary patterns and their associations with clinical outcomes in hemodialysis patients. We identified dietary patterns in hemodialysis patients in Japan and examined associations between dietary patterns and clinical outcomes. Design, setting, participants, measurements: We used data from 3,080 general-population participants in the Hisayama study (year 2007), and data from 1,355 hemodialysis patients in the Japan Dialysis Outcomes and Practice Patterns Study (JDOPPS: years 2005-2007). Food intake was measured using a brief self-administered diet-history questionnaire (BDHQ). To identify food groups with the Hisayama population data, we used principal components analysis with Promax rotation. We adjusted the resulting food groups for total daily energy intake, and then we used those adjusted food-group scores to identify dietary patterns in the JDOPPS patients by cluster analysis (Ward's method). We then used Cox regression to examine the association between dietary patterns and a composite of adverse clinical outcomes: hospitalization due to cardiovascular disease or death due to any cause. Results: We identified three food groups: meat, fish, and vegetables. Using those groups we then identified three dietary patterns: well-balanced, unbalanced, and other. After adjusting for potential confounders, we found an association between an unbalanced diet and important clinical events (hazard ratio 1.90, 95% C.I. 1.19-3.04). Conclusions: Hemodialysis patients whose diet was unbalanced were more likely to have adverse clinical outcomes. Thus hemodialysis patients might benefit not only from portion control, but also from a diet that is well-balanced diet with regard to the food groups identified here as meat, fish, and vegetables.

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