Nutrition and dietary intake and their association with mortality and hospitalisation in adults with chronic kidney disease treated with haemodialysis: protocol for DIET-HD, a prospective multinational cohort study

Suetonia C Palmer, Marinella Ruospo, Katrina L Campbell, Vanessa Garcia Larsen, Valeria Saglimbene, Patrizia Natale, Letizia Gargano, Jonathan C Craig, David W Johnson, Marcello Tonelli, John Knight, Anna Bednarek-Skublewska, Eduardo Celia, Domingo Del Castillo, Jan Dulawa, Tevfik Ecder, Elisabeth Fabricius, João Miguel Frazão, Ruben Gelfman, Susanne Hildegard HoischenStaffan Schön, Paul Stroumza, Delia Timofte, Marietta Török, Jörgen Hegbrant, Charlotta Wollheim, Luc Frantzen, G F M Strippoli

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Abstract

INTRODUCTION: Adults with end-stage kidney disease (ESKD) treated with haemodialysis experience mortality of between 15% and 20% each year. Effective interventions that improve health outcomes for long-term dialysis patients remain unproven. Novel and testable determinants of health in dialysis are needed. Nutrition and dietary patterns are potential factors influencing health in other health settings that warrant exploration in multinational studies in men and women treated with dialysis. We report the protocol of the "DIETary intake, death and hospitalisation in adults with end-stage kidney disease treated with HaemoDialysis (DIET-HD) study," a multinational prospective cohort study. DIET-HD will describe associations of nutrition and dietary patterns with major health outcomes for adults treated with dialysis in several countries.

METHODS AND ANALYSIS: DIET-HD will recruit approximately 10,000 adults who have ESKD treated by clinics administered by a single dialysis provider in Argentina, France, Germany, Hungary, Italy, Poland, Portugal, Romania, Spain, Sweden and Turkey. Recruitment will take place between March 2014 and June 2015. The study has currently recruited 8000 participants who have completed baseline data. Nutritional intake and dietary patterns will be measured using the Global Allergy and Asthma European Network (GA(2)LEN) food frequency questionnaire. The primary dietary exposures will be n-3 and n-6 polyunsaturated fatty acid consumption. The primary outcome will be cardiovascular mortality and secondary outcomes will be all-cause mortality, infection-related mortality and hospitalisation.

ETHICS AND DISSEMINATION: The study is approved by the relevant Ethics Committees in participating countries. All participants will provide written informed consent and be free to withdraw their data at any time. The findings of the study will be disseminated through peer-reviewed journals, conference presentations and to participants via regular newsletters. We expect that the DIET-HD study will inform large pragmatic trials of nutrition or dietary interventions in the setting of advanced kidney disease.

Original languageEnglish
Article numbere006897
JournalBMJ Open
Volume5
Issue number3
DOIs
Publication statusPublished - 20 Mar 2015
Externally publishedYes

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    Palmer, S. C., Ruospo, M., Campbell, K. L., Garcia Larsen, V., Saglimbene, V., Natale, P., Gargano, L., Craig, J. C., Johnson, D. W., Tonelli, M., Knight, J., Bednarek-Skublewska, A., Celia, E., Del Castillo, D., Dulawa, J., Ecder, T., Fabricius, E., Frazão, J. M., Gelfman, R., ... Strippoli, G. F. M. (2015). Nutrition and dietary intake and their association with mortality and hospitalisation in adults with chronic kidney disease treated with haemodialysis: protocol for DIET-HD, a prospective multinational cohort study. BMJ Open, 5(3), [e006897]. https://doi.org/10.1136/bmjopen-2014-006897