Short-term effects of the DASH diet in adults with moderate chronic kidney disease: a pilot feeding study.
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2016-08
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Although the Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP) for adults with normal kidney function, evidence is lacking regarding its safety and efficacy in chronic kidney disease (CKD). We aimed to test the effects of the DASH diet on serum electrolytes and BP in adults with moderate CKD.In a prospective before-after feeding study, 11 adults with an estimated glomerular filtration rate of 30-59 mL/min/1.73 m(2) and medication-treated hypertension were provided a reduced-sodium, run-in diet for 1 week followed by a reduced-sodium, DASH diet for 2 weeks. Changes in serum electrolytes and BP were compared pre-post DASH.Eleven participants underwent feeding; 1 completed 1 week and 10 completed 2 weeks of DASH. Compared with baseline, DASH modestly increased serum potassium at 1 week (mean ± standard deviation, +0.28 ± 0.4 mg/dL; P = 0.043) but had no significant effect on potassium at 2 weeks (+0.15 ± 0.28 mg/dL; P = 0.13). Serum bicarbonate was reduced (-2.5 ± 3.0 mg/dL; P = 0.03) at 2 weeks. Neither incident hyperkalemia nor new onset metabolic acidosis was observed. Clinic BP and mean 24-h ambulatory BP was unchanged. DASH significantly reduced mean nighttime BP (-5.3 ± 5.8 mmHg; P = 0.018), and enhanced percent declines in both nocturnal systolic BP (-2.1% to -5.1%; P = 0.004) and diastolic BP (-3.7% to -10.0%; P = 0.008).These pilot data suggest that a reduced-sodium DASH dietary pattern does not cause acute metabolic events in adults with moderate CKD and may improve nocturnal BP. Definitive studies are needed to determine long-term effects of DASH in CKD.
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Tyson, Crystal C, Pao-Hwa Lin, Leonor Corsino, Bryan C Batch, Jenifer Allen, Shelly Sapp, Huiman Barnhart, Chinazo Nwankwo, et al. (2016). Short-term effects of the DASH diet in adults with moderate chronic kidney disease: a pilot feeding study. Clinical kidney journal, 9(4). pp. 592–598. 10.1093/ckj/sfw046 Retrieved from https://hdl.handle.net/10161/17678.
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Crystal Cenell Tyson
As a board-certified nephrologist and a certified clinical hypertension specialist (ASH-SCH), I take care of patients with kidney disorders and/or high blood pressure. Patients with chronic kidney disease and high blood pressure have an increased risk for developing complications of cardiovascular disease, such as heart attacks, congestive heart failure, strokes, kidney failure requiring dialysis or a kidney transplant, and a shortened lifespan. My clinical focus is to slow the progression of chronic kidney disease and reduce complications from cardiovascular disease with lifestyle modification. I particularly enjoy treating patients with severe or difficult to control high blood pressure by focusing on finding an effective medication regimen that provides the least side effects, eliminating ineffective medications, simplifying medication schedules, and promoting healthy lifestyle behavior. I see patients 2 days per week in the Duke Nephrology Clinic and the Duke Nephrology Hypertension Clinic.
My research interests are to reduce racial and health disparities among patients with hypertension and chronic kidney disease using lifestyle modifications. My past and current research investigates the effects of diet (i.e., the DASH diet, sodium reduction), exercise, and weight loss on blood pressure and kidney function, as well as the effect of bilateral renal artery denervation on blood pressure.
Pao-Hwa Lin
My research interest lies generally in the area of dietary patterns and chronic diseases including hypertension using controlled feeding study and lifestyle intervention designs.
Two major controlled feeding clinical trials that I was involved in include the Dietary Approaches to Stop Hypertension (DASH) Study and the Dietary Approaches to Stop Hypertension-Sodium (DASH-Sodium) Study. In addition to being an active member for the diet committee for DASH, I also function as the chair of the diet committee for the DASH-Sodium study. I am familiar with the development and operation of a controlled feeding study, which means the process of study design, development of questionnaire/forms for data collection/monitoring, development of quality assurance procedure, and data analysis.
I've also helped with the design and implementation of the lifestyle behavioral intervention program for the Hypertension Improvement Project (HIP), PREMIER clinical trial, Weight Loss Maintenance trial (WLM), ENCORE study, and the Cell Phone Intervention for You (CITY) trial.
Key words: Diet, controlled feeding study, mineral, blood pressure, nutrition.
Leonor Corsino
Dr. Leonor Corsino is a Board- Certified Adult Endocrinologist, an experienced physician-scientist, and an organizational and health professional education leader. She offers an extensive and diverse leadership background with successfully implementing innovative clinical, research, and workforce development and education programs. Her expertise and strengths lie in her diverse portfolio that expands from basic science to clinical and community-engaged research, innovative curriculum development, successful clinical program implementation, and collaborations.
Dr. Corsino's research focuses on diabetes, obesity, and related complications and health disparities, with a particular interest in Hispanic/Latino populations. She has successfully led and extensively collaborated with investigators locally, nationally, and internationally. Her research and contribution have been recognized locally and nationally with many awards, including the NIH/NIDDK Network of Minority Health Research Investigators medallion.
Dr. Corsino has extensive leadership experience, including her current roles as a member of the Executive Committee Member and Associate Director of the Duke School of Medicine Masters of Biomedical Sciences (MBS), Co-Director for the Duke Clinical and Translational Science Institute - Community Engagement Core / Community-Engaged Research Initiative (CERI) and Associate Dean for Students Affairs/Advisory Dean Duke School of Medicine MD program.
She is the former Co-Director, Education and Training Sub-core of the Duke Center for REsearch to AdvanCe Healthcare Equity, Director of the Duke Population Health Improvement Initiative Program, Associate Chair for the Department of Medicine Minority Recruitment and Retention Committee, and Associate Director for the Duke School of Medicine Office of Faculty Mentoring Training.
Dr. Corsino's leadership led to the successful development and implementation of unique and innovative programs, including the Duke MBS program selective curriculum, the REACH Equity Summer Undergraduate Research Program, the CTSI/CERI Population Health Improvement Award, E-library, consultation services, and the interactive platform for the Duke Population Health Improvement Program.
Her visionary and innovative initiatives have enhanced patient care, population health, and the recruitment, training, development, and support of health professions students, residents, fellows, and junior faculty, having a significant, palpable, impact on the diversity of health profession workforce and health disparities research.
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