American Journal of Kidney Diseases
Volume 53, Issue 4 , Pages 638-646 , April 2009

The Effects of Dietary Patterns on Urinary Albumin Excretion: Results of the Dietary Approaches to Stop Hypertension (DASH) Trial

  • David R. Jacobs Jr, PhD

      Affiliations

    • Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
    • Department of Nutrition, University of Oslo, Oslo, Norway
    • Corresponding Author InformationAddress correspondence to David R. Jacobs Jr, PhD, University of Minnesota, Division of Epidemiology and Community Health, School of Public Health, 1300 South 2nd St, Ste 300, Minneapolis, MN 55454
  • ,
  • Myron D. Gross, PhD

      Affiliations

    • Department of Laboratory Medicine and Pathology, School of Public Health, University of Minnesota, Minneapolis, MN
  • ,
  • Lyn Steffen, PhD

      Affiliations

    • Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
  • ,
  • Michael W. Steffes, MD

      Affiliations

    • Department of Laboratory Medicine and Pathology, School of Public Health, University of Minnesota, Minneapolis, MN
  • ,
  • Xinhua Yu, MD

      Affiliations

    • Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, MN
  • ,
  • Laura P. Svetkey, MD

      Affiliations

    • Department of Medicine, Duke Hypertension Center, and Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, NC
  • ,
  • Lawrence J. Appel, MD

      Affiliations

    • Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD
  • ,
  • William M. Vollmer, PhD

      Affiliations

    • Kaiser Permanente Center for Health Research, Portland, OR
  • ,
  • George A. Bray, MD

      Affiliations

    • Pennington Biomedical Research Center, part of the Louisiana State University System, Baton Rouge, LA
  • ,
  • Thomas Moore, MD

      Affiliations

    • Office of Clinical Research, Boston University Medical Center, Brigham & Women's Hospital and Harvard Medical School, Boston, MA
  • ,
  • Paul R. Conlin, MD

      Affiliations

    • Department of Nutrition, Harvard School of Public Health, and Channing Laboratory, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA
  • ,
  • Frank Sacks, MD

      Affiliations

    • Department of Nutrition, Harvard School of Public Health, and Channing Laboratory, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA

Received 30 May 2008 ,Accepted 23 October 2008.

References 

  1. Appel LJ, Moore TJ, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure (DASH Collaborative Research Group). N Engl J Med. 1997;336:1117–1124
  2. Gerstein HC, Mann JF, Yi Q, et al. Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals. JAMA. 2001;286:421–426
  3. Hillege HL, Fidler V, Diercks GF, et al. Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general population. Circulation. 2002;106:1777–1782
  4. Arnlov J, Evans JC, Meigs JB, et al. Low-grade albuminuria and incidence of cardiovascular disease events in nonhypertensive and nondiabetic individuals: The Framingham Heart Study. Circulation. 2005;112:969–975
  5. de Zeeuw D, Remuzzi G, Parving HH, et al. Albuminuria, a therapeutic target for cardiovascular protection in type 2 diabetic patients with nephropathy. Circulation. 2004;110:921–927
  6. Jager A, Kostense PJ, Ruhe HG, et al. Microalbuminuria and peripheral arterial disease are independent predictors of cardiovascular and all-cause mortality, especially among hypertensive subjects: Five-year follow-up of the Hoorn Study. Arterioscler Thromb Vasc Biol. 1999;19:617–624
  7. Viberti G, Bognetti E, Wiseman MJ, Dodds R, Gross JL, Keen H. Effect of protein-restricted diet on renal response to a meat meal in humans. Am J Physiol. 1987;253:F388–F393
  8. Kontessis P, Jones S, Dodds R, et al. Renal, metabolic and hormonal responses to ingestion of animal and vegetable proteins. Kidney Int. 1990;38:136–144
  9. Pecis M, de Azevedo MJ, Gross JL. Chicken and fish diet reduces glomerular hyperfiltration in IDDM patients. Diabetes Care. 1994;17:665–672
  10. Hansen HP, Christensen PK, Tauber-Lassen E, Klausen A, Jensen BR, Parving HH. Low-protein diet and kidney function in insulin-dependent diabetic patients with diabetic nephropathy. Kidney Int. 1999;55:621–628
  11. Raal FJ, Kalk WJ, Lawson M, et al. Effect of moderate dietary protein restriction on the progression of overt diabetic nephropathy: A 6-mo prospective study. Am J Clin Nutr. 1994;60:579–585
  12. Jibani MM, Bloodworth LL, Foden E, Griffiths KD, Galpin OP. Predominantly vegetarian diet in patients with incipient and early clinical diabetic nephropathy: Effects on albumin excretion rate and nutritional status. Diabet Med. 1991;8:949–953
  13. Appel LJ, Vollmer WM, Obarzanek E, et al. Recruitment and baseline characteristics of participants in the Dietary Approaches to Stop Hypertension trial (DASH Collaborative Research Group). J Am Diet Assoc. 1999;99(8 suppl):S69–S75
  14. Vogt TM, Appel LJ, Obarzanek E, et al. Dietary Approaches to Stop Hypertension: Rationale, design, and methods (DASH Collaborative Research Group). J Am Diet Assoc. 1999;99(8 suppl):S12–S18
  15. Sacks FM, Appel LJ, Moore TJ, et al. A dietary approach to prevent hypertension: A review of the Dietary Approaches to Stop Hypertension (DASH) Study. Clin Cardiol. 1999;22:III6–III10
  16. Karanja NM, Obarzanek E, McCullough ML, et al. Descriptive characteristics of the dietary patterns used in the Dietary Approaches to Stop Hypertension trial. J Am Diet Assoc. 1999;99(8 suppl):S19–S27
  17. Jacobs DR, Murtaugh MA, Steffes M, Yu X, Roseman J, Goetz FC. Gender- and race-specific determination of albumin excretion rate using albumin-to-creatinine ratio in single, untimed urine specimens: The Coronary Artery Risk Development in Young Adults Study. Am J Epidemiol. 2002;155:1114–1119
  18. Warram JH, Gearin G, Laffel L, Krolewski AS. Effect of duration of type I diabetes on the prevalence of stages of diabetic nephropathy defined by urinary albumin/creatinine ratio. J Am Soc Nephrol. 1996;7:930–937
  19. Mandayam S, Mitch WE. Dietary protein restriction benefits patients with chronic kidney disease. Nephrology. 2006;11:53–57
  20. Murassi M, Campagnolo N, Beck MO, Gross JL, Silveiro SP. High-normal levels of albuminuria predict the development of micro- and macroalbuminuria and increased mortality in Brazilian type 2 diabetic patients: An 8-year follow-up study. Diabet Med. 2007;24:1136–1142
  21. Dullaart RP, Beusekamp BJ, Meijer S, van Doormaal JJ, Sluiter WJ. Long-term effects of protein-restricted diet on albuminuria and renal function in IDDM patients without clinical nephropathy and hypertension. Diabetes Care. 1993;16:483–492
  22. Skov AR, Toubro S, Bulow J, Krabbe K, Parving HH, Astrup A. Changes in renal function during weight loss induced by high vs low-protein low-fat diets in overweight subjects. Int J Obes Relat Metab Disord. 1999;23:1170–1177
  23. Chagnac A, Weinstein T, Herman M, Hirsh J, Gafter U, Ori Y. The effects of weight loss on renal function in patients with severe obesity. J Am Soc Nephrol. 2003;14:1480–1486
  24. Ohashi H, Oda H, Ohno M, Watanabe S. Weight reduction improves high blood pressure and microalbuminuria in hypertensive patients with obesity [Japanese]. Nippon Jinzo Gakkai Shi. 2001;43:333–339
  25. Chang FT, Shin SJ, Hu SH, Tsai JH. Reduced urinary protein after dietary protein restriction instruction in proteinuric diabetic patients. J Formos Med Assoc. 1993;92:1060–1065
  26. Wheeler ML, Fineberg SE, Fineberg NS, Gibson RG, Hackward LL. Animal versus plant protein meals in individuals with type 2 diabetes and microalbuminuria: Effects on renal, glycemic, and lipid parameters. Diabetes Care. 2002;25:1277–1282
  27. Pomerleau J, Verdy M, Garrel DR, Nadeau MH. Effect of protein intake on glycaemic control and renal function in type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia. 1993;36:829–834
  28. Gross JL, Zelmanovitz T, Moulin CC, et al. Effect of a chicken-based diet on renal function and lipid profile in patients with type 2 diabetes: A randomized crossover trial. Diabetes Care. 2002;25:645–651
  29. Teixeira SR, Tappenden KA, Carson L, et al. Isolated soy protein consumption reduces urinary albumin excretion and improves the serum lipid profile in men with type 2 diabetes mellitus and nephropathy. J Nutr. 2004;134:1874–1880
  30. Halvorsen BL, Carlsen MH, Phillips KM, et al. Content of redox-active compounds (ie, antioxidants) in foods consumed in the United States. Am J Clin Nutr. 2006;84:95–135
  31. Nettleton JA, Steffen LM, Mayer-Davis EJ, et al. Dietary patterns are associated with biochemical markers of inflammation and endothelial activation in the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Clin Nutr. 2006;83:1369–1379
  32. Nettleton JA, Steffen LM, Palmas W, Burke GL, Jacobs DR. Associations between microalbuminuria and animal foods, plant foods, and dietary patterns in the Multiethnic Study of Atherosclerosis. Am J Clin Nutr. 2008;87:1825–1836

 Originally published online as doi:10.1053/j.ajkd.2008.10.048 on January 17, 2009.

PII: S0272-6386(08)01748-4

doi: 10.1053/j.ajkd.2008.10.048

American Journal of Kidney Diseases
Volume 53, Issue 4 , Pages 638-646 , April 2009