Mediterranean Diet: A Dietary Pattern Related to Nutritional Benefits for Hemodialysis Patients

Abstract

In adults with CKD, not on dialysis, there is a recent recommendation suggesting the prescription of a Mediterranean Diet pattern but there is still no evidence to suggest a specific dietary pattern for hemodialysis (HD) patients. The aim of this study was to identify dietary patterns in HD patients and analyze their relationship with nutritional status, physical activity, and survival. This was a longitudinal prospective multicenter study with 12 months of follow-up that included 582 HD patients from 37 dialysis centers. Clinical parameters, dietary intake and physical activity were assessed. Dietary patterns were derived from principal component analysis. A p-value lower than 0.05 was considered statistically significant. Three different dietary patterns were identified: "Mediterranean", "Western" and "Low animal protein". Patients in the Mediterranean pattern group showed higher intakes of protein (p=0.040), omega 3 fatty acids (p< 0.001), vitamins B12 (p< 0.001), B6 (p< 0.001), C (p< 0.001), D (p< 0.001), folic acid (p< 0.001) and presented a higher practice of moderate physical activity (p=0.010). Despite the lower number of deaths that occurred in the Mediterranean dietary pattern group, we did not observe a statistically significant lower mortality risk (p=0.096). The Mediterranean style pattern was associated with a better nutritional intake profile and in lifestyle related factors such as a higher practice of moderate physical activity in HD patients.