Healthy diets may improve cardiovascular health in the general population, but they do not appear to have this benefit among patients with end-stage kidney disease (ESKD), according to the findings of a systematic review presented at the National Kidney Foundation’s 2023 Spring Clinical Meetings in Austin, Texas.

The review included 7 studies with 9400 patients receiving dialysis (8395 on hemodialysis and 1005 on peritoneal dialysis) that examined survival outcomes in the ESKD population associated with adhering to the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), and plant-based diets. In pooled analyses, Mariam Charkviani, MD, of Mayo Clinic in Rochester, Minnesota, and colleagues found no significant difference in cardiovascular mortality risk between patients who adhered to a Mediterranean or a DASH diet and those who did not. Patients who adhered to a plant-based diet had a nonsignificant 14% decreased risk for cardiovascular mortality compared with those who did not, the investigators reported in a poster presentation.

The Mediterranean diet, however, was significantly associated with an 18% decreased risk for left ventricular hypertrophy in a study that included 127 patients with ESKD. Dr Charkviani’s team also found no significant association between a plant-based diet and hyperkalemia risk.

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The investigators found no significant association between any of the diets and overall mortality risk.

“While our systemic review demonstrated no significant associations of Mediterranean, DASH, and plant-based diet with reduced mortality and cardiovascular mortality, there [was] also no evidence [that] suggested harmful effects of these diets among ESKD patients,” the authors concluded.

The Mediterranean diet emphasizes consumption of fruits and vegetables, whole grains, legumes, nuts, fish, and olive oil and lesser amounts of red meat and dairy products. The DASH diet limits foods high in sodium, saturated fat, and added sugars and emphasizes intake of fruits, vegetables, and whole grains, as well as foods rich in magnesium, potassium, and calcium.


Charkviani M, Thongprayoon C, Tangpanithandee S, et al. Effects of Mediterranean diet, DASH diet, and plant-based diet on outcomes among end stage kidney disease patients. Presented at: NKF 2023 Spring Clinical Meetings, April 11-15, Austin, Texas. Poster 391.