Higher consumption of fruits and vegetables may be associated with a lower risk of premature death in patients undergoing hemodialysis, a study claims. The findings, published in the Clinical Journal of the American Society of Nephrology (CJASN), suggest that more studies are needed to fine-tune dietary recommendations for patients with kidney failure.
Higher fruit and vegetable intake is linked with lower cardiovascular and all-cause mortality in the general population, but kidney failure patients on hemodialysis are often discouraged from this type of diet due to its potential to cause a buildup of potassium.
Researchers, including those from the University of Bari, Italy and University of Sydney in Australia evaluated the association of fruit and vegetable intake with all-cause, cardiovascular, and non-cardiovascular mortality among adults treated with hemodialysis.
"Although diet is a key component of self-management and provides an important opportunity for a collaborative approach between patients and healthcare professionals to improve care, there is limited evidence on the impact of diet on patient-relevant outcomes," said Valeria Saglimbene from the University of Sydney.
In the study of 8,078 hemodialysis patients who completed food frequency questionnaires, only four per cent of patients consumed at least four servings of fruits and vegetables per day as recommended in the general population.
The team noted that there were 2,082 deaths (954 from cardiovascular causes) over a median follow-up of 2.7 years. Compared with patients who had 0-5.5 servings of combined fruits and vegetables per week, those who had 5.6-10 servings and those who had over 10 servings had 10 per cent and 20 per cent lower risks of dying from any cause, respectively.
They also had a 12 per cent and 23 per cent lower risks of dying from non-cardiovascular causes respectively, researchers said. "These findings suggest that well-meaning guidance to limit fruit and vegetable intake to prevent higher dietary potassium load may deprive hemodialysis patients of the potential benefits of these foods," said Germaine Wong from the University of Sydney.
"However, intervention trials of fruit and vegetable intake are needed to support dietary recommendations for hemodialysis patients," said Wong.