{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T23:17:06Z","timestamp":1762298226937,"version":"build-2065373602"},"reference-count":32,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,2,26]]},"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Adults with end-stage kidney disease (ESKD) treated with haemodialysis experience mortality of between 15% and 20% each year. Effective interventions that improve health outcomes for long-term dialysis patients remain unproven. Novel and testable determinants of health in dialysis are needed. Nutrition and dietary patterns are potential factors influencing health in other health settings that warrant exploration in multinational studies in men and women treated with dialysis. We report the protocol of the \u201cDIETary intake, death and hospitalisation in adults with end-stage kidney disease treated with HaemoDialysis (DIET-HD) study,\u201d a multinational prospective cohort study. DIET-HD will describe associations of nutrition and dietary patterns with major health outcomes for adults treated with dialysis in several countries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>DIET-HD will recruit approximately 10\u2005000 adults who have ESKD treated by clinics administered by a single dialysis provider in Argentina, France, Germany, Hungary, Italy, Poland, Portugal, Romania, Spain, Sweden and Turkey. Recruitment will take place between March 2014 and June 2015. The study has currently recruited 8000 participants who have completed baseline data. Nutritional intake and dietary patterns will be measured using the Global Allergy and Asthma European Network (GA<jats:sup>2<\/jats:sup>LEN) food frequency questionnaire. The primary dietary exposures will be n-3 and n-6 polyunsaturated fatty acid consumption. The primary outcome will be cardiovascular mortality and secondary outcomes will be all-cause mortality, infection-related mortality and hospitalisation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>The study is approved by the relevant Ethics Committees in participating countries. All participants will provide written informed consent and be free to withdraw their data at any time. The findings of the study will be disseminated through peer-reviewed journals, conference presentations and to participants via regular newsletters. We expect that the DIET-HD study will inform large pragmatic trials of nutrition or dietary interventions in the setting of advanced kidney disease.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2014-006897","type":"journal-article","created":{"date-parts":[[2015,3,20]],"date-time":"2015-03-20T23:33:51Z","timestamp":1426894431000},"page":"e006897","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Nutrition and dietary intake and their association with mortality and hospitalisation in adults with chronic kidney disease treated with haemodialysis: protocol for DIET-HD, a prospective multinational cohort study"],"prefix":"10.1136","volume":"5","author":[{"given":"Suetonia C","family":"Palmer","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand"}]},{"given":"Marinella","family":"Ruospo","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"},{"name":"Division of Nephrology and Transplantation, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy"}]},{"given":"Katrina L","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia"}]},{"given":"Vanessa","family":"Garcia Larsen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, National Health and Lung Institute, Imperial College of Science, Technology, and Medicine, Royal Brompton campus, London, UK"}]},{"given":"Valeria","family":"Saglimbene","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"}]},{"given":"Patrizia","family":"Natale","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"}]},{"given":"Letizia","family":"Gargano","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"}]},{"given":"Jonathan C","family":"Craig","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, Edward Ford Building, University of Sydney, Sydney, New South Wales, Australia"}]},{"given":"David W","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia"}]},{"given":"Marcello","family":"Tonelli","sequence":"additional","affiliation":[{"name":"Cumming School of Medicine, University of Calgary, 2500 University Drive Northwest, Calgary, Alberta, Canada"}]},{"given":"John","family":"Knight","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Sydney, New South Wales, Australia"}]},{"given":"Anna","family":"Bednarek-Skublewska","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"},{"name":"Department of Nephrology, Medical University of Lublin, Lublin, Poland"}]},{"given":"Eduardo","family":"Celia","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"}]},{"given":"Domingo","family":"del Castillo","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"}]},{"given":"Jan","family":"Dulawa","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"},{"name":"Department of Internal Medicine, Metabolic Diseases, Medical University of Silesia, Katowice, Poland"}]},{"given":"Tevfik","family":"Ecder","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"}]},{"given":"Elisabeth","family":"Fabricius","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"}]},{"given":"Jo\u00e3o Miguel","family":"Fraz\u00e3o","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"},{"name":"Nephrology and Infectiology Research and Development Group, INEB, and School of Medicine, Porto University, Porto, Portugal"}]},{"given":"Ruben","family":"Gelfman","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"}]},{"given":"Susanne Hildegard","family":"Hoischen","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"}]},{"given":"Staffan","family":"Sch\u00f6n","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"}]},{"given":"Paul","family":"Stroumza","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"}]},{"given":"Delia","family":"Timofte","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"}]},{"given":"Marietta","family":"T\u00f6r\u00f6k","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"}]},{"given":"J\u00f6rgen","family":"Hegbrant","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"}]},{"given":"Charlotta","family":"Wollheim","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"}]},{"given":"Luc","family":"Frantzen","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"}]},{"given":"G F M","family":"Strippoli","sequence":"additional","affiliation":[{"name":"Diaverum Medical Scientific Office, Lund, Sweden"},{"name":"Sydney School of Public Health, Edward Ford Building, University of Sydney, Sydney, New South Wales, Australia"},{"name":"Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy"},{"name":"Diaverum Academy, Bari, Italy"}]}],"member":"239","published-online":{"date-parts":[[2015,3,20]]},"reference":[{"key":"2025101814221871000_5.3.e006897.1","unstructured":"U.S. Renal Data System, USRDS 2009 Annual Data Report: Atlas of End-Stage Renal Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2009."},{"key":"2025101814221871000_5.3.e006897.2","doi-asserted-by":"crossref","unstructured":"Palmer S , Hanson C , Craig J , et al . Dietary and fluid restriction in CKD: a thematic synthesis of patient views from qualitative studies. Am J Kidney Dis 2014. doi:10.1053\/j.ajkd.2014.09.012 [Epub ahead of print 6 Nov 2014].","DOI":"10.1053\/j.ajkd.2014.09.012"},{"key":"2025101814221871000_5.3.e006897.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-139X.2010.00745.x"},{"key":"2025101814221871000_5.3.e006897.4","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5002585"},{"key":"2025101814221871000_5.3.e006897.5","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2006.07.015"},{"key":"2025101814221871000_5.3.e006897.6","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2000.00945.x"},{"key":"2025101814221871000_5.3.e006897.7","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2002.30543"},{"issue":"(1S Suppl)","key":"2025101814221871000_5.3.e006897.8","doi-asserted-by":"crossref","first-page":"247S","DOI":"10.1093\/jn\/129.1.247S","article-title":"Pathophysiology of protein-energy wasting in chronic renal failure","volume":"129","author":"Kopple","year":"1999","journal-title":"J Nutr"},{"key":"2025101814221871000_5.3.e006897.9","doi-asserted-by":"crossref","first-page":"s77","DOI":"10.1053\/ajkd.2001.20754","article-title":"Survival on hemodialysis and peritoneal dialysis over 12 years with emphasis on nutritional parameters","volume":"37","author":"Avram","year":"2001","journal-title":"Am J Kidney Dis"},{"key":"2025101814221871000_5.3.e006897.10","doi-asserted-by":"crossref","first-page":"s81","DOI":"10.1053\/ajkd.2001.20756","article-title":"Influence of nutritional factors and hemodialysis adequacy on the survival of 1,610 French patients","volume":"37","author":"Combe","year":"2001","journal-title":"Am J Kidney Dis"},{"key":"2025101814221871000_5.3.e006897.11","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2002.34509"},{"key":"2025101814221871000_5.3.e006897.12","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2002.00658.x"},{"key":"2025101814221871000_5.3.e006897.13","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.1681\/ASN.V10102177","article-title":"Eicosapentanoic acid reduces plasma levels of remnant lipoproteins and prevents in vivo peroxidation of LDL in dialysis patients","volume":"10","author":"Ando","year":"1999","journal-title":"J Am Soc Nephrol"},{"key":"2025101814221871000_5.3.e006897.14","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00740805"},{"key":"2025101814221871000_5.3.e006897.15","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1053\/j.ajkd.2013.02.362","article-title":"Serum n-3 and n-6 polyunsaturated fatty acid profile as an independent predictor of cardiovascular events in hemodialysis patients","volume":"62","author":"Shoji","year":"2013","journal-title":"Am J Kidney Dis"},{"key":"2025101814221871000_5.3.e006897.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61239-8"},{"key":"2025101814221871000_5.3.e006897.17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199411033311804"},{"key":"2025101814221871000_5.3.e006897.18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1200303"},{"key":"2025101814221871000_5.3.e006897.19","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-7-25"},{"key":"2025101814221871000_5.3.e006897.20","doi-asserted-by":"crossref","first-page":"680","DOI":"10.3109\/0886022X.2013.789960","article-title":"Reduced plasma zinc levels, lipid peroxidation, and inflammation biomarkers levels in hemodialysis patients: implications to cardiovascular mortality","volume":"35","author":"Lobo","year":"2013","journal-title":"Ren Fail"},{"key":"2025101814221871000_5.3.e006897.21","first-page":"CD008176","article-title":"Antioxidants for chronic kidney disease","volume":"10","author":"Jun","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"2025101814221871000_5.3.e006897.22","first-page":"21","article-title":"A dietary survey in Indian hemodialysis patients","volume":"9","author":"Sharma","year":"1999","journal-title":"J Res Nutr"},{"key":"2025101814221871000_5.3.e006897.23","doi-asserted-by":"crossref","first-page":"S97","DOI":"10.1016\/S0272-6386(98)70171-4","article-title":"Dietary protein and energy requirements in ESRD patients","volume":"32","author":"Kopple","year":"1998","journal-title":"Am J Kidney Dis"},{"key":"2025101814221871000_5.3.e006897.24","first-page":"846","article-title":"Malnutrition predicting factors in hemodialysis patients","volume":"21","author":"Jahromi","year":"2010","journal-title":"Saudi J Kidney Dis Transpl"},{"key":"2025101814221871000_5.3.e006897.25","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2005.10.003"},{"key":"2025101814221871000_5.3.e006897.26","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01770211"},{"key":"2025101814221871000_5.3.e006897.27","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfp110"},{"key":"2025101814221871000_5.3.e006897.28","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1038\/ejcn.2011.15","article-title":"Use of a common food frequency questionnaire (FFQ) to assess dietary patterns and their relation to allergy and asthma in Europe: pilot study of the GA2LEN FFQ","volume":"65","author":"Garcia-Larsen","year":"2011","journal-title":"Eur J Clin Nutr"},{"issue":"(Suppl 2)","key":"2025101814221871000_5.3.e006897.29","doi-asserted-by":"crossref","first-page":"S33","DOI":"10.1038\/sj.ejcn.1601427","article-title":"Selection of a food classification system and a food composition database for future food consumption surveys","volume":"56","author":"Ireland","year":"2002","journal-title":"Eur J Clin Nutr"},{"key":"2025101814221871000_5.3.e006897.30","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1601432"},{"issue":"(Suppl 3)","key":"2025101814221871000_5.3.e006897.31","doi-asserted-by":"crossref","first-page":"S134","DOI":"10.1038\/ejcn.2010.224","article-title":"Capacity development in food composition database management and nutritional research and education in Central and Eastern European, Middle Eastern and North African countries","volume":"64","author":"Gurinovic","year":"2010","journal-title":"Eur J Clin Nutr"},{"key":"2025101814221871000_5.3.e006897.32","doi-asserted-by":"publisher","DOI":"10.1016\/0169-2607(89)90122-3"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2014-006897","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T21:22:26Z","timestamp":1760822546000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2014-006897"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3]]},"references-count":32,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2015,3,20]]},"published-print":{"date-parts":[[2015,3]]}},"alternative-id":["10.1136\/bmjopen-2014-006897"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2014-006897","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2015,3]]}}}