IntroductionAdults 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 “DIETary intake, death and hospitalisation in adults with end-stage kidney disease treated with HaemoDialysis (DIET-HD) study,” 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.Methods and analysisDIET-HD will recruit approximately 10 000 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 (GA2LEN) 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.Ethics and disseminationThe 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.

The treatment of HTA plays a central part in the management of Chronic Kidney Disease (CKD) in all its stages, especially in patients following a substitute treatment of renal functions. HBP can be both the cause and the consequence of CKD. The HBP control in CKD patients represents one of the most important concerns of clinicians. HBP treatment is non pharmacological as well as pharmacological.

Rationale & Objective: Clinical practice guidelines for dietary intake in hemodialysis focus on individual nutrients. Little is known about associations of dietary patterns with survival. We evaluated the associations of dietary patterns with cardiovascular and all-cause mortality among adults treated by hemodialysis.

Uric acid is the end product of endogenous and exogenous of purine nucleotides catabolism, the serum concentrate being determined by the production and elimination ratio. Elimination is achieved through renal excretion � two thirds- and the rest through digestive way. In most studies, hyperuricemia is defined as ] 7 mg/dL uric acid in men and ] 6 mg/dL in women, and the guides for gout treatment recommend target value of uric acid under 6 mg/dL [1]. According to the NHANES ( National Health and Nutrition Examination Survey) register, the prevalence of hyperuricemia has increased by 3.2% and that of gout by 1.2% during the past twenty years[1].

Magnesium (Mg) is one of the most important cations in the organism, essential for regulating vascular tone, cardiac rhythm, and endothelial functions. In patients with advanced stage chronic kidney disease (CKD) Mg deficit was associated in various studies with vascular calcifications and increased cardiovascular morbidity and mortality. Patients with CKD frequently have hyperparathyroidism, parathormone (PTH) being an important risk factor for vascular calcifications. Increased serum Mg levels inhibit PTH secretion and stimulate left ventricular hypertrophy, while low serum Mg levels stimulate PTH secretion. Correcting Mg de deficiency results in reduced cardiovascular mortality in these patients.