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Dietary habits and counseling focused on phosphate intake in hemodialysis patients with hyperphosphatemia.
J Ren Nutr. 2004 Oct; 14(4):220-5.JR

Abstract

OBJECTIVE

To evaluate the dietary habits of hemodialysis patients with hyperphosphatemia and the effects of a dietetic intervention focused on limiting dietary phosphate load.

DESIGN

Cross-sectional dietary evaluation and prospective intervention study.

SETTING

Hospital hemodialysis units of Pisa and Pistoia, Italy. Subjects Forty-three stable adult hemodialysis patients, 20 of whom had phosphorus serum levels >5.5 mg/dL.

INTERVENTION

Analysis of dietary composition and of the effects of individual dietetic counseling in an attempt to reduce phosphorus intake while preserving the same protein intake.

MAIN OUTCOME MEASURES

Differences in nutrient intake between normophosphatemic and hyperphosphatemic patients, and changes in dietary phosphorus and phosphorus-protein ratio, serum phosphate, and calcium-phosphate product after dietetic intervention.

RESULTS

No major differences in nutrient intake were detected between hyperphosphatemia and normophosphatemia patients, apart from a lower phosphorus-protein ratio (13.1 +/- 1.7 versus 14.1 +/- 2.1 mg/g, P < .05) in the former. After dietetic intervention in the hyperphosphatemia patients, phosphate and calcium intake decreased significantly (by 100 mg on average), whereas dietary protein did not change. A further decrease of the dietary phosphate-protein ratio (12.5 +/- 1.8 mg/g, P < .05) also occurred. Serum phosphate showed a trend to decrease in the intervention group, whereas the serum calcium-phosphate product decreased significantly (from 66.8 +/- 13.1 to 61.0 +/- 13.8 mg2 /dL2 , P < .05).

CONCLUSIONS

In compliant and motivated patients, individual dietetic counseling may be useful in reducing phosphate load and in limiting the phosphate burden related to an adequate protein intake, with a potentially favorable impact on calcium-phosphate retention. A phosphate-controlled diet has a role in an integrated therapeutic approach to hyperphosphatemia and positive calcium-phosphorus balance in hemodialysis patients.

Authors+Show Affiliations

U. O. Nefrologia Universitaria, Dipartimento di Medicina Interna, Università di Pisa, Pisa, Italy. acupisti@med.unipi.itNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15483782

Citation

Cupisti, Adamasco, et al. "Dietary Habits and Counseling Focused On Phosphate Intake in Hemodialysis Patients With Hyperphosphatemia." Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 14, no. 4, 2004, pp. 220-5.
Cupisti A, D'Alessandro C, Baldi R, et al. Dietary habits and counseling focused on phosphate intake in hemodialysis patients with hyperphosphatemia. J Ren Nutr. 2004;14(4):220-5.
Cupisti, A., D'Alessandro, C., Baldi, R., & Barsotti, G. (2004). Dietary habits and counseling focused on phosphate intake in hemodialysis patients with hyperphosphatemia. Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 14(4), 220-5.
Cupisti A, et al. Dietary Habits and Counseling Focused On Phosphate Intake in Hemodialysis Patients With Hyperphosphatemia. J Ren Nutr. 2004;14(4):220-5. PubMed PMID: 15483782.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary habits and counseling focused on phosphate intake in hemodialysis patients with hyperphosphatemia. AU - Cupisti,Adamasco, AU - D'Alessandro,Claudia, AU - Baldi,Rita, AU - Barsotti,Giuliano, PY - 2004/10/16/pubmed PY - 2006/4/7/medline PY - 2004/10/16/entrez SP - 220 EP - 5 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 14 IS - 4 N2 - OBJECTIVE: To evaluate the dietary habits of hemodialysis patients with hyperphosphatemia and the effects of a dietetic intervention focused on limiting dietary phosphate load. DESIGN: Cross-sectional dietary evaluation and prospective intervention study. SETTING: Hospital hemodialysis units of Pisa and Pistoia, Italy. Subjects Forty-three stable adult hemodialysis patients, 20 of whom had phosphorus serum levels >5.5 mg/dL. INTERVENTION: Analysis of dietary composition and of the effects of individual dietetic counseling in an attempt to reduce phosphorus intake while preserving the same protein intake. MAIN OUTCOME MEASURES: Differences in nutrient intake between normophosphatemic and hyperphosphatemic patients, and changes in dietary phosphorus and phosphorus-protein ratio, serum phosphate, and calcium-phosphate product after dietetic intervention. RESULTS: No major differences in nutrient intake were detected between hyperphosphatemia and normophosphatemia patients, apart from a lower phosphorus-protein ratio (13.1 +/- 1.7 versus 14.1 +/- 2.1 mg/g, P < .05) in the former. After dietetic intervention in the hyperphosphatemia patients, phosphate and calcium intake decreased significantly (by 100 mg on average), whereas dietary protein did not change. A further decrease of the dietary phosphate-protein ratio (12.5 +/- 1.8 mg/g, P < .05) also occurred. Serum phosphate showed a trend to decrease in the intervention group, whereas the serum calcium-phosphate product decreased significantly (from 66.8 +/- 13.1 to 61.0 +/- 13.8 mg2 /dL2 , P < .05). CONCLUSIONS: In compliant and motivated patients, individual dietetic counseling may be useful in reducing phosphate load and in limiting the phosphate burden related to an adequate protein intake, with a potentially favorable impact on calcium-phosphate retention. A phosphate-controlled diet has a role in an integrated therapeutic approach to hyperphosphatemia and positive calcium-phosphorus balance in hemodialysis patients. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/15483782/Dietary_habits_and_counseling_focused_on_phosphate_intake_in_hemodialysis_patients_with_hyperphosphatemia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S105122760400130X DB - PRIME DP - Unbound Medicine ER -