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Phosphate restriction in diet therapy.
Contrib Nephrol. 2007; 155:113-124.CN

Abstract

Hyperphosphatemia and hyperparathyroidism, frequently observed in patients with endstage renal disease, are associated with renal osteodystrophy, organ calcification, cardiovascular disease and sudden death. Restriction of dietary protein and phosphorus is beneficial in slowing the progression of renal failure. Dietary phosphorus restriction must be prescribed at all stages of renal failure in adults. It may be achieved by decreasing protein intake and avoiding foods rich in phosphorus. An average of 60-80% of the phosphorus intake is absorbed in the gut in dialysis patients. If phosphate binders are employed, the phosphorus absorbed from the diet may be reduced to 40%. Conventional hemodialysis with a high-flux, high-efficiency dialyzer removes approximately 30 mmol (900 mg) phosphorus during each dialysis performed three times weekly. Therefore, 750 mg of phosphorus intake should be the critical value above which a positive balance of phosphorus may occur. This value corresponds to a protein diet of 45-50 g/day or 0.8 g/kg body weight/day for a 60 kg patient. Target levels should become 9.2-9.6 mg/dl for calcium, 2.5-5.5 mg/dl for phosphorus, <55 mg2/dl2 for the calcium-phosphorus product, and 100-200 pg/ml for intact parathyroid hormone.

Authors+Show Affiliations

Department of Clinical Nutrition, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17369719

Citation

Takeda, Eiji, et al. "Phosphate Restriction in Diet Therapy." Contributions to Nephrology, vol. 155, 2007, pp. 113-124.
Takeda E, Yamamoto H, Nishida Y, et al. Phosphate restriction in diet therapy. Contrib Nephrol. 2007;155:113-124.
Takeda, E., Yamamoto, H., Nishida, Y., Sato, T., Sawada, N., & Taketani, Y. (2007). Phosphate restriction in diet therapy. Contributions to Nephrology, 155, 113-124. https://doi.org/10.1159/000101004
Takeda E, et al. Phosphate Restriction in Diet Therapy. Contrib Nephrol. 2007;155:113-124. PubMed PMID: 17369719.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Phosphate restriction in diet therapy. AU - Takeda,Eiji, AU - Yamamoto,Hironori, AU - Nishida,Yuka, AU - Sato,Tadatoshi, AU - Sawada,Naoki, AU - Taketani,Yutaka, PY - 2007/3/21/pubmed PY - 2007/6/1/medline PY - 2007/3/21/entrez SP - 113 EP - 124 JF - Contributions to nephrology JO - Contrib Nephrol VL - 155 N2 - Hyperphosphatemia and hyperparathyroidism, frequently observed in patients with endstage renal disease, are associated with renal osteodystrophy, organ calcification, cardiovascular disease and sudden death. Restriction of dietary protein and phosphorus is beneficial in slowing the progression of renal failure. Dietary phosphorus restriction must be prescribed at all stages of renal failure in adults. It may be achieved by decreasing protein intake and avoiding foods rich in phosphorus. An average of 60-80% of the phosphorus intake is absorbed in the gut in dialysis patients. If phosphate binders are employed, the phosphorus absorbed from the diet may be reduced to 40%. Conventional hemodialysis with a high-flux, high-efficiency dialyzer removes approximately 30 mmol (900 mg) phosphorus during each dialysis performed three times weekly. Therefore, 750 mg of phosphorus intake should be the critical value above which a positive balance of phosphorus may occur. This value corresponds to a protein diet of 45-50 g/day or 0.8 g/kg body weight/day for a 60 kg patient. Target levels should become 9.2-9.6 mg/dl for calcium, 2.5-5.5 mg/dl for phosphorus, <55 mg2/dl2 for the calcium-phosphorus product, and 100-200 pg/ml for intact parathyroid hormone. SN - 0302-5144 UR - https://www.unboundmedicine.com/medline/citation/17369719/Phosphate_restriction_in_diet_therapy_ L2 - https://www.karger.com?DOI=10.1159/000101004 DB - PRIME DP - Unbound Medicine ER -