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Dietary phosphate restriction in dialysis patients: a new approach for the treatment of hyperphosphataemia.
Nutr Metab Cardiovasc Dis. 2011 Nov; 21(11):879-84.NM

Abstract

BACKGROUND AND AIM

Elevated serum phosphate and calcium-phosphate levels play an important role in the pathogenesis of vascular calcifications in uraemic patients and appear to be associated with increased cardiovascular mortality. We aimed to evaluate the effects of a partial replacement of food protein with a low-phosphorus and low-potassium whey protein concentrate on phosphate levels of dialysis patients with hyperphosphataemia.

METHODS AND RESULTS

Twenty-seven patients undergoing chronic haemodialysis were studied for a 3-month period. In the intervention group (n = 15), food protein were replaced by 30 or 40 g of low-phosphorus and low-potassium protein concentrate aimed at limiting the phosphate intake. In the control group (n = 12) no changes were made to their usual diet. Anthropometric measurements, biochemical markers and dietary interviews were registered at baseline and during the follow-up period. From baseline to the end of the study, in the intervention group, serum phosphate and circulating intact parathyroid hormone levels lessened significantly (8.3 ± 1.2 mg/dL vs 5.7 ± 1.4 mg/dL and 488 ± 205 pg/ml vs 177 ± 100 pg/ml respectively; p < 0.05) with decreasing of phosphate and potassium intake. No significant differences were found in the control group. No significant changes were observed in serum albumin, calcium, potassium, Kt/V, body weight and body composition in both the intervention and control groups.

CONCLUSION

Dietary intake of phosphate mainly comes from protein sources, so dietary phosphorus restriction may lead to a protein/energy malnutrition in a dialysis patient. A phosphorus-controlled diet plan including a nutritional substitute resulted in serum phosphate and intact parathyroid hormone decrease without nutritional status modifications in dialysis patients.

Authors+Show Affiliations

Department of Neuroscience, Physiology Nutrition Unit, University Federico II, Naples, Italy. bguida@unina.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20609572

Citation

Guida, B, et al. "Dietary Phosphate Restriction in Dialysis Patients: a New Approach for the Treatment of Hyperphosphataemia." Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, vol. 21, no. 11, 2011, pp. 879-84.
Guida B, Piccoli A, Trio R, et al. Dietary phosphate restriction in dialysis patients: a new approach for the treatment of hyperphosphataemia. Nutr Metab Cardiovasc Dis. 2011;21(11):879-84.
Guida, B., Piccoli, A., Trio, R., Laccetti, R., Nastasi, A., Paglione, A., Memoli, A., & Memoli, B. (2011). Dietary phosphate restriction in dialysis patients: a new approach for the treatment of hyperphosphataemia. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 21(11), 879-84. https://doi.org/10.1016/j.numecd.2010.02.021
Guida B, et al. Dietary Phosphate Restriction in Dialysis Patients: a New Approach for the Treatment of Hyperphosphataemia. Nutr Metab Cardiovasc Dis. 2011;21(11):879-84. PubMed PMID: 20609572.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary phosphate restriction in dialysis patients: a new approach for the treatment of hyperphosphataemia. AU - Guida,B, AU - Piccoli,A, AU - Trio,R, AU - Laccetti,R, AU - Nastasi,A, AU - Paglione,A, AU - Memoli,A, AU - Memoli,B, Y1 - 2010/07/06/ PY - 2009/11/12/received PY - 2010/01/28/revised PY - 2010/02/10/accepted PY - 2010/7/9/entrez PY - 2010/7/9/pubmed PY - 2012/2/3/medline SP - 879 EP - 84 JF - Nutrition, metabolism, and cardiovascular diseases : NMCD JO - Nutr Metab Cardiovasc Dis VL - 21 IS - 11 N2 - BACKGROUND AND AIM: Elevated serum phosphate and calcium-phosphate levels play an important role in the pathogenesis of vascular calcifications in uraemic patients and appear to be associated with increased cardiovascular mortality. We aimed to evaluate the effects of a partial replacement of food protein with a low-phosphorus and low-potassium whey protein concentrate on phosphate levels of dialysis patients with hyperphosphataemia. METHODS AND RESULTS: Twenty-seven patients undergoing chronic haemodialysis were studied for a 3-month period. In the intervention group (n = 15), food protein were replaced by 30 or 40 g of low-phosphorus and low-potassium protein concentrate aimed at limiting the phosphate intake. In the control group (n = 12) no changes were made to their usual diet. Anthropometric measurements, biochemical markers and dietary interviews were registered at baseline and during the follow-up period. From baseline to the end of the study, in the intervention group, serum phosphate and circulating intact parathyroid hormone levels lessened significantly (8.3 ± 1.2 mg/dL vs 5.7 ± 1.4 mg/dL and 488 ± 205 pg/ml vs 177 ± 100 pg/ml respectively; p < 0.05) with decreasing of phosphate and potassium intake. No significant differences were found in the control group. No significant changes were observed in serum albumin, calcium, potassium, Kt/V, body weight and body composition in both the intervention and control groups. CONCLUSION: Dietary intake of phosphate mainly comes from protein sources, so dietary phosphorus restriction may lead to a protein/energy malnutrition in a dialysis patient. A phosphorus-controlled diet plan including a nutritional substitute resulted in serum phosphate and intact parathyroid hormone decrease without nutritional status modifications in dialysis patients. SN - 1590-3729 UR - https://www.unboundmedicine.com/medline/citation/20609572/Dietary_phosphate_restriction_in_dialysis_patients:_a_new_approach_for_the_treatment_of_hyperphosphataemia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0939-4753(10)00070-0 DB - PRIME DP - Unbound Medicine ER -