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Replacing Phosphorus-Containing Food Additives With Foods Without Additives Reduces Phosphatemia in End-Stage Renal Disease Patients: A Randomized Clinical Trial.
J Ren Nutr. 2017 03; 27(2):97-105.JR

Abstract

OBJECTIVE

The purpose of the study was to verify the effects of replacing phosphorus-containing food additives with foods without additives on phosphatemia in end-stage renal disease (ESRD) patients.

DESIGN

Randomized clinical trial.

SETTING

Adult patients on hemodialysis for ≥6 months at a single center.

SUBJECTS

A total of 134 patients with phosphorus levels of >5.5 mg/dL were included and were randomized into an intervention group (n = 67) and a control group (n = 67).

INTERVENTION

The IG received individual orientation to replace processed foods that have phosphorus additives with foods of similar nutritional value without these additives. The CG received only the nutritional orientation given before the study. Clinical laboratory data, nutritional status, energy and protein intake, and normalized protein nitrogen appearance (nPNA) were evaluated at the beginning of the study and after 90 days.

RESULTS

There was no initial difference between the groups in terms of serum phosphorus levels, nutritional status, and energy intake. After 3 months, there was a decline in phosphorus levels in the IG (from 7.2 ± 1.4 to 5.0 ± 1.3 mg/dL, P < .001), but there was no significant difference in the CG (from 7.1 ± 1.2 to 6.7 ± 1.2 mg/dL, P = .65). In the IG, 69.7% of the patients reached the serum phosphorus target of ≤5.5 mg/dL; however, only 18.5% of the CG subjects reached this level (P < .001).

CONCLUSION

At the end, there was no difference between the two groups in terms of nutritional status, energy intake, protein intake, and nPNA. The replacing phosphorus-containing food additives with foods without additives reduced serum phosphorus without interfering in the nutritional status of ESRD patients.

Authors+Show Affiliations

Post Graduation in Health Sciences Division of Santa Casa of São Paulo School of Medical Sciences, São Paulo, SP, Brazil; Nephron Group, Substitutive Renal Therapy, São Paulo, SP, Brazil. Electronic address: mglage@bol.com.br.Post Graduation in Health Sciences Division of Santa Casa of São Paulo School of Medical Sciences, São Paulo, SP, Brazil.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27751628

Citation

de Fornasari, Margareth Lage Leite, and Yvoty Alves Dos Santos Sens. "Replacing Phosphorus-Containing Food Additives With Foods Without Additives Reduces Phosphatemia in End-Stage Renal Disease Patients: a Randomized Clinical Trial." Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 27, no. 2, 2017, pp. 97-105.
de Fornasari ML, Dos Santos Sens YA. Replacing Phosphorus-Containing Food Additives With Foods Without Additives Reduces Phosphatemia in End-Stage Renal Disease Patients: A Randomized Clinical Trial. J Ren Nutr. 2017;27(2):97-105.
de Fornasari, M. L., & Dos Santos Sens, Y. A. (2017). Replacing Phosphorus-Containing Food Additives With Foods Without Additives Reduces Phosphatemia in End-Stage Renal Disease Patients: A Randomized Clinical Trial. Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 27(2), 97-105. https://doi.org/10.1053/j.jrn.2016.08.009
de Fornasari ML, Dos Santos Sens YA. Replacing Phosphorus-Containing Food Additives With Foods Without Additives Reduces Phosphatemia in End-Stage Renal Disease Patients: a Randomized Clinical Trial. J Ren Nutr. 2017;27(2):97-105. PubMed PMID: 27751628.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Replacing Phosphorus-Containing Food Additives With Foods Without Additives Reduces Phosphatemia in End-Stage Renal Disease Patients: A Randomized Clinical Trial. AU - de Fornasari,Margareth Lage Leite, AU - Dos Santos Sens,Yvoty Alves, Y1 - 2016/10/14/ PY - 2016/03/29/received PY - 2016/08/16/revised PY - 2016/08/17/accepted PY - 2016/10/19/pubmed PY - 2018/2/23/medline PY - 2016/10/19/entrez SP - 97 EP - 105 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 27 IS - 2 N2 - OBJECTIVE: The purpose of the study was to verify the effects of replacing phosphorus-containing food additives with foods without additives on phosphatemia in end-stage renal disease (ESRD) patients. DESIGN: Randomized clinical trial. SETTING: Adult patients on hemodialysis for ≥6 months at a single center. SUBJECTS: A total of 134 patients with phosphorus levels of >5.5 mg/dL were included and were randomized into an intervention group (n = 67) and a control group (n = 67). INTERVENTION: The IG received individual orientation to replace processed foods that have phosphorus additives with foods of similar nutritional value without these additives. The CG received only the nutritional orientation given before the study. Clinical laboratory data, nutritional status, energy and protein intake, and normalized protein nitrogen appearance (nPNA) were evaluated at the beginning of the study and after 90 days. RESULTS: There was no initial difference between the groups in terms of serum phosphorus levels, nutritional status, and energy intake. After 3 months, there was a decline in phosphorus levels in the IG (from 7.2 ± 1.4 to 5.0 ± 1.3 mg/dL, P < .001), but there was no significant difference in the CG (from 7.1 ± 1.2 to 6.7 ± 1.2 mg/dL, P = .65). In the IG, 69.7% of the patients reached the serum phosphorus target of ≤5.5 mg/dL; however, only 18.5% of the CG subjects reached this level (P < .001). CONCLUSION: At the end, there was no difference between the two groups in terms of nutritional status, energy intake, protein intake, and nPNA. The replacing phosphorus-containing food additives with foods without additives reduced serum phosphorus without interfering in the nutritional status of ESRD patients. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/27751628/Replacing_Phosphorus_Containing_Food_Additives_With_Foods_Without_Additives_Reduces_Phosphatemia_in_End_Stage_Renal_Disease_Patients:_A_Randomized_Clinical_Trial_ DB - PRIME DP - Unbound Medicine ER -