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Phosphorus Counting Table for the control of serum phosphorus levels without phosphate binders in hemodialysis patients.
Clin Nutr ESPEN. 2019 08; 32:153-157.CN

Abstract

BACKGROUND AND AIMS

Hyperphosphatemia constitutes one of the major problems faced by patients with chronic kidney disease, and nourishment plays a significant role in its control. The present study aimed to evaluate the maintenance of phosphorus serum levels by observing measurements before and after an intervention using the Phosphorus Counting Table (PCT), in hemodialysis patients lacking phosphate binder use.

METHODS

The assessment included fifty individuals on hemodialysis who underwent phosphate binder suspension 30 days prior to the intervention. The participants received food and nutrition education on the PCT tool, which assists in the control of dietary phosphorus intake, and followed its instructions for two months. Fasting blood samples were collected at three moments for phosphorus, total calcium, and parathyroid hormone (PTH) analysis. The study sample was initially analyzed as a whole, then sub-classified into two groups: adherence and non-adherence.

RESULTS

At the end of the study, no significant difference in serum phosphorus was observed in the total and the adherence groups (p > 0.05). The non-adherence group showed a substantial increase of 0.74 mg/dL in serum phosphorus levels and 6.16 mg2/dL2 in the calcium-phosphorus product after the intervention. Meanwhile, the calcium-phosphorus product improved from 56.42 ± 11.49 mg2/dL2 to 51.05 ± 10.67 mg2/dL2 in the adherence group. Serum calcium levels did not change throughout the study in the three groups. A significant increment in PTH serum levels was observed at the end of the study in all groups.

CONCLUSION

The PCT showed to be efficient in the maintenance of serum phosphorus in the individuals who adhered well to the tool, without the administration of phosphate binders. Such a method can assist in patient adherence to treatment and enables better diet flexibility. The present trial was registered under the Brazilian Clinical Trials Registry (Rebec). Registration number: RBR-2vzd48.

Authors+Show Affiliations

Graduate Program in Science, Department of Clinical Medicine, Ribeirão Preto Medical School - São Paulo University, Brazil. Electronic address: vi.reisb@gmail.com.CKD-MBD Unit, Nephrology Division, Department of Clinical Medicine, Ribeirão Preto Medical School - University of São Paulo, Brazil. Electronic address: leandro.ibene@gmail.com.Nephrology Division, Department of Clinical Medicine, Ribeirão Preto Medical School - University of São Paulo, Brazil. Electronic address: jacdcost@fmrp.usp.br.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31221281

Citation

Bertonsello-Catto, Vivianne Rêis, et al. "Phosphorus Counting Table for the Control of Serum Phosphorus Levels Without Phosphate Binders in Hemodialysis Patients." Clinical Nutrition ESPEN, vol. 32, 2019, pp. 153-157.
Bertonsello-Catto VR, Lucca LJ, da Costa JAC. Phosphorus Counting Table for the control of serum phosphorus levels without phosphate binders in hemodialysis patients. Clin Nutr ESPEN. 2019;32:153-157.
Bertonsello-Catto, V. R., Lucca, L. J., & da Costa, J. A. C. (2019). Phosphorus Counting Table for the control of serum phosphorus levels without phosphate binders in hemodialysis patients. Clinical Nutrition ESPEN, 32, 153-157. https://doi.org/10.1016/j.clnesp.2019.03.008
Bertonsello-Catto VR, Lucca LJ, da Costa JAC. Phosphorus Counting Table for the Control of Serum Phosphorus Levels Without Phosphate Binders in Hemodialysis Patients. Clin Nutr ESPEN. 2019;32:153-157. PubMed PMID: 31221281.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Phosphorus Counting Table for the control of serum phosphorus levels without phosphate binders in hemodialysis patients. AU - Bertonsello-Catto,Vivianne Rêis, AU - Lucca,Leandro Junior, AU - da Costa,José Abrão Cardeal, Y1 - 2019/04/20/ PY - 2019/02/26/received PY - 2019/03/18/accepted PY - 2019/6/22/entrez PY - 2019/6/22/pubmed PY - 2020/8/5/medline KW - Chronic kidney disease KW - Food and nutrition education KW - Hyperphosphatemia KW - Phosphorus, dietary KW - Renal dialysis SP - 153 EP - 157 JF - Clinical nutrition ESPEN JO - Clin Nutr ESPEN VL - 32 N2 - BACKGROUND AND AIMS: Hyperphosphatemia constitutes one of the major problems faced by patients with chronic kidney disease, and nourishment plays a significant role in its control. The present study aimed to evaluate the maintenance of phosphorus serum levels by observing measurements before and after an intervention using the Phosphorus Counting Table (PCT), in hemodialysis patients lacking phosphate binder use. METHODS: The assessment included fifty individuals on hemodialysis who underwent phosphate binder suspension 30 days prior to the intervention. The participants received food and nutrition education on the PCT tool, which assists in the control of dietary phosphorus intake, and followed its instructions for two months. Fasting blood samples were collected at three moments for phosphorus, total calcium, and parathyroid hormone (PTH) analysis. The study sample was initially analyzed as a whole, then sub-classified into two groups: adherence and non-adherence. RESULTS: At the end of the study, no significant difference in serum phosphorus was observed in the total and the adherence groups (p > 0.05). The non-adherence group showed a substantial increase of 0.74 mg/dL in serum phosphorus levels and 6.16 mg2/dL2 in the calcium-phosphorus product after the intervention. Meanwhile, the calcium-phosphorus product improved from 56.42 ± 11.49 mg2/dL2 to 51.05 ± 10.67 mg2/dL2 in the adherence group. Serum calcium levels did not change throughout the study in the three groups. A significant increment in PTH serum levels was observed at the end of the study in all groups. CONCLUSION: The PCT showed to be efficient in the maintenance of serum phosphorus in the individuals who adhered well to the tool, without the administration of phosphate binders. Such a method can assist in patient adherence to treatment and enables better diet flexibility. The present trial was registered under the Brazilian Clinical Trials Registry (Rebec). Registration number: RBR-2vzd48. SN - 2405-4577 UR - https://www.unboundmedicine.com/medline/citation/31221281/Phosphorus_Counting_Table_for_the_control_of_serum_phosphorus_levels_without_phosphate_binders_in_hemodialysis_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2405-4577(19)30048-8 DB - PRIME DP - Unbound Medicine ER -