Document Detail


Dietary phosphorus restriction in advanced chronic kidney disease: merits, challenges, and emerging strategies.
MedLine Citation:
PMID:  20557490     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hyperphosphatemia is an independent risk factor for mortality in patients on maintenance dialysis. Since phosphorus clearance by standard three times-weekly dialysis is insufficient to balance ongoing dietary phosphorus intake, strategies to prevent absorption of dietary phosphorus are essential for attenuating increased serum levels. Dietary phosphorus binders are used widely for this purpose but dietary phosphorus restriction is relatively underutilized, most likely because of the logistical complexity of instituting and monitoring a low phosphorus diet, and for fear of worsening protein-energy wasting, which itself is a potent risk factor for mortality. In this review, we propose sustainable strategies for reducing phosphorus intake while avoiding exacerbation of protein-energy wasting. The approach is based on recognition of the dissociation between protein and phosphorus content in phosphorus-rich processed foods and the varying phosphorus bioavailability in different dietary sources. Controlling serum phosphate levels is among the most challenging aspects of day-to-day dialysis care but integration of sensible dietary interventions will likely improve phosphorus control.
Authors:
Orlando M Gutiérrez; Myles Wolf
Publication Detail:
Type:  Journal Article; Review     Date:  2010-06-14
Journal Detail:
Title:  Seminars in dialysis     Volume:  23     ISSN:  1525-139X     ISO Abbreviation:  Semin Dial     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-08-12     Completed Date:  2010-12-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8911629     Medline TA:  Semin Dial     Country:  United States    
Other Details:
Languages:  eng     Pagination:  401-6     Citation Subset:  IM    
Affiliation:
Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
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MeSH Terms
Descriptor/Qualifier:
Humans
Hyperphosphatemia / etiology,  prevention & control*
Kidney Failure, Chronic / blood,  complications,  diet therapy*
Phosphorus, Dietary / administration & dosage,  adverse effects*,  pharmacokinetics
Risk Factors
Chemical
Reg. No./Substance:
0/Phosphorus, Dietary

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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