Limiting Phosphorus Additives in Foods Lowers Serum Phosphorus

ATLANTA—Restricting foods with phosphorus additives decreases serum phosphorus without adversely affecting nutritional status of patients on hemodialysis (HD), Brazilian researchers reported here at the American Society of Nephrology's Kidney Week 2013.

Margareth Fornasari, MD, and colleagues at the School of Medical Sciences in Sao Paulo studied 134 HD patients with serum phosphorus levels above 5.5 mg/dL. Patients were randomly assigned to an intervention or control group, each having 67 patients. The intervention group received orientation to substitute processed foods with phosphorus additives for foods without these additives, but having similar nutritional value. The control arm maintained the nutritional orientation given prior to the study. The prescription of phosphate binders was not modified for either group.

At baseline, the two groups were similar with respect to serum phosphorus levels, nutritional status and protein and caloric intake. After three months, serum phosphorus levels declined from 7.2 to 5.0 mg/dL in the intervention arm, but declined non-significantly from 7.1 to 6.7 mg/dL in the control arm.

In addition, 65.6% of patients in the intervention group achieved a serum phosphorus target of 5.5 mg/dL or below compared with 18.5% in the control group.

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