Lower Phosphorus, Higher Protein Intake Improve Survival

Protein levels found to modify the effect of serum phosphorus with mortality in HD patients.
Protein levels found to modify the effect of serum phosphorus with mortality in HD patients.

Higher protein intake and well-controlled serum phosphorus are associated with a greatest survival benefit in maintenance hemodialysis (MHD) patients, researchers reported at the National Kidney Foundation 2014 Spring Clinical Meeting in Las Vegas.

In a cohort study, Kamyar Kalantar-Zadeh, MD, PhD, of the University of California Irvine, and colleagues studied 108,635 MHD patients followed for up to 5 years. The cohort had a mean age of 64 years. The composition of the cohort was 59% diabetic, 45% women, and 33% black.

Compared with patients who had a serum phosphorus level of 7.0 mg/dL or higher and a normalized protein catabolic rate (nPCR)—a surrogate of dietary protein intake—below 0.8 g/kg/day, patients with a serum phosphorus level of at least 3.5 but less than 5.5 mg/dL and an nPCR of at least 1 but less than 1.2 g/kg/day had the greatest survival: a 51% decreased risk of death in a fully adjusted model.

The researchers noted that their results are limited by the lack data on protein binders.

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