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Novel Approaches for Dietary Phosphorus Management in Chronic Kidney Disease


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1 Development Centre of Nephrology, Apex Kidney Care, Mumbai, Maharashtra - 400 060, India
     

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Conventional approaches to alleviating hyperphosphatemia in patients with Chronic Kidney Disease (CKD) include dietary phosphorus restriction and use of phosphate binders. These approaches are, however not enough to control hyperphosphatemia and hence the need for novel nutritional approaches arises. Dietary phosphorus, protein and phytate values of some common food ingredients were obtained. Phosphates to protein ratio and net phosphorus absorption from the gut were reported on the basis of the phytate content of these ingredients. Among some common Indian food ingredients, phosphate to protein ratio was high in cereals, millets and dairy products. However due to presence of high amount of phytate, the net absorption of phosphate was lower from plant based sources of phosphorus as compared to animal based sources. It can be concluded that phosphorus to protein ratio is a metric which helps to ensure dietary phosphorus restriction with sufficient intake of proteins. Tables providing phosphorus to protein ratio along with phytate and per cent absorption may prove to be beneficial in achieving desired target levels of phosphorus for renal dieticians in case of CKD patients with hyperphosphatemia.


Keywords

Hyperphosphatemia, Phytate, Phosphorus to Protein Ratio, Dialysis.
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  • Novel Approaches for Dietary Phosphorus Management in Chronic Kidney Disease

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Authors

Rachana Jasani
Development Centre of Nephrology, Apex Kidney Care, Mumbai, Maharashtra - 400 060, India
Rajesh Kumar
Development Centre of Nephrology, Apex Kidney Care, Mumbai, Maharashtra - 400 060, India
Paras Dedhia
Development Centre of Nephrology, Apex Kidney Care, Mumbai, Maharashtra - 400 060, India

Abstract


Conventional approaches to alleviating hyperphosphatemia in patients with Chronic Kidney Disease (CKD) include dietary phosphorus restriction and use of phosphate binders. These approaches are, however not enough to control hyperphosphatemia and hence the need for novel nutritional approaches arises. Dietary phosphorus, protein and phytate values of some common food ingredients were obtained. Phosphates to protein ratio and net phosphorus absorption from the gut were reported on the basis of the phytate content of these ingredients. Among some common Indian food ingredients, phosphate to protein ratio was high in cereals, millets and dairy products. However due to presence of high amount of phytate, the net absorption of phosphate was lower from plant based sources of phosphorus as compared to animal based sources. It can be concluded that phosphorus to protein ratio is a metric which helps to ensure dietary phosphorus restriction with sufficient intake of proteins. Tables providing phosphorus to protein ratio along with phytate and per cent absorption may prove to be beneficial in achieving desired target levels of phosphorus for renal dieticians in case of CKD patients with hyperphosphatemia.


Keywords


Hyperphosphatemia, Phytate, Phosphorus to Protein Ratio, Dialysis.

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DOI: https://doi.org/10.21048/ijnd.2020.57.1.23775