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Jasani, Rachana
- Novel Approaches for Dietary Phosphorus Management in Chronic Kidney Disease
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Authors
Affiliations
1 Development Centre of Nephrology, Apex Kidney Care, Mumbai, Maharashtra - 400 060, IN
1 Development Centre of Nephrology, Apex Kidney Care, Mumbai, Maharashtra - 400 060, IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 57, No 1 (2020), Pagination: 108-114Abstract
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.
References
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- Nazanin Noori, Kamyar Kalantar-Zadeh, Csaba, et al. Association of dietary phosphorus intake and phosphorus to protein ratio with mortality in hemodialysis patients. Clin. J. Amer. Soc. Nephrol., 2010, 5, 683-692.
- Individual and Combined Prevalence of Malnutrition, Inflammation and Atherosclerosis with Cardiovascular Calcification in Hemodialysis Patients
Abstract Views :171 |
PDF Views:1
Authors
Affiliations
1 Department of Nephrology, Apex Kidney Care, Mumbai, Maharashtra - 400 064, IN
1 Department of Nephrology, Apex Kidney Care, Mumbai, Maharashtra - 400 064, IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 57, No 2 (2020), Pagination: 178-184Abstract
The triad of Malnutrition, Inflammation, Atherosclerosis (MIA) is associated with a high mortality rate in hemodialysis patients. The concomitant existence of cardiovascular calcification worsens the condition. Hence, it is of interest to study whether patients with calcification present with higher prevalence of MIA. The main objective of the study was to assess individual and combined prevalence of MIA with cardiovascular calcification in hemodialysis patients. This was a cross sectional study. Subjects above 18 years of age, undergoing chronic hemodialysis not less than twice a week were screened. Out of 126 screened subjects, 109 were eligible and 100 completed the study. Blood samples were drawn for renal profile, calcium, phosphorus, vitamin D3, parathyroid hormone (PTH), lipid profile and high sensitivity (hs) CRP. Computed Tomography (CT) scans of coronary arteries and Subjective Global Assessment (SGA) score were performed. A comparison of individual and combined prevalence of MIA was reported using Z-test for proportions. When individual conditions were compared, the prevalence of atherosclerosis was found to be highly significant (P: 42%, N: 10%, p-value: 0.00001). When a combined prevalence of all three conditions was compared, it was found to be highly significant in calcified subjects (P: 17%, N: 0%, p-value: 0.000001). It was concluded that the prevalence of MIA syndrome individually or in a combined form was greater in subjects with cardiovascular calcification. This may further predispose this group to increased risk of morbidity and mortality. Early screening of these conditions and planning of treatment strategies to lower them are recommended.Keywords
Malnutrition, Inflammation, Atherosclerosis, Calcification, Hemodialysis.References
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