Our study suggests that nutritional knowledge of hemodialysis patients, although higher than the general population, is lower for phosphorus with respect to the other nutrients, such as protein, sodium, and potassium. This occurs even in patients with hyperphosphatemia or those taking phosphate binder medications. Nurses showed the best scores; however, improvement is necessary, especially with regard to knowledge of phosphorus. Training programs on nutrition for nurses and on information for patients should be implemented. They can contribute to achievement of a more effective control of phosphate balance, reduction of costs, and improvement of the quality of care for hemodialysis patients.

Accurate assessment of the quantity and chemical type of phosphorus (P) content in processed meat products may have major clinical implications for management of kidney disease patients. We examined 40 lots of cooked ham including 20 without and 20 with P-containing preservatives. Novel spectro-photometrical methods were employed to measure total P and 3 different P subtypes, i.e., water-soluble (inorganic) P including added preservatives and natural P derived from phospholipids and phosphoproteins separately. Total Nitrogen and fat contents were assayed, as well. There was 66% more inorganic P in preserved vs. non-enhanced ham, i.e., 169±36 vs. 102±16 mg/100g (p<0.001), respectively; there were no significant differences in P contents derived from proteins or lipids. The P-to-protein ratio in preserved and non-enhanced ham was 16.1±4.0 and 9.8±0.8 mg/g, respectively (p<0.001). The sum of measured inorganic P and P from phospholipids and phosphoproteins was 91%±4 % of measured total P (207.1±50.7 vs 227.2±54.4 mg/100g, p>0.05), indicating a small portion of unspecified P and/or undermeasurement Novel differential dietary P measurement detects added P-containing preservatives. Processed cooked ham has 66% more measurable inorganic P and 64% higher P-to-protein ratio than non-enhanced product. The contribution of processed food to global dietary phosphorus burden can negatively influence CKD outcome and counteract the efficacy of P-binder medications.

Phosphorus is an important natural nutrient, but high dietary phosphorus intake, including that sourced from added preservatives, is of great concern in renal patients. In this context a reliable analytical method able to quantify differential phosphorus in food could be a valuable tool for monitoring diet composition This paper presents a novel analytical procedure to quantify the following kinds of phosphorus in cooked ham: total (TP), inorganic (IP), from phospholipids (PL), and from phosphoproteins (PP). This technique is based on a suitable sample preparation followed by spectrophotometric analyses. Analytical performances of each method were evaluated, taking advantage also of food industry certified material and in-house reference samples. Limit of detection and limit of quantification values for TP, IP, PP-derived, and PL-derived phosphorus were 13 and 37, 11 and 33, 2 and 20, and 6 and 16 mg P/100 g fresh mass, respectively. Similar results were obtained when this procedure was used to quantify different types of phosphorus present in cooked ham samples. In conclusion, this procedure is effective for quantifying the content of different types of phosphorus present in cooked ham, which can be contributed by different phosphorus-containing ingredients and additives. To the best of the authors' knowledge, this is the first time that simultaneous determination of TP, IP, PL, and PP in cooked ham has been reported.

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