Psychosocial Factors That Create Barriers to Managing Serum Phosphorus Levels in Pediatric Dialysis Patients: A Retrospective Analysis

Taylor, J. Madison; Oladitan, Leah; Degnan, Angela; Henderson, Sarah B.; Dai, Hongying; Warady, Bradley A.

doi:10.1053/j.jrn.2016.02.003

Cited by 8 publications

(3 citation statements)

References 17 publications

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“…La hiperfosfemia se correlaciona directamente con el hiperparatiroidismo, enfermedad metabólica ósea y compromiso cardiovascular en ERC [39][40][41][42] . La remoción de fósforo disminuye con la pérdida de diuresis residual, siendo importante tener una depuración peritoneal adecuada 36 .…”

Section: Manejo Del Fósforounclassified

ABC de la diálisis peritoneal en pediatría

Gajardo

Cano

2020

Rev Chil Pediatr

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La enfermedad renal crónica terminal (ERCT) tiene una incidencia de 5,5 a 9 ppm, y una prevalencia de 23 a 65 ppm en menores de 15 años. La diálisis peritoneal (DP) crónica representa en pediatría la terapia de reemplazo renal más usada, previo al trasplante renal. Existen 2 tipos de DP crónicas, manual (DPCA) y automatizada (DPA), cuya elección se basa en las características del peritoneo evaluado mediante el test de equilibrio peritoneal (PET), que divide a los pacientes en transportadores altos (intercambio rápido), promedio alto, promedio bajo, y bajos (intercambio lento). Este test evalúa básicamente el transporte de solutos, al cual se ha sumado el MiniPET, que evalúa el transporte peritoneal de agua libre. Se debe igualmente determinar la cuantía de diálisis (Kt/V), que representa la dosis de diálisis aplicada, con un valor mínimo sugerido de 1,7, relacionado a la morbimortalidad. Estos parámetros deben ser evaluados periódicamente para ajustar la DP, y cada vez que se sospeche una depuración o ultrafiltración inadecuadas. El objetivo de esta revisión es entregar conceptos básicos sobre fisiología del transporte peritoneal, modalidades de DP, evaluación del transporte de agua y solutos peritoneal, y el cálculo de la dosis de diálisis para una diálisis ajustada a las necesidades de cada paciente, como también revisar los mecanismos de corrección y ajuste del procedimiento cada vez que se requiera.

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Section: Manejo Del Fósforounclassified

ABC de la diálisis peritoneal en pediatría

Gajardo

Cano

2020

Rev Chil Pediatr

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“…In one study, children younger than age six were the only age group to have mean phosphorus levels within normal limits, attributed to use of low phosphorus enteral formulas. Thirty-eight percent of these patients were hypophosphatemic and phosphorus supplementation was appropriate (41). However, as the oral food diet advances for phosphorus restriction may become necessary.…”

Section: Fitting Enteral Products To Patient Needsmentioning

confidence: 99%

Optimizing Enteral Nutrition for Growth in Pediatric Chronic Kidney Disease (CKD)

Nelms

2018

Front. Pediatr.

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Growth in pediatric Chronic Kidney Disease is important for long-term outcomes including final adult height and cognitive function. However, there are many barriers for children with chronic kidney disease to achieve adequate nutritional intake to optimize growth. This review highlights these unique concerns, including route of nutrition, dialysis contributions and biochemical indices. Fitting the enteral feeding to the patients' needs involves choosing an appropriate product or products, limiting harmful nutrients in excess, notably aluminum, and altering for electrolyte and micronutrient needs. Unique adjustments to the enteral regimen include accommodating volume needs, optimizing macronutrient ratios, specific electrolyte adjustments, the blending of products together, and adjustments made to consider patient and family psychosocial needs. When a holistic approach to medical nutrition therapy is applied, taking the above factors into consideration, adequate intake for growth of the child with CKD is achievable.

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“…Hence, a recent study identified elevated phosphate levels in adolescents undergoing kidney dialysis. 10 Moreover, more than a quarter of food products were found to contain phosphorous additives in a study to determine the prevalence of phosphorous-containing food additives in top selling foods in grocery stores, uncovering the risk of high exposure to phosphate additives in low cost food products, and a socioeconomic association with the development of phosphate induced chronic diseases. 11 As reported, abject poverty has also been linked to high serum phosphate concentration and increased likelihood of phosphate toxicity due to limited food choices.…”

Section: Socioeconomic Impactmentioning

confidence: 99%

Health implications of inorganic phosphate additives in food products: a systematic review

Anukam

Agu

2017

Int J Community Med Public Health

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Background: Evidence based data identifies phosphate additives in food products as a public health concern, especially in the progression of chronic kidney disease (CKD). However, there is limited public awareness of the risks associated with phosphate additives. This study focuses on a systematic review of findings on health implications of phosphate additives, with the aim of strengthening public health knowledge, insight, understanding and prevention of exposure to phosphate toxicity and chronic diseases.Methods: Studies with primary data on phosphate additives were identified using keyword electronic database search in PubMed and BMC. To meet the review criteria, articles needed to (1) be published in English (2) focus on phosphate additives (3) address the potential health risks associated with phosphate additives (4) identify existing health problems caused by phosphate additives (5) published between 2005 to 2017 to provide a more dynamic review and (6) hold a strong research evidence that confirms the associated risks of phosphate additives.Results: Findings from reviewed literature suggest a link between high phosphate content in food products and chronic renal failure, cardiovascular complications, accelerated aging process, allergic reactions and increased morality rate. The need to regulate the use of phosphates additives in food products and strengthen public health education is essential to minimise high exposure to phosphate additives.Conclusions: Further research, proper food labelling, strict regulation of unhealthy food additives, nutrition education and sensitisation of consumers are required to minimise exposure to phosphate additives and susceptibility to chronic diseases.

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Psychosocial Factors That Create Barriers to Managing Serum Phosphorus Levels in Pediatric Dialysis Patients: A Retrospective Analysis

Cited by 8 publications

References 17 publications

ABC de la diálisis peritoneal en pediatría

ABC de la diálisis peritoneal en pediatría

Optimizing Enteral Nutrition for Growth in Pediatric Chronic Kidney Disease (CKD)

Health implications of inorganic phosphate additives in food products: a systematic review

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