Recent Advances in the Role of Diet in Bone and Mineral Disorders in Chronic Kidney Disease

Gutiérrez, Orlando M.

doi:10.1007/s11914-021-00710-x

Cited by 4 publications

(1 citation statement)

References 33 publications

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“…When the blood phosphate level is high [ 19 ], CKD affects calcium-phosphate metabolism and bone homeostasis, inducing osteomalacia, renal osteodystrophy, and vascular and ectopic calcification, resulting in chronic kidney disease mineral bone disorder (CKD MBD) [ 18 , 20 ]. Moreover, various experimental studies highlighted the mechanisms by which phosphate in excess may adversely affect the cardiovascular system [ 21 , 22 ]. Thus, it may directly contribute to vascular damage by pro-inflammatory actions on the vascular smooth muscle cell leading to endothelial dysfunction and promoting vascular calcification [ 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Medical Nutrition Intervention on the Management of Hyperphosphatemia in Hemodialysis Patients with Stage 5 Chronic Kidney Disease: A Case Series

Moroșan

Popovici

Elian

et al. 2023

IJERPH

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The treatment and interdisciplinary management of patients with chronic kidney disease (CKD) continue to improve long-term outcomes. The medical nutrition intervention’s role is to establish a healthy diet plan for kidney protection, reach blood pressure and blood glucose goals, and prevent or delay health problems caused by kidney disease. Our study aims to report the effects of medical nutrition therapy—substituting foods rich in phosphorus-containing additives with ones low in phosphates content on phosphatemia and phosphate binders drug prescription in stage 5 CKD patients with hemodialysis. Thus, 18 adults with high phosphatemia levels (over 5.5 mg/dL) were monitored at a single center. Everyone received standard personalized diets to replace processed foods with phosphorus additives according to their comorbidities and treatment with prosphate binder drugs. Clinical laboratory data, including dialysis protocol, calcemia, and phosphatemia, were evaluated at the beginning of the study, after 30 and 60 days. A food survey was assessed at baseline and after 60 days. The results did not show significant differences between serum phosphate levels between the first and second measurements; thus, the phosphate binders’ initial doses did not change. After 2 months, phosphate levels decreased considerably (from 7.322 mg/dL to 5.368 mg/dL); therefore, phosphate binder doses were diminished. In conclusion, medical nutrition intervention in patients with hemodialysis significantly reduced serum phosphate concentrations after 60 days. Restricting the intake of processed foods containing phosphorus additives—in particularized diets adapted to each patient’s comorbidities—and receiving phosphate binders represented substantial steps to decrease phosphatemia levels. The best results were significantly associated with life expectancy; at the same time, they showed a negative correlation with the dialysis period and participants’ age.

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