Zusammenfassung
Bei Dialysepatienten sind hohe Phosphatzufuhr und Hyperphosphatämie verknüpft mit erhöhtem kardiovaskulären Risiko und gesteigerter Mortalität. Neben dem Einsatz von Phosphatbindern oder Hemmern der intestinalen Phosphatabsorption kommt daher der Vermeidung hoher Phosphatzufuhr in Lebensmitteln große Bedeutung zu. Neben dem in Lebensmitteln vorhandenen organisch gebundenen Phosphat (welches nur teilweise absorbiert wird) spielt zunehmend Phosphat als Lebensmittelzusatz eine wichtige Rolle. Die Abschätzung der Phosphatzusätze in kommerziellen Lebensmitteln wird erschwert durch fehlende Angaben zum Phosphatgehalt. Umso wichtiger ist die Schulung und Aufklärung nierenkranker Patienten zur Abschätzung des Phosphatgehalts in Nahrungsmitteln.
Abstract
In patients with advanced chronic kidney disease (CKD) and in patients on dialysis high phosphate intake and hyperphosphatemia are associated with increased cardiovascular risk and increased mortality. Apart from phosphate binders and inhibitors of intestinal phosphate absorption, it is important to avoid high dietary phosphate intake, specifically phosphate-enriched food items. Apart from phosphate bound by organic molecules (which is less avidly absorbed in the gut), inorganic phosphate added for various reasons to food items, plays an increasingly important role. Because it is not legally required to indicate added phosphate in commercial food items it is very difficult for patients to assess the effective (actual) phosphate content. Against this background it is important to educate patients with CKD to be able to estimate the phosphate content in food items and to avoid high phosphate nutrients.
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Hahn, K., Kuhlmann, M. & Ritz, E. Phosphat und Nahrung. Nephrologe 8, 37–42 (2013). https://doi.org/10.1007/s11560-012-0649-4
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DOI: https://doi.org/10.1007/s11560-012-0649-4
Schlüsselwörter
- Dialysepatienten
- Hyperphosphatämie
- Phosphatgehalt in Nahrungsmitteln
- Intestinale Phosphatabsorption
- Phosphatbinder