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Dietary phosphorus intake and distribution in Chinese peritoneal dialysis patients with and without hyperphosphatemia

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Abstract

Background

The present study was conducted to analyze the dietary phosphorus intake and distribution in different food categories in peritoneal dialysis (PD) patients, to evaluate the relationship between dietary phosphorus intake and hyperphosphatemia.

Methods

It was a cross-sectional study, in which prevalent Chinese PD patients were instructed by dietitians to record 3-day diet diary. Dietary phosphorus and other nutrient contents were calculated using a food composition computer program. Renal and peritoneal phosphorus clearance (CPh) was estimated, and serum phosphorus, as well as other serological parameters, were measured at the same time.

Results

93 PD patients [age 52.9 ± 13.0 years, PD duration 30.1 (8.0, 71.0) months] finished the 3-day diet diary. Hyperphosphatemic patients (serum phosphorus level 1.97 ± 0.28 mmol/l, n = 48) showed higher dietary phosphorus intake (771.6 ± 195.1 versus 620.8 ± 155.3 mg/day, p = 0.040) than those with normal serum phosphorus level (1.37 ± 0.21 mmol/l, n = 45), due to greater phosphorus intake from meat, snacks, beverage, food condiments and additives. Significantly lower dietary phosphorus intake (605.6 ± 122.5 mg/day) and phosphorus to protein ratio (12.7 ± 1.4 mg/g) were observed in patients with anuria who maintained serum phosphorus within normal range. Multivariate linear regression analysis indicated normalized phosphorus intake, renal CPh and dietary protein intake were independently associated with serum phosphorus level.

Conclusion

High dietary phosphorus intake is associated with elevated serum phosphorus level in PD patients. The study suggests that PD patients, particularly those with anuria, shall limit the intake of meat, snacks, beverage, food condiments and additives to reduce dietary phosphorus ingestion.

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Acknowledgments

The study was supported by research grants from National Natural Science Foundation of China (No. 81200553 and No. 81370794), Shanghai Municipal Education Commission (No. jdy10070), and Renal Research Grant of Baxter China (No. CHN-RENAL-IIS-2010-020). The authors thank Prof. Yanping Wan and her staff from Clinical Nutrition Division of Renji Hospital, Shanghai Jiaotong University School of Medicine, for the help in patients training on 3-day diet diary recording. We also thank Ms Aiping Gu and Ms Jiaying Huang from the Renal Division of Renji Hospital, Shanghai Jiaotong University School of Medicine, for the help in 3-day diet diary collection. We thank Dr. Man Fai Lam from the Renal Division of Queen Mary Hospital, Hong Kong for the constructive advice in the manuscript writing.

Conflict of interest

All the authors declared no competing interests.

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Authors and Affiliations

  1. Renal Division, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Center for Peritoneal Dialysis Research, No. 145 Middle ShanDong Road, Shanghai, 200001, People’s Republic of China

    Na Jiang, Wei Fang, Xiaoxiao Yang, Lin Zhang, Jiangzi Yuan, Aiwu Lin, Zhaohui Ni & Jiaqi Qian

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  1. Na Jiang
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  2. Wei Fang
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  3. Xiaoxiao Yang
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  4. Lin Zhang
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  5. Jiangzi Yuan
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  6. Aiwu Lin
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  7. Zhaohui Ni
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  8. Jiaqi Qian
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Corresponding author

Correspondence to Jiaqi Qian.

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Jiang, N., Fang, W., Yang, X. et al. Dietary phosphorus intake and distribution in Chinese peritoneal dialysis patients with and without hyperphosphatemia. Clin Exp Nephrol 19, 694–700 (2015). https://doi.org/10.1007/s10157-014-1024-8

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  • DOI: https://doi.org/10.1007/s10157-014-1024-8

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