Novel Approaches for Dietary Phosphorus Management in Chronic Kidney Disease

Jump To References Section

Authors

  • ,IN
  • ,IN
  • ,IN

DOI:

https://doi.org/10.21048/ijnd.2020.57.1.23775

Keywords:

Hyperphosphatemia, phytate, phosphorus to protein ratio, dialysis
Phosphorus management

Abstract

Conventional approaches to alleviating hyperphosphatemia in patients with Chronic Kidney Disease (CKD) include dietary phosphorus restriction and use of phosphate binders. These approaches are, however not enough to control hyperphosphatemia and hence the need for novel nutritional approaches arises. Dietary phosphorus, protein and phytate values of some common food ingredients were obtained. Phosphates to protein ratio and net phosphorus absorption from the gut were reported on the basis of the phytate content of these ingredients. Among some common Indian food ingredients, phosphate to protein ratio was high in cereals, millets and dairy products. However due to presence of high amount of phytate, the net absorption of phosphate was lower from plant based sources of phosphorus as compared to animal based sources. It can be concluded that phosphorus to protein ratio is a metric which helps to ensure dietary phosphorus restriction with sufficient intake of proteins. Tables providing phosphorus to protein ratio along with phytate and per cent absorption may prove to be beneficial in achieving desired target levels of phosphorus for renal dieticians in case of CKD patients with hyperphosphatemia.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Published

2020-01-03

How to Cite

Jasani, R., Kumar, R., & Dedhia, P. (2020). Novel Approaches for Dietary Phosphorus Management in Chronic Kidney Disease. The Indian Journal of Nutrition and Dietetics, 57(1), 108–114. https://doi.org/10.21048/ijnd.2020.57.1.23775

Issue

Section

Review Articles
Received 2019-06-03
Accepted 2019-11-25
Published 2020-01-03

 

References

Guillermina Barril-Cuadrado, M. Bernardita Puchulu Jose A. Table showing dietary phosphorus to protein ratio for the Spanish population. Nefrol., 2013, 33, 362-371.

Adamasco Cupisti and Kanyar Kalantar-Zadeh. Management of natural and added dietary phosphorus burden in kidney disease. Semin. Nephrol., 2013, 33, 180-190.

Nazanin Noori, John J. Sims., Joel D. Kopple., et al. Organic and inorganic dietary phosphorus and its management in chronic kidney disease. Iraninan J. Kidney Dis., 2010, 4, 89-100.

Gopalan, G., Rama Shahstri, B. and Bala Subramanian, S. Nutritive Value of Indian Foods. National Institute of Nutrition. Indian Council of Medical Research.

Kamyar Kalantar-Zadeh, Lisa Gutekunst, Rajnish Mehrotra, et al. Understanding sources of dietary phosphorus in the treatment of patients with Chronic Kidney Disease. Clin. J. Amer. Soc. Neph., 2010, 1-10.

St. Jules, D.E., Woolf, K., Pompeii, M.L., Kalantar-Zadeh, K. and Sevick, M.A. Re-examining the phosphorus-protein dilemma: Does phosphorus restriction compromise protein status? J. Ren. Nutr., 2016, 26, 136-140.

Nazanin Noori, Kamyar Kalantar-Zadeh, Csaba, et al. Association of dietary phosphorus intake and phosphorus to protein ratio with mortality in hemodialysis patients. Clin. J. Amer. Soc. Nephrol., 2010, 5, 683-692