Kidney Week

Abstract: SA-PO1039

Comparison of Mixed-Based vs Animal-Based Low Phosphorus Diet on Hyperphosphatemia in Dialysis Patients: Randomized Clinical Trial

Session Information

• Diet and Nutrition: Clinical
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Health Maintenance, Nutrition, and Metabolism

• 1302 Health Maintenance, Nutrition, and Metabolism: Clinical

Authors

• Atilano carsi, Ximena, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico

Ximena Atilano carsi,

• Ramirez-Sandoval, Juan Carlos, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, México city, DIStrito federal, Mexico

Juan Carlos Ramirez-Sandoval,

• Sánchez, Jorge Alberto, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de México, Mexico

Jorge Alberto Sánchez,

• Arce santander, Celene V., Lapi Unidad de Hemodiálisis, Ciudad de México, Mexico

Celene V. Arce santander,

• Cruz, Cristinoc, INCMNSZ, Mexico city, Mexico

Cristinoc Cruz,

• Tamez Pedroza, Luis, Universidad Autonoma de Baja California, Ciudad de M?xico, Mexico

Luis Tamez Pedroza,

• Garcia de Leon, Miguel Angel, Instituto Mexicano del Seguro Social, Distrito Federal, Mexico

Miguel Angel Garcia de Leon,

• Espinosa-Cuevas, Angeles, Nacional Medical Science and Nutrition Institute, Mexico, Mexico

Angeles Espinosa-Cuevas,

• Correa-Rotter, Ricardo, Institutor Nacional de la Nutricion, Mexico City, Mexico

Ricardo Correa-Rotter,

Background

Dietary P restriction is major component of hyperphosphatemia treatment in dialysis. Bioavailability of vegetable and animal P sources is not taken in consideration.KDIGO recommends to conduct clinical trials with different sources of dietary P. Aim:assess the effect on serum P of 2 low-Pdiets(<1000mg/day;Animal Vs.vegetal+animal) in dialysis patients.

Methods

Randomized,multicenter,open-label clinical trial.Subjects on dialysis for>6 mo and P>4.5mg/dL were randomized into a mixed-based(3oz equivalent animal protein+3oz equivalent legumes)vs.animal-based(6oz equivalent animal protein) low P diet with equivalent nutrients (protein=1.3 g/kg/d).Primary outcome was the change in serum P after 12 wks. We excluded patients who modified their dialysis dose, phosphate binder or vitamin D prescription during trial.

Results

56 subjects(38HD,18PD) were randomized. Age,sex,phosphate-binders use and other baseline characteristics were similar between groups. Baseline P values were 5.6±1.6 and 4.9±1.2 in mixed-based and animal-based groups respectively(p=0.06). Mixed-based group had a significant decrease in P after 12 wks of intervention(5.6±1.6 to 5.0±1.3,p=0.04).Animal-based group did not change P significantly(4.9±1.2 to 4.7±1.4,p=0.46).Serum P in the mixed-based and animal-based declined by -0.66(95%CI:-1.39 to -0.04)mg/dL and -0.21(95%IC:-0.81 to 0.38) respectively(p=0.14,Fig).There were no differences between groups in the change of other biochemical parameters.

Conclusion

Dietary P restriction with animal or mixed-based P sources had a similar efficacy to achieve and maintain P concentration in dialysis. Mixed-based group had a non-statistically significant trend to achieve a higher decrease in serum P.