Kido Shinsuke, Nomura Kengo, Sasaki Shohei, Shiozaki Yuji, Segawa Hiroko, Tatsumi Sawako
Department of Molecular Nutrition, University of Tokushima Graduate School, Japan.
Clin Calcium. 2012 Oct;22(10):1583-91.
Hyperphosphatemia is a common disorder in patients with chronic kidney disease (CKD) , and may result in hyperparathyroidism and renal osteodystrophy. Hyperphosphatemia also may contribute to deterioration vascular calcification and increase mortality. Hence, correction and prevention of hyperphosphatemia is a main component of the management of CKD. This goal is usually approached both by administering phosphorus binders and by restricting dietary phosphorus (P) intake. Dietary intake of phosphorus (P) is derived largely from foods with high protein content or food additives and is an important determinant of P balance in patient with CKD. Food additives (PO4) can dramatically increase the amount of P consumed in the daily diet, especially because P is more readily absorbed in its inorganic form. In addition, information about the P content and type in prepared foods is often unavailable or misleading. Therefore, during dietary counseling of patients with CKD, we recommended that they consider both the absolute dietary P content and the P-to-protein ratio of foods and meals including food additives.
高磷血症是慢性肾脏病（CKD）患者的常见病症，可能导致甲状旁腺功能亢进和肾性骨营养不良。高磷血症还可能促使血管钙化恶化并增加死亡率。因此，纠正和预防高磷血症是CKD管理的主要组成部分。这一目标通常通过服用磷结合剂和限制饮食中磷（P）的摄入量来实现。饮食中磷（P）的摄入主要来自高蛋白含量的食物或食品添加剂，并且是CKD患者磷平衡的重要决定因素。食品添加剂（PO4）可显著增加日常饮食中磷的摄入量，特别是因为磷以无机形式更容易被吸收。此外，关于加工食品中磷含量和类型的信息通常无法获取或具有误导性。因此，在对CKD患者进行饮食咨询时，我们建议他们既要考虑食物和膳食（包括食品添加剂）中磷的绝对含量，也要考虑磷与蛋白质的比例。
