Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Department of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Medicine (RMH), The University of Melbourne, Parkville, Victoria, Australia; Department of Nephrology, Western Health, St Albans, Victoria, Australia.
J Ren Nutr. 2021 Mar;31(2):155-163. doi: 10.1053/j.jrn.2020.02.007. Epub 2020 May 25.
Dietary phosphate modification is a common therapy to treat hyperphosphatemia in individuals with chronic kidney disease (CKD). However, current dietary intake and common food sources of phosphate typically consumed by individuals with CKD are not well characterized. This study examined a cohort of CKD patients to determine total dietary intake and common food sources of phosphate, including phosphate additives.
Participants with CKD stages 3b and 4 recruited to a substudy of the "IMPROVE-CKD (IMpact of Phosphate Reduction On Vascular End-points in Chronic Kidney Disease) Study" completed a 7-day self-administered diet record at baseline. Diet histories were analyzed and daily phosphate intakes determined using FoodWorks V.9 (Xyris). The proportion of phosphate contributed by each food group was determined using the AUSNUT 2011-2013 Food Classification System. Ingredient lists of packaged food items consumed were reviewed to determine frequency of phosphate-based additives.
Ninety participants (mean eGFR 26.5 mL/min/1.73 m) completed this substudy. Mean phosphate intake of participants was 1544 ± 347 mg/day, with 96% of individuals exceeding the recommended daily intake of phosphate (1000 mg/day). The highest sources of dietary phosphate were milk-based products (25%) and meat and poultry products/dishes (25%). Phosphate-based food additives were identified in 39% (n = 331/845) of packaged foods consumed by participants.
Dietary phosphate intakes of Australians with CKD are high and come from a variety of sources. Managing dietary phosphate intake requires a patient-centered, tailored approach with an emphasis on maintaining nutritional adequacy and awareness of phosphate additives.
饮食磷酸盐改性是治疗慢性肾脏病（CKD）患者高磷酸盐血症的常用疗法。然而，目前CKD 患者的饮食摄入量和常见的磷酸盐食物来源尚未得到很好的描述。本研究检查了一组 CKD 患者，以确定总饮食摄入和常见的磷酸盐食物来源，包括磷酸盐添加剂。
招募到“改善 CKD（磷酸盐减少对慢性肾脏病血管终点的影响）研究”子研究的 CKD 3b 和 4 期患者在基线时完成了为期 7 天的自我管理饮食记录。分析饮食史并使用 FoodWorks V.9（Xyris）确定每日磷酸盐摄入量。使用 AUSNUT 2011-2013 食品分类系统确定每个食物组贡献的磷酸盐比例。审查食用的包装食品的成分清单，以确定基于磷酸盐的添加剂的频率。
90 名参与者（平均 eGFR 26.5 mL/min/1.73 m）完成了这项子研究。参与者的平均磷酸盐摄入量为 1544 ± 347 mg/天，96%的个体超过了推荐的每日磷酸盐摄入量（1000 mg/天）。饮食中磷酸盐的主要来源是乳基产品（25%）和肉类和家禽产品/菜肴（25%）。在参与者食用的 845 种包装食品中，有 39%（n = 331/845）发现了基于磷酸盐的食品添加剂。
澳大利亚 CKD 患者的饮食磷酸盐摄入量较高，且来源广泛。管理饮食磷酸盐摄入量需要以患者为中心，采用个性化方法，重点是保持营养充足和注意磷酸盐添加剂。
