Maimonides Institute for Biomedical Research of Cordoba (IMIBIC), University of Cordoba, Nephrology Service, Reina Sofia University Hospital, 14004 Cordoba, Spain.
Spanish Renal Research Network (REDinREN), Institute of Health Carlos III, 28029 Madrid, Spain.
Nutrients. 2021 Jan 20;13(2):292. doi: 10.3390/nu13020292.
In chronic kidney disease (CKD) patients, it would be desirable to reduce the intake of inorganic phosphate (P) rather than limit the intake of P contained in proteins. Urinary excretion of P should reflect intestinal absorption of P(inorganic plus protein-derived). The aim of the present study is to determine whether the ratio of urinary P to urinary urea nitrogen (P/UUN ratio) helps identify patients with a high intake of inorganic P.A cross-sectional study was performed in 71 patients affected by metabolic syndrome with CKD (stages 2-3) with normal serum P concentration. A 3-day dietary survey was performed to estimate the average daily amount and the source of P ingested. The daily intake ofPwas1086.5 ± 361.3mg/day; 64% contained in animal proteins, 22% in vegetable proteins, and 14% as inorganic P. The total amount of P ingested did not correlate with daily phosphaturia, but it did correlate with the P/UUN ratio ( < 0.018). Patients with the highest tertile of the P/UUN ratio >71.1 mg/g presented more abundant inorganic P intake ( < 0.038).The P/UUN ratio is suggested to be a marker of inorganic P intake. This finding might be useful in clinical practices to identify the source of dietary P and to make personalized dietary recommendations directed to reduce inorganic P intake.
在慢性肾脏病(CKD)患者中,减少无机磷(P)的摄入而不是限制蛋白质中所含的 P 摄入可能是理想的。尿磷排泄应反映肠道对 P(无机和蛋白衍生)的吸收。本研究的目的是确定尿磷与尿尿素氮(P/UUN 比值)的比值是否有助于确定高无机 P 摄入的患者。
对 71 例患有代谢综合征伴 CKD(2-3 期)且血清 P 浓度正常的患者进行了横断面研究。进行了 3 天饮食调查以估计摄入的 P 平均日摄入量和来源。P 的日摄入量为 1086.5 ± 361.3mg/天;64%存在于动物蛋白中,22%存在于植物蛋白中,14%为无机 P。摄入的总磷量与每日磷排泄量无关,但与 P/UUN 比值相关(<0.018)。P/UUN 比值最高 tertile(>71.1mg/g)的患者无机 P 摄入量更多(<0.038)。
建议 P/UUN 比值是无机 P 摄入的标志物。这一发现可能有助于临床实践中确定饮食 P 的来源,并制定针对减少无机 P 摄入的个性化饮食建议。