Sczip Andrea C, Morais Jyana G, Calegari Adaiane, Kruger Tatiana S, Oliveira Jorgiane C, Scatone Natália K, Dos Santos Rafaela G, Barreto Fellype C, Nerbass Fabiana B
Departamento de Clínica Médica, Programa de Pós-Graduação em Medicina Interna e Ciências da Saúde, Universidade Federal do Paraná, Curitiba, Paraná, Brazil; Centro de Tratamento de Doenças Renais, Mafra, Santa Catarina, Brazil.
Fundação Pró-Rim, Joinville, Santa Catarina, Brazil.
J Ren Nutr. 2025 Jul 21. doi: 10.1053/j.jrn.2025.07.007.
We aimed to investigate the role of dietary diversity of unprocessed and minimally processed foods and the intake of ultraprocessed foods (UPFs), along with their respective phosphorus source subgroups, in hyperphosphatemia among patients on chronic hemodialysis.
This is a secondary analysis of a multicenter cross-sectional study conducted in seven dialysis units in Southern Brazil. Two validated questionnaires were used: a dietary diversity questionnaire to assess the intake of unprocessed and minimally processed foods, and a UPFs consumption questionnaire to evaluate the intake of UPFs. Dietary intake was assessed on 2 separate days-1 dialysis day and 1 nondialysis day. From these instruments, scores were calculated for overall dietary diversity, total UPFs consumption, and phosphorus sources subgroups.
A total of 297 patients participated (age: 52.1 ± 14.1 years; 57.9% men; 42% with hyperphosphatemia). While unprocessed and minimally processed phosphorus sources were more commonly consumed, multivariate analysis revealed that UPFs, particularly those from animal-based sources, were independently associated with hyperphosphatemia. Each one-point increase in intake of UPFs scores corresponded to an increased likelihood of hyperphosphatemia: 25% for total UPF, 76% for animal-based UPFs, and 24% for other UPF sources.
Our findings indicate that although phosphorus sources from UPFs were consumed less frequently than those from unprocessed and minimally processed foods, consumption of UPFs-especially those from animal-based sources-was an independent determinant of hyperphosphatemia. These results highlight the need for dietary interventions that prioritize healthy food choices in the management of hyperphosphatemia.
我们旨在研究未加工和最低限度加工食品的饮食多样性以及超加工食品（UPF）的摄入量，以及它们各自的磷源亚组，在慢性血液透析患者高磷血症中的作用。
这是对在巴西南部七个透析单位进行的多中心横断面研究的二次分析。使用了两份经过验证的问卷：一份饮食多样性问卷，用于评估未加工和最低限度加工食品的摄入量；一份UPF消费问卷，用于评估UPF的摄入量。在2个不同的日子评估饮食摄入量——1个透析日和1个非透析日。从这些工具中，计算出总体饮食多样性、UPF总消费量和磷源亚组的得分。
共有297名患者参与（年龄：52.1±14.1岁；57.9%为男性；42%患有高磷血症）。虽然未加工和最低限度加工的磷源消费更为普遍，但多变量分析显示，UPF，尤其是来自动物源的UPF，与高磷血症独立相关。UPF得分每增加1分，高磷血症的可能性就增加：总UPF增加25%，动物源UPF增加76%，其他UPF来源增加24%。
我们的研究结果表明，虽然UPF中的磷源消费频率低于未加工和最低限度加工食品中的磷源，但UPF的消费——尤其是来自动物源的UPF——是高磷血症的独立决定因素。这些结果凸显了在高磷血症管理中优先选择健康食品的饮食干预措施的必要性。
