Randomized Trial of Acute Changes in Plasma Phosphate After Phosphorus-Standardized Meals in Peritoneal Dialysis

Hyperphosphatemia is associated with increased morbidity and mortality in patients with chronic kidney disease. The aim of this study was to assess whether a meal with high phosphorus content would affect plasma phosphate in the hours that follow among subjects with end-stage kidney disease on perit...

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Bibliographic Details
Published in:	Kidney international reports Vol. 6; no. 2; pp. 304 - 312
Main Authors:	Lundin, Martin Thorbjørn, Bressendorff, Iain, Kristensen, Bent, Jørgensen, Niklas Rye, Butt, Rizwan, Hansen, Ditte
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-02-2021 Elsevier
Subjects:	Clinical Research end-stage kidney disease mineral metabolism nutrition peritoneal dialysis phosphate phosphorus phosphate nutrition peritoneal dialysis end-stage kidney disease mineral metabolism phosphorus
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Summary:	Hyperphosphatemia is associated with increased morbidity and mortality in patients with chronic kidney disease. The aim of this study was to assess whether a meal with high phosphorus content would affect plasma phosphate in the hours that follow among subjects with end-stage kidney disease on peritoneal dialysis. This was a single-blinded randomized cross-over trial of 12 subjects on maintenance peritoneal dialysis, in which subjects were randomized to consume a meal with either high or low phosphorus content on 2 separate trial days. On each trial day, plasma phosphate was measured immediately before consumption of the standardized meal and after 1, 2, 3, and 5 hours. The mean fasting plasma phosphate at baseline was 1.69 ± 0.22 mmol/l. Plasma phosphate was similar between the 2 meals at baseline, as well as at 1, 2, 3, and 5 hours after consumption. The largest observed difference in plasma phosphate between the 2 meals was 0.15 mmol/l, which occurred 5 hours after consumption (high-phosphorus meal 1.75 ± 0.32 mmol/l vs. low-phosphorus meal 1.60 ± 0.14 mmol/l (P = 0.06)). Using summary analyses for repeated measures, we observed a significant difference in the plasma phosphate between the 2 meals (P = 0.03). Our results show that in subjects with end-stage kidney disease, a meal with high phosphorus content has only a negligible effect on plasma phosphate compared to a meal with low phosphorus content. Thus, large increases in plasma phosphate cannot be accounted for by a high intake of phosphorus in the hours before blood sampling. [Display omitted]
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2468-0249 2468-0249
DOI:	10.1016/j.ekir.2020.11.003