Differences in phosphatemia and frequency of consumption of dietary sources of phosphorus in hemodialysis patients in southern and northern Brazil

Abstract

Introduction: Hyperphosphatemia is associated with unfavorable outcomes, and the percentage of patients presenting with this condition in hemodialysis (HD) in kidney foundation units in the state of Santa Catarina (SC) is historically higher than that of patients in the state of Tocantins (TO). Objective: To assess the frequency of consumption of the main dietary sources of phosphorus and to compare them between the two states. Methodology: A cross-sectional study was carried out involving 123 patients, 66 of SC and 57 of TO: 52% were men, average age was 46.9 ± 15.7 years, and mean HD time 48 (57-71) months. A food frequency questionnaire (FFQ) with 33 items that are dietary sources of phosphorus was applied. A consumption score was calculated for sources of organic, inorganic, and total phosphorus, and the six-month average of phosphatemia was obtained. Results: The mean phosphatemia of SC patients was higher (6.2 ± 1.5 vs 4.7 ± 1.3 mg/dL, p <0001) than TO patients, as well as the prevalence of hyperphosphatemia (62% vs 28%; p <10001). In the total sample, the foods most frequently consumed were milk and beans. Comparing the frequency of consumption between the two states, a significant difference was found in 17 items. In TO, beef and beans were the foods most frequently consumed, and in SC, fourteen other items of the FFQ (pork, sausages, dairy products, etc.) were the most frequently consumed. Phosphatemia correlated with the frequency of consumption of inorganic phosphorus sources. Conclusion: the frequency of consumption of several items was different between the states, and this explains the differences in phosphatemia between the two regions.

Diet in Chronic Kidney Disease: an integrated approach to nutritional therapy

“…51 After evaluating the influence of foods sources of organic or inorganic phosphorus on the phosphatemia of patients under HD, only inorganic phosphorus was associated with hyperphosphatemia. 52 Thus, encouraging greater consumption of in natura and minimally processed foods, instead of processed ones, is a good strategy to control phosphatemia. This also contributes to the reduction of sodium intake and improves dietary quality.…”

Low-Phosphate Processed Cheese Diminishes Diclofenac-Induced Hepato-Renal Injury in Male Rats

“…The consumption of a high amount of sodium in human nutrition is considered a risk factor for numerous diseases (Palar & Sturm, 2009), mainly hypertension and cardiovascular disease (He & MacGregor, 2007). On the other hand, the excessive consumption of phosphorus or kidney dysfunction has been linked to hyperphosphatemia (Nerbass et al, 2019). The term "hyperphosphatemia" refers to the occurrences of elevated concentration of phosphate in the blood which may lead to the development of calcium deposits in the soft tissue.…”

Prevalência de hiperfosfatemia e consumo de fósforo em portadores de doença renal crônica em tratamento hemodialítico em um município brasileiro de médio porte

“…4 Uma restrição importante na doença é a do fósforo, que quando aumentado pode desencadear complicações mineral-ósseas, além de elevar as taxas de mortalidade. 5 A concentração elevada de fósforo sérico (hiperfosfatemia) na doença renal crônica está associada a maior progressão, aumento do risco de mortalidade e maior taxa de acidentes cardiovasculares. 6 A problemática pode decorrer da ineficiência do tratamento e, portanto, requer algumas estratégias para contornar o problema.…”

“…6 A problemática pode decorrer da ineficiência do tratamento e, portanto, requer algumas estratégias para contornar o problema. 5,7 A hiperfosfatemia apresenta grande risco para comorbidades, mas pode ser solucionada com estratégias simples, por meio de alimentação equilibrada, uso de quelantes e realização periódica de sessões de hemodiálise. 8 Apesar das estratégias disponíveis, a prevalência de hiperfosfatemia é elevada nesses pacientes.…”

“…8 Apesar das estratégias disponíveis, a prevalência de hiperfosfatemia é elevada nesses pacientes. Estudo realizado por Nerbass et al 5 em Santa Catarina e no Tocantins mostrou que a prevalência de hiperfosfatemia em unidades de hemodiálise foi de 62% e 28%, respectivamente.…”