Phosphorus and nutrition in chronic kidney disease
Entity
UAM. Departamento de Medicina; Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD)Publisher
HindawiDate
2012-09-18Citation
10.1155/2012/597605
International Journal of Nephrology 2012 (2012): 597605
ISSN
2090-214XDOI
10.1155/2012/597605Funded by
The authors are supported by FIS PS09/00447, PI10/00072, EUS2008/03565, Fundacion Lilly, cvREMOD, ISCIII-RETIC REDinREN/RD06/0016, Comunidad de Madrid/CIFRA/SBIO0283/ 2006, S2010/BMD-2378, Sociedad Española de Nefrología, ERA-EDTA, Rio Hortega FIS and, Programa Intensificación Actividad Investigadora (ISCIII/Agencia Laın- Entralgo/CM) to A. Ortiz.Project
Comunidad de Madrid. S2010/BMD-2378/CIFRA; Comunidad de Madrid. S2006/BIO-0283/FRACMEditor's Version
http://dx.doi.org/10.1155/2012/597605Subjects
Kidney; Nutrition; Phosphorus; MedicinaRights
© 2012 Emilio González-Parra et al.Abstract
Patients with renal impairment progressively lose the ability to excrete phosphorus. Decreased glomerular filtration of phosphorus
is initially compensated by decreased tubular reabsorption, regulated by PTH and FGF23, maintaining normal serum phosphorus
concentrations. There is a close relationship between protein and phosphorus intake. In chronic renal disease, a low dietary protein
content slows the progression of kidney disease, especially in patients with proteinuria and decreases the supply of phosphorus,
which has been directly related with progression of kidney disease and with patient survival. However, not all animal proteins
and vegetables have the same proportion of phosphorus in their composition. Adequate labeling of food requires showing the
phosphorus-to-protein ratio. The diet in patients with advanced-stage CKD has been controversial, because a diet with too low
protein content can favor malnutrition and increase morbidity and mortality. Phosphorus binders lower serum phosphorus and
also FGF23 levels, without decreasing diet protein content. But the interaction between intestinal dysbacteriosis in dialysis patients,
phosphate binder efficacy, and patient tolerance to the binder could reduce their efficiency.
Files in this item
Google Scholar:González-Parra, Emilio
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Gracia-Iguacel, Carolina
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Egido, Jesús
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Ortiz Arduán, Alberto
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