Portal de Periódicos da CAPES

The hidden and complex relationship between dietary phosphorus and malnutrition in hemodialysis patients with chronic kidney disease

2023; De Gruyter; Volume: 62; Issue: 1 Linguagem: Inglês

10.2478/rjim-2023-0029

2501-062X

Clonia Milla, Widodo Widodo, Teddy Heri Wardhana,

Dialysis and Renal Disease Management

Abstract Introduction: Chronic kidney disease (CKD) has always been a complicated global challenge, ranking as the 12th leading cause of death worldwide. Hemodialysis, being one of the most opted renal replacement therapies (RRTs) for patients with end-stage renal disease (ESRD), still possesses some limitations in preventing complications, such as malnutrition and mineral bone disease (CKD-MBD). While efforts have focused on controlling CKD-MBD parameters like calcium and phosphate, less attention has been given to dietary interventions. Moreover, the adoption of low-phosphorus diets for hemodialysis patients is very complex due to potential conflicts with the guideline-recommended high-protein dietary approach. This study sought to investigate the relationship between dietary phosphorus intake and nutritional status in CKD patients undergoing regular hemodialysis. Method: This non-randomized cross-sectional study comprising 88 patients was conducted at the Hemodialysis Unit, RSUD Dr. Soetomo, Surabaya, East Java, using a three-day dietary record in March 2022. Relationships between variables were analyzed using Spearman and ANOVA tests. Result: No significant positive association was found between dietary calcium with corrected calcium levels (p = 0.988; r s = −0.002) and between dietary phosphorus with plasma phosphate levels (p = 0.082; r s = 0.187). However, Spearman's analysis revealed a weak but positive correlation between dietary phosphorus and nutritional status (p = 0.022; r s = 0.215*). Conclusion: Our study highlights a positive relationship between dietary phosphorus and nutritional status among hemodialysis patients, offering insights into potential strategies for optimizing patient care and outcomes.