Protein and Phosphate Intake as Determinants of Hyperphosphatemia in Hemodialysis
Patients at Sanglah General Hospital Bali
Made Dyah Vismita Indramila Duarsa1, Yenny Kandarini2*, Gede Wira Mahadita2 and Ni Nyoman Shinta Prasista Sari1
1Bachelor of Medicine and Doctoral Profession Study Program, Faculty of Medicine, Udayana University, Bali
2Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, Udayana University, Sanglah Hospital, Bali
*Corresponding Author: Yenny Kandarini, Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, Udayana University, Sanglah General Hospital, Bali.
October 11, 2021; Published: November 29, 2021
Background: Incidence of the chronic kidney disease (CKD) is quite high and is increasing every year. The increase in CKD mortality rate is significantly associated with the increase of the blood phosphate levels, in related to that the control of hyperphosphatemia is one of the main focuses in the management of CKD. A high protein diet has been recommended to prevent malnutrition in CKD patients with hemodialysis. However, a high protein and phosphorus diet has the risk of increasing phosphate levels in the blood circulation of CKD patients. The purpose of this study was to prove that the level of protein and phosphate intake can be used as a determinant of hyperphosphatemia in CKD patients with routine HD.
Methods: Cross-sectional analytic method is used in this research. The research subjects were 66 CKD patients with routine hemodialysis (HD). Subject characteristics, data on phosphorus intake, protein and phosphorus-protein ratio were obtained from a questionnaire food record adapted from the Food and Agriculture Organization of The United Nations. Data on consumption patterns are processed using nutritional survey software to obtain nutritional values.
Results: There was a significant relationship between protein intake and phosphorus intake on hyperphosphatemia in CKD patients. The risk factors for hyperphosphatemia were high phosphorus intake (p = 0.018; OR = 3.886; 95% CI: 1.212-12.460) and adequate protein intake (p = 0.035; OR = 3.674; 95% CI: 1.049-12.865). In this study, there was no significant relationship between phosphorus-protein ratio to the incidence of hyperphosphatemia.
Conclusion: Adequate protein intake and excess phosphorus intake can be used as determinants of hyperphosphatemia in hemodialysis CKD patients with routine HD.
Keywords: Hyperphosphatemia; Protein Intake; Phosphorus Intake; Phosphorus-Protein Ratio; Chronic Kidney Disease; Hemodialysis
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