title: Dietary egg whites for phosphorus control in maintenance haemodialysis patients: a pilot study.
abstract: BACKGROUND
  High dietary protein intake is associated with greater survival in maintenance haemodialysis (MHD) patients. High-protein foods may increase dietary phosphorus burden, which is associated with increased mortality in these patients. Hypothesis is: an egg white based diet with low phosphorus to protein ratio (<1.4 mg/g) will lower serum phosphorus without deteriorating the nutritional status in MHD patients.
  
  
  OBJECTIVE
  We assessed serum phosphorus and albumin levels in MHD patients who agreed to ingest one meal per day with pasteurised liquid egg whites without phosphorus additives, as principal protein source.
  
  
  METHODS
  Thirteen otherwise stable MHD patients with serum phosphorus >4.0 mg/dl agreed to consume eight ounces (225 g) of pasteurised liquid egg whites one meal per day for six weeks. Recipes were suggested to improve diet variety.
  
  
  RESULTS
  Thirteen participating patients included seven women, three African Americans and five diabetics. Twelve patients exhibited drop in serum phosphorus. Mean population fall in serum phosphorus was 0.94 mg/dl, i.e. from 5.58 ± 1.34 (mean ± SD) to 4.63 ± 1.18 (p = 0.003). Serum albumin showed an increase by 0.19 g/dl, i.e. from 4.02 ± 0.29 to 4.21 ± 0.36 g/dl (p = 0.014). Changes in phosphorus pill count were not statistically significant (p = 0.88). The egg white diet was well tolerated, and recipe variety appreciated.
  
  
  CONCLUSIONS
  Pasteurised liquid egg whites may be an effective diet component lowering serum phosphorus without risking malnutrition. Controlled trials are indicated to examine egg white based dietary interventions in MHD patients at home or during haemodialysis treatment.
authors.affiliation: DaVita Carroll County Dialysis, Westminster, MD, USA.
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Taylor
authors.forename: Kamyar
authors.initials: K
authors.lastname: Kalantar-Zadeh
authors.forename: Theodore
authors.initials: T
authors.lastname: Markewich
authors.forename: Sara
authors.initials: S
authors.lastname: Colman
authors.forename: Debbie
authors.initials: D
authors.lastname: Benner
authors.forename: John J
authors.initials: JJ
authors.lastname: Sim
authors.forename: Csaba P
authors.initials: CP
authors.lastname: Kovesdy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004044:Dietary Proteins / Q000008:administration & dosage*; D004529:Egg White; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000178:diet therapy* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010758:Phosphorus / Q000097:blood*; D010865:Pilot Projects; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis
chemical_list: D004044:Dietary Proteins; D012709:Serum Albumin; D010758:Phosphorus