title: Improving diet recipe and cooking methods attenuates hyperphosphatemia in patients undergoing peritoneal dialysis.
abstract: OBJECTIVE
  Hyperphosphatemia is an independent predictor for cardiovascular and all-cause mortality in patients undergoing peritoneal dialysis (PD). The study aimed to investigate the effect of dietary intervention on reducing serum phosphate concentration in hyperphosphatemic PD patients.
  
  
  RESULTS
  In this single-center clinical trial, 97 prevalent PD patients with serum phosphate concentration ≥ 1.6 mmol/l were allocated to the intervention (n = 48) or control (n = 49) group and followed up for 1 year. In addition to phosphate binder (calcium carbonate) therapy, patients in the intervention group were intensively educated to reduce phosphate-rich food intake and improve cooking methods. While stable in the control group (1.97 ± 0.20 to 1.94 ± 0.35 mmol/l, p > 0.05), the serum phosphate concentration decreased significantly in the intervention group (1.98 ± 0.28 to 1.65 ± 0.33 mmol/l, p = 0.015) concurrently with the drop in dietary phosphate intake (13.03 ± 3.39 to 10.82 ± 3.00 mg/kg ideal body weight/day, p = 0.001). Moreover, after 6 months of intervention, fewer patients needed to use calcium carbonate (from 64.6% to 41.5%, p = 0.029) and the medicine dose reduced significantly (from 2.25 (0, 3.94) to 0 (0, 1.50) g/day, p < 0.001).
  
  
  CONCLUSIONS
  Our data indicated that intensive dietary intervention of reducing phosphate-rich food intake and improving cooking methods attenuated hyperphosphatemia in PD patients. It suggests that regular assessment of dietary phosphate intake and modification of diet recipe and cooking methods are essential for hyperphosphatemia treatment in PD patients in addition to phosphate binder therapy.
authors.affiliation: Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai, PR China.
authors.forename: N
authors.initials: N
authors.lastname: Jiang
authors.affiliation: Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai, PR China.
authors.forename: W
authors.initials: W
authors.lastname: Fang
authors.affiliation: Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai, PR China.
authors.forename: A P
authors.initials: AP
authors.lastname: Gu
authors.affiliation: Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai, PR China.
authors.forename: J Z
authors.initials: JZ
authors.lastname: Yuan
authors.affiliation: Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai, PR China.
authors.forename: X X
authors.initials: XX
authors.lastname: Yang
authors.affiliation: Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai, PR China.
authors.forename: A W
authors.initials: AW
authors.lastname: Lin
authors.affiliation: Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai, PR China.
authors.forename: Z H
authors.initials: ZH
authors.lastname: Ni
authors.affiliation: Department of Nephrology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Center for Peritoneal Dialysis Research, Shanghai, PR China. Electronic address: jiaqiqian@126.com.
authors.forename: J Q
authors.initials: JQ
authors.lastname: Qian
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002118:Calcium / Q000097:blood; D002119:Calcium Carbonate / Q000627:therapeutic use; D003296:Cooking; D004032:Diet; D005260:Female; D006801:Humans; D054559:Hyperphosphatemia / Q000178:diet therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010710:Phosphates / Q000008:administration & dosage / Q000097:blood; D016226:Phosphorus, Dietary / Q000008:administration & dosage; D011446:Prospective Studies; D012709:Serum Albumin / Q000378:metabolism; D055815:Young Adult
chemical_list: D010710:Phosphates; D016226:Phosphorus, Dietary; D012709:Serum Albumin; D002119:Calcium Carbonate; D002118:Calcium
keywords: Cooking method; Dietary intervention; Dietary phosphate intake; Hyperphosphatemia; Peritoneal dialysis