Association of Dietary Phosphorus Intake with Serum Phosphate: An Observational Study in Maintenance of Hemodialysis Patients

Hyperphosphatemia increases mortality in chronic kidney disease (CKD) patients on maintenance hemodialysis (MHD). Hyperphosphatemia in MHD patients is affected by diet and phosphate binders treatment. Thus, we undertook observational research to determine how dietary phosphorus consumption and phosphate binders adherence affect serum phosphate and phosphorus-to-protein ratio (PPR) in MHD. Associations of serum phosphate were examined with identified dietary patterns, organic (plant and animal-based) and inorganic, and whether the patients fully or partially adhered to the phosphate binders. We found a significant difference in phosphate binders on animal and plant sources, high with the animal pattern. However, our study showed no significant correlation in serum phosphate levels. This result could be due to phosphate bioavailability differing by food source and adherence of phosphate binders, which reflect the quantity of phosphate absorbed in the intestines. However, further mechanistic study is warranted. Keywords: Dietary phosphorus, Maintenance hemodialysis, Serum phosphate, Phosphorus­to­protein ratio