PHOSPHATE LOWERING EFFECT OF PLANT-BASED DIET IN END-STAGE KIDNEY DISEASE WITH CHRONIC HYPERPHOSPHATEMIC HEMODIALYSIS PATIENTS : A RANDOMIZED CONTROL TRIAL

 

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https://storage.unitedwebnetwork.com/files/1099/aeedc7c875060e5dfd2a69ff0a0a355c.pdf
PHOSPHATE LOWERING EFFECT OF PLANT-BASED DIET IN END-STAGE KIDNEY DISEASE WITH CHRONIC HYPERPHOSPHATEMIC HEMODIALYSIS PATIENTS : A RANDOMIZED CONTROL TRIAL

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Krit
Tipchaichatta
Krit Tipchaichatta krit.tip@pcm.ac.th Phramongkutklao Hospital and College of Medicine Department of Medicine Bangkok Thailand *
Amnart Chaiprasert achaiprasert@hotmail.com Phramongkutklao Hospital and College of Medicine Department of Medicine Bangkok Thailand -
Narongrit Siriwattanasit psy_chodoctor@hotmail.com Phramongkutklao Hospital and College of Medicine Department of Medicine Bangkok Thailand -
Pitchamon Inkong beaupitchamon@gmail.com Phramongkutklao Hospital and College of Medicine Department of Medicine Bangkok Thailand -
Narittaya Varothai narittarya.nga@gmail.com Phramongkutklao Hospital and College of Medicine Department of Medicine Bangkok Thailand -
Theerasak Tangwonglert kt_pcm25@hotmail.com Phramongkutklao Hospital and College of Medicine Department of Medicine Bangkok Thailand -
Naowanit Nata naowanitnata@yahoo.com Phramongkutklao Hospital and College of Medicine Department of Medicine Bangkok Thailand -
Samitti Chotsriluecha samitti.ch@gmail.com Phramongkutklao Hospital and College of Medicine Department of Medicine Bangkok Thailand -
Bancha Satirapoj satirapoj@yahoo.com Phramongkutklao Hospital and College of Medicine Department of Medicine Bangkok Thailand -
Ouppatham Supasyndh ouppatham@hotmail.com Phramongkutklao Hospital and College of Medicine Department of Medicine Bangkok Thailand -
 
 
 
 
 

Chronic hyperphosphatemia leads to increased mortality in maintenance hemodialysis (MHD) patients. While both plant-based (PB) and animal-based (AB) proteins contain phosphorus, the presence of phytate in plant sources may offer a unique advantage by reducing intestinal absorption of this mineral.  Limited evidence exists on whether PB protein, compared to AB protein, can better control phosphate levels among this population.

This randomized, controlled, cross-over trial enrolled MHD patients with chronic hyperphosphatemia. Participants were randomly assigned to consume either PB or AB protein for 2 weeks, with a 2-week washout between interventions. Serum phosphate, electrolytes, pre-albumin, dietary intake, and muscle mass were assessed through the study. The main outcome was mean change in serum phosphate level.

Average nutrient intake during the study assessed through a 3-day dietary recordTotal of 201 patients were screened, of whom 12 MHD patients were enrolled in the studied. Both groups consumed similar protein intake (1.24 vs. 1.15 g/kg/day, P=0.185), but the PB group had significantly higher phosphate intake (920 vs. 621 mg/day, P<0.001). At the end of the study, a significantly lower proportion of patients in the PB group had serum phosphate levels below 5 mg/dL, which is considered optimal for this population (50% vs. 8.3%, P=0.025). Additionally, the mean change in serum phosphate level was significantly lower in the PB group compared to the AB group (-1.34±1.8 vs. -0.24±1.32 mg/dL, P=0.041). No significant differences in the mean change of electrolytes, prealbumin, and muscle mass were observed between groups.

In conclusions, this study suggests that PB protein consumption may be a promising strategy for managing hyperphosphatemia in dialysis patients without compromising other aspects of health. 

Kewords