VALIDITY OF PHOSPHORUS INTAKE ASSESSMENT TOOLS IN CHRONIC KIDNEY DISEASE AND DIALYSIS POPULATIONS

 

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https://storage.unitedwebnetwork.com/files/1099/663bf1233d40ce465b67beae5fcf3c85.pdf
VALIDITY OF PHOSPHORUS INTAKE ASSESSMENT TOOLS IN CHRONIC KIDNEY DISEASE AND DIALYSIS POPULATIONS

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Ana Catalina
Alvarez Elias
Ana Catalina Alvarez Elias anacatalina.alvarezelias@rriny.com Fresenius Medical Care Clinical Research - PCOR New York United States * United States United States
Krister Cromm krister.cromm@freseniusmedicalcare.com Fresenius Medical Care Clinical Research - PCOR Frankfurt Germany -
Ngoc Pham ngoc.pham@freseniusmedicalcare.com Fresenius Medical Care Clinical Research - PCOR Frankfurt Germany -
Giovanni Strippoli gfmstrippoli@gmail.com University of Bari 4. Department of Precision and Regenerative Medicine and Jonian Area Bari Italy -
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Managing hyperphosphatemia in chronic and end-stage kidney disease patients requires accurate dietary assessment of phosphorus intake. Clinicians often rely on self-reported data, which may be prone to error. We are summarizing existing evidence from studies evaluating the reliability and validity of phosphorus intake assessment tools in people with chronic kidney disease or on any type of dialysis.

We performed a literature search in PubMed and Google Scholar from inception to April 2025, using MeSH terms for “food frequency”, “dietary recall”, “phosphate”, “chronic kidney disease”, “end-stage kidney disease” “dialysis”, “surveys” and “questionnaires”. We included studies with assessment of either validity or reliability of the tools. Data was summarized descriptively reporting quantitative measurements.

We identified 5 studies (543 patients). Key characteristics of the studies included and their implications for clinical use are reported in the table.  All studies were from different countries.  Participants were older than 18 years. Four studies included people on at least one dialysis modality, while one study only included people with moderate to advanced chronic kidney disease but no dialysis patients. The tools comprised food frequency questionnaires (FFQs), short FFQs (SFFQs), and phosphorus knowledge instruments combined with food intake report. Two studies used self-administered tools. All studies found weak to moderate correlations between dietary intake and serum phosphorus or nutrient biomarkers, with questionnaire formats ranging from 31 to 154 food items.

Despite being practical for use in outpatient settings, all tools in this review showed some accuracy limitations, especially among elderly or multi-morbid populations. Moreover, literature addressing the accuracy of self-reported intake warns of systematic underreporting, particularly among patients with advanced disease or lower health literacy. For nephrologists, this implies a need for cautious interpretation of patient-reported phosphorus intake and consideration of supplemental strategies—such as biochemical monitoring, dietitian interviews, or digital tracking—for more accurate dietary evaluation.  We are currently converting this analysis into a systematic review using world class methods of all available unbiased evidence.

The present abstract was presented at the European Renal Association Meeting 2025 in Vienna

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