| Theme |
The appropriate management for CKD-MBD in the elderly patients |
| Title |
Evaluation of phosphate kinetics in hemodialysis patients by estimating the amount of phosphate removal and absorption |
| Author |
Hiroshi Kikuchi |
Internal Medicine, Toyosaka Hospital |
| Author |
Hisaki Shimada |
Kidney Center, Shinraku-en Hospital |
| Author |
Ryo Karasawa |
Internal Medicine, Toyosaka Hospital |
| Author |
Masashi Suzuki |
Kidney Center, Shinraku-en Hospital |
| [ Summary ] |
An excess of phosphate is a major risk factor for death in hemodialysis patients. Currently, predialytic phosphate concentration has been used as the only guide for understanding phosphate metabolism. We proposed that estimation of the amount of phosphate removal could be useful for evaluating phosphate metabolism. In addition, we established a simple method for the accurate estimation of phosphate removal. Because phosphate mass balance is maintained, almost the same amount of phosphate absorbed through the intestine is eliminated through hemodialysis. Therefore, estimating the amount of phosphate removal provides an estimate of the amount of phosphate absorption. Using the estimation of phosphate removal, we can evaluate the effect of phosphate binders, over-intake of inorganic phosphate, diet therapy, and other factors. Additionally, we evaluated protein and phosphate intake in hemodialysis patients. Low neutralized protein catabolic rate, low intake of protein, and low absorption of phosphate were observed in elderly patients. On the other hand, young patients were suggested to have over-intake of inorganic phosphate. |