| [ Summary ] |
The relationship between serum phosphate level and mortality risk has been reported primarily in maintenance hemodialysis patients. Recently, this relationship has been reported in predialysis patients and even in non-CKD patients. The clinical significance of control of serum phosphate level has been emphasized in the CKD-MBD guideline of the Japanese Society for Dialysis Therapy. Additionally, advanced age and increase in diabetes mellitus may lead to an increased incidence of malnutrition in CKD patients. Because dietary phosphorus intake is associated with dietary protein intake, dietary phosphorus restriction may result in dietary protein restriction. Observational studies indicate that decreased dietary protein intake may be associated with poor survival in hemodialysis patients. Accordingly, it is necessary to when selecting food, to take into consideration both the phosphate to protein ratio and the bioavailability of phosphorus. In particular, food additives containing large amounts of inorganic phosphorus should be restricted. |