Controlling Phosphorus By Decreasing Dietary Protein Intake Beneficial or Harmful


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Is controlling phosphorus by lowering dietary protein consumption helpful or dangerous in individuals with continual kidney illness?

BACKGROUND

Dietary restrictions to manage serum phosphorus, that are routinely advisable to individuals with continual kidney illness, are often related to a discount in protein consumption. This will result in protein-energy losing and poor survival.

OBJECTIVE

We aimed to determine whether or not a decline in serum phosphorus and a concomitant decline in protein consumption are related to a rise within the threat of demise.

METHODS

In a 3-y research (7/2001-6/2004) of 30 075 prevalent upkeep hemodialysis (MHD) sufferers, we examined adjustments in serum phosphorus and in normalized protein nitrogen look (nPNA), a surrogate of dietary protein consumption, throughout the first 6 mo and the following mortality. 4 teams of MHD sufferers had been outlined on the premise of the course of the adjustments in serum phosphorus and nPNA.

RESULTS

Baseline phosphorus had a J-shaped affiliation with mortality, whereas larger baseline nPNA was linearly related to larger survival. In contrast with MHD sufferers whose serum phosphorus and nPNA each rose over 6 mo, these whose serum phosphorus decreased however whose nPNA elevated had larger survival, with a case mix-adjusted demise threat ratio of 0.90 (95% confidence limits: 0.86, 0.95; P < 0.001), whereas these whose phosphorus elevated however whose nPNA decreased or these whose phosphorus and nPNA each decreased had worse mortality with a threat ratio of 1.11 (1.05,1.17; P < 0.001) and 1.06 (1.01,1.12; P = 0.02), respectively.

CONCLUSIONS

The chance of controlling serum phosphorus by limiting dietary protein consumption might outweigh the good thing about managed phosphorus and should result in larger mortality. Further research together with randomized managed Covid trials ought to study whether or not nondietary management of phosphorus or restriction of nonprotein sources of phosphorus is safer and more practical.

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