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Phosphorus Additives and Albuminuria in Early Stages of CKD: A Randomized Controlled Trial.

ABSTRACT: Little is known about the effects of phosphorus additives on patients with kidney disease.Randomized, double-blind, crossover trial.31 adults with early stages of presumed chronic kidney disease (estimated glomerular filtration rate ? 45mL/min/1.73m2; urine albumin-creatinine ratio sex-specific cutoff points: men ? 17mg/g, women ? 25mg/g).Higher versus lower phosphorus intake for 3 weeks. Higher phosphorus intake was achieved by the addition of commercially available diet beverages and breakfast bars to diet.Change in 24-hour urine albumin excretion and plasma fibroblast growth factor 23 level.Two 24-hour urine collections and a single fasting blood draw at the end of each period.Mean baseline values for phosphorus intake, 24-hour urine phosphorus excretion, and estimated glomerular filtration rate were 1,113±549 (SD) mg/d, 688±300mg/d, and 74.6±22.0mL/min/1.73m2. Median urine albumin excretion of 82.7 (IQR, 39.6-174.1) mg/d. Although phosphorus intake from study products increased by 993mg/d (P<0.001) during the higher compared to lower phosphorus additive period, background phosphorus intake decreased by 151mg/d (P=0.004). Higher phosphorus additive consumption increased 24-hour urine phosphorus excretion by 505 (95% CI, 381 to 629) mg/d (P<0.001), but did not significantly increase albuminuria (higher vs lower: 14.3%; 95% CI, -2.5% to 34.0%; P=0.1) or fibroblast growth factor 23 level (higher vs lower: 3.4%; 95% CI, -5.9% to 13.6%; P=0.4).Small sample size, short duration of intervention, changes in background diet during the intervention.A 3-week consumption of higher phosphorus food additives did not significantly increase albuminuria. Further studies are needed to confirm these results.

SUBMITTER: Chang AR

PROVIDER: S-EPMC5263092 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Phosphorus Additives and Albuminuria in Early Stages of CKD: A Randomized Controlled Trial.

Chang Alex R AR Miller Edgar R ER Anderson Cheryl A CA Juraschek Stephen P SP Moser Melissa M White Karen K Henry Bobbie B Krekel Caitlin C Oh Susan S Charleston Jeanne J Appel Lawrence J LJ

American journal of kidney diseases : the official journal of the National Kidney Foundation 20161116 2

<h4>Background</h4>Little is known about the effects of phosphorus additives on patients with kidney disease.<h4>Study design</h4>Randomized, double-blind, crossover trial.<h4>Setting & participants</h4>31 adults with early stages of presumed chronic kidney disease (estimated glomerular filtration rate ≥ 45mL/min/1.73m<sup>2</sup>; urine albumin-creatinine ratio sex-specific cutoff points: men ≥ 17mg/g, women ≥ 25mg/g).<h4>Intervention</h4>Higher versus lower phosphorus intake for 3 weeks. Highe ...[more]

PMID: 27865566

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Dataset Information

Phosphorus Additives and Albuminuria in Early Stages of CKD: A Randomized Controlled Trial.

Publications

Phosphorus Additives and Albuminuria in Early Stages of CKD: A Randomized Controlled Trial.

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