Short-term effects of very-low-phosphate and low-phosphate diets on fibroblast growth factor 23 in hemodialysis patients a randomized crossover trial
Journal
Clinical Journal of the American Society of Nephrology
Journal Volume
14
Journal Issue
10
Pages
1475-1483
Date Issued
2019
Author(s)
Tsai W.-C.
Wu H.-Y.
Peng Y.-S.
Hsu S.-P.
Chiu Y.-L.
Yang J.-Y.
Chen H.-Y.
Pai M.-F.
Chu F.-Y.
Tsai S.-M.
Abstract
BACKGROUND AND OBJECTIVES: The short-term effects of low-phosphate diets on fibroblast growth factor 23 (FGF23) level and the optimal amount of dietary phosphate restriction in patients undergoing hemodialysis remain unknown. DESIGN SETTING, PARTICIPANTS, & MEASUREMENTS: This was a randomized, active-controlled trial with a crossover design that included 35 adults with ESKD undergoing thrice-weekly hemodialysis and with a serum phosphate level >5.5 mg/dl or between 3.5 and 5.5 mg/dl with regular phosphate binder use at a hemodialysis unit of tertiary teaching hospital in Taiwan. Subjects were randomized 1:1 to receive a very-low-phosphate diet, with a phosphate-to-protein ratio of 8 mg/g, or a low-phosphate diet, with a phosphate-to-protein ratio of 10 mg/g for 2 days, each with a 5-day washout during which subjects adhered to their usual diet. The primary outcome measure was mean difference in change-from-baseline intact FGF23 level between intervention groups. Secondary outcomes included difference in change-from-baseline serum phosphate, intact parathyroid hormone (PTH), and C-terminal FGF23 level between intervention groups. RESULTS: =0.002). There were no significant differences in change-from-baseline intact PTH and C-terminal FGF23 levels between the two study diets. CONCLUSIONS: Over the 2-day period, the FGF23-lowering effect of the very-low-phosphate diet is similar to that of the low-phosphate diet. The very-low-phosphate diet has an additional phosphate-lowering effect compared with the low-phosphate diet.
SDGs
Publisher
American Society of Nephrology
Type
journal article