Short-Term Effects of Very-Low-Phosphate and Low-Phosphate Diets on Fibroblast Growth Factor 23 in Hemodialysis Patients: A Randomized Crossover Trial.
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ID: 47525
2019
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.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.There was no significant difference in the mean change-from-baseline in intact FGF23 levels between the two study diets. The very-low-phosphate diet significantly lowered serum phosphate (mean difference, 0.6 mg/dl; 95% confidence interval [95% CI], 0.2 to 1.0; =0.002). There were no significant differences in change-from-baseline intact PTH and C-terminal FGF23 levels between the two study diets.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.
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tsai2019shorttermclinical
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| Authors | Tsai, Wan-Chuan;Wu, Hon-Yen;Peng, Yu-Sen;Hsu, Shih-Ping;Chiu, Yen-Ling;Yang, Ju-Yeh;Chen, Hung-Yuan;Pai, Mei-Fen;Lin, Wan-Yu;Hung, Kuan-Yu;Chu, Fang-Yeh;Tsai, Shu-Min;Chien, Kuo-Liong; |
| Journal | clinical journal of the american society of nephrology : cjasn |
| Year | 2019 |
| DOI | CJN.04250419 |
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