Phosphorus content of foods containing additives and the association of phosphatemia of chronic hemodialysis patients

• Grant number: 13/17956-0
• Support Opportunities: Regular Research Grants
• Start date: February 01, 2014
• End date: January 31, 2017
• Field of knowledge: Health Sciences - Nutrition - Dietetics
• Principal Investigator: Jacqueline do S Costa Teixeira Caramori
• Grantee: Jacqueline do S Costa Teixeira Caramori
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil
• Associated researchers: Helio Grassi Filho ; Pasqual Barretti ; Pricila Veiga dos Santos

Abstract

Despite the scientific and technological advances seen in renal replacement therapy, also observed high mortality in patients with advanced chronic kidney disease (CKD). Cardiovascular diseases particularly ischemic in nature, are associated with atherosclerosis, but closely related to the uremic condition, coursing with vascular calcification influenced by disturbances in the metabolism of calcium and phosphorus, factors associated with high mortality. Due to the smaller capacity of phosphorus excretion, patients tend to develop hyperphosphatemia, especially if they eat foods high in phosphorus. The control of serum phosphorus may be obtained by the combination of dietary restrictions that element, decreased gastrointestinal absorption with the use of phosphate binder and measures promoting the increase in its elimination by dialysis methods. The phosphorous-containing additives are increasingly being included among the processed foods, it is emphasized that the phosphate salts are almost completely absorbed, while the P absorption of food "in natura" is about 60%. Moreover, there is no legal requirement that the amount of phosphorus present in additives to be included in nutrition labeling, and that no Brazilian study addressed this issue. This study aims to develop a list of meat products and beverages most widely consumed; to determine the phosphorus content in these foods, and to evaluate the association between the amount of phosphorus intake from foods and drinks containing additives and the presence of hyperphosphatemia in the patient population with CKD on dialysis for a university center.It will be an analytical and descriptive, observational, cross-sectional and prospective, which will be included adult patients aged less than 18 years, patients with CKD treated by regular hemodialysis (HD), for at least 90 days, in the Dialysis Unit of the Faculty of Medicine of Botucatu - UNESP. Be applied food frequency questionnaires to patients, where it will be prepared list of foods and beverages. From the list will be selected 20 foods and 10 beverages containing in its labeling designation corresponding to phosphorus-containing additives, which will be analyzed in duplicate samples. The determination of total phosphorus in solids will be colorimetia by the metavanadate, and the liquid will by atomic absorption spectrophotometry. Examine the association between serum phosphorus and phosphorus intake through dietary survey and biochemical parameters, content of phosphorus derived from these foods and beverages will be calculated based on the measurements performed in the food, based therefore on the determination of phosphorus average of each product. For this, the results of the determinations of each food will be registered in the software "DietPro 5i Professional" for calculating the 72-hour food records considering the patient's total diet and diet foods considering only those belonging to the list. The estimation of daily protein intake will be performed by calculating the protein equivalent of nitrogen appearance (PNA). Will be performed univariate logistic regression to test the association between demographic, clinical, dialysis, laboratory, besides PNA and serum phosphorus were included in the multivariate model those that present less than 0.20 probability of random association with the presence of hyperphosphatemia . To evaluate the association between intake of phosphorus from foods and drinks containing additives and phosphatemia after adjusting for possible confounding variables, will be used binary logistic regression model in which the dependent variables are the presence or absence of hyperphosphatemia. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

WATANABE, MARCELA T.; ARAUJO, RAPHAEL M.; VOGT, BARBARA P.; BARRETTI, PASQUAL; CARAMORI, JACQUELINE C. T.. Most consumed processed foods by patients on hemodialysis: Alert for phosphate-containing additives and the phosphate-to-protein ratio. CLINICAL NUTRITION ESPEN, v. 14, p. 37-41, AUG 2016. (13/17956-0)

WATANABE, MARCELA T.; BARRETTI, PASQUAL; CARAMORI, JACQUELINE C. T.. Dietary Intervention in Phosphatemia Control-Nutritional Traffic Light Labeling. JOURNAL OF RENAL NUTRITION, v. 28, n. 6, p. 2-pg., 2018-11-01. (13/17956-0)

WATANABE, MARCELA T.; BARRETTI, PASQUAL; CARAMORI, JACQUELINE C. T.. Attention to Food Phosphate and Nutrition Labeling. JOURNAL OF RENAL NUTRITION, v. 28, n. 4, p. 3-pg., 2018-07-01. (13/17956-0)