Journal List > J Nutr Health > v.47(1) > 1081352

J Nutr Health. 2014 Feb;47(1):33-44. Korean.
Published online February 28, 2014.  https://doi.org/10.4163/jnh.2014.47.1.33
© 2014 The Korean Nutrition Society
Association of food intake with serum levels of phosphorus and potassium in hemodialysis patients
Hye Jin Woo,1 Yeon Joo Lee,1 Il Hwan Oh,2 Chang Hwa Lee,2 and Sang Sun Lee1
1Department of Food and Nutrition, Hanyang University, Seoul 133-791, Korea.
2Department of Nephrology, Seoul Hospital, Hanyang University, Seoul 133-792, Korea.

To whom correspondence should be addressed. tel: +82-2-2220-1206, Email: leess@hanyang.ac.kr
Received October 04, 2013; Revised October 23, 2013; Accepted December 10, 2013.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Purpose

Elevated serum phosphorus and potassium levels are a major problem for hemodialysis (HD) patients. Hyperphosphatemia and hyperkalemia are closely related to intake of dietary phosphorus and potassium.

Methods

This study was conducted in order to investigate the effects of food consumed on serum phosphorus and potassium levels in 48 HD patients (20 males and 28 females). We collected anthropometric data, biochemical parameters, and dietary data of the subjects. Dietary data for usual intake were obtained by use of a food-frequency questionnaire (FFQ) consisting of 21 food items.

Results

The mean body mass index (BMI) was 22.2 ± 3.0 kg/m2, mean serum phosphorus level was 4.50 ± 1.52 mg/dl, and mean serum potassium level was 4.74 ± 0.73 mEq/l. Hyperphosphatemia (> 4.5 mg/dl) was found in 45.8% of subjects, and hyperkalemia (> 5.0 mEq/l) in 35.4%. Subjects who took medication only were 56% of total, and those who took medication with dietary therapy were 27%. Patients with medication and dietary therapy showed significantly lower serum phosphorus levels compared to patients with medication only (p < 0.05). Mean duration of HD was 7.9 ± 7.3 years and it showed positive correlation with serum potassium levels (p < 0.05). Serum phosphorus levels showed positive correlation with intake of mixed grains and soybean milk (p < 0.05). Serum potassium levels showed positive correlation with intake of mixed grains (p < 0.01), potatoes, fish, and high-potassium vegetables (p < 0.05). On the other hand, intake of white rice showed negative correlation with serum potassium levels (p < 0.05).

Conclusion

The results of our study suggest that intake of white rice rather than mixed grains is an important factor in sustaining normal serum phosphorus and potassium levels. In addition, limiting intake of soybean milk, potatoes, and fish to under three serving per week is recommended. Finally, conduct of a strict dietary therapy along with medical treatment is desirable because inappropriate food intake increases serum phosphorus and potassium levels to a higher than normal range.

Keywords: hemodialysis; hyperphosphatemia; hyperkalemia; food frequency questionnaire (FFQ)

Tables


Table 1
General characteristics and anthropometric variables of hemodialysis patients
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Table 2
Blood parameters of hemodialysis patients
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Table 3
Serum levels of phosphorus and potassium in hemodialysis patients according to general characteristics
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Table 4
Serum levels of phosphorus and potassium in hemodialysis patients according to intake of grains and starch food
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Table 5
Serum levels of phosphorus and potassium in hemodialysis patients according to intake of meat, fish, eggs and legumes
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Table 6
Serum levels of phosphorus and potassium in hemodialysis patients according to intake of vegetables, fruits and mushrooms
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Table 7
Serum levels of phosphorus and potassium in hemodialysis patients according to nutrient intake
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Table 8
Partial correlation coefficients between serum levels of phosphorus, potassium and general characteristics, food intake, nutrient intake of hemodialysis patients
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Notes

This work was supported by grants of the National Research Foundation of Korea (2012R1A1A2008077).

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