Kidney Week

Abstract: TH-PO430

Narrowing the Phosphate Divide: A Comparison between UK and Chinese Haemodialysis Patients

Session Information

• Nutrition, Inflammation, Metabolism: Basic Mechanisms
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Nutrition, Inflammation, and Metabolism

• 1401 Nutrition, Inflammation, Metabolism

Authors

• Song, Yan, University of Leicester, Leicester, United Kingdom

Yan Song,

• Highton, Patrick J., Loughborough University, Leicester, United Kingdom

Patrick J. Highton,

• Vogt, Barbara Perez, Universidade Estadual Paulista UNESP , Botucatu, Brazil

Barbara Perez Vogt,

• Biruete, Annabel, University of Illinois, Urbana, Illinois, United States

Annabel Biruete,

• Wilund, Ken, University of Illinois, Urbana, Illinois, United States

Ken Wilund,

• Smith, Alice C., University of Leicester, Leicester, United Kingdom

Alice C. Smith,

• Burton, James, University of Leicester, Leicester, United Kingdom

James Burton,

Background

Management of hyperphosphataemia requires a multi directional approach. Dietary restriction of phosphate (Ph) is often inadequate by itself; other strategies such as extended dialysis and Ph binders are often necessary. Designing an effective intervention to manage hyperphosphataemia, whilst balancing Ph restriction and maintaining adequate protein intake, requires a thorough understanding of dietary Ph. In addition, perception and habits related to dietary behaviour may be influenced by ethnicity and culture. The aim of the study was to contrast data about Ph intake on dialysis and non-dialysis days with haemodialysis (HD) patients from UK and China.

Methods

In this cross-sectional study, 24-hour diet recall interviews were undertaken with patients in UK and China during four normal dialysis sessions distributed evenly in two consecutive weeks. Patients were asked to recall food intake for the previous 24 hours on dialysis and non-dialysis days. Demographic and clinical data were collected from patients’ medical records. Nutritics and China Food Composition were used as nutrition database for UK and Chinese dietary data respectively.

Results

A total of 83 patients were recruited (UK, n=40; China, n=43). The UK patients were older (56.8±16.1 vs. 42.4±9.1 years; P=0.001) with a higher body mass index (BMI) than the Chinese cohort (26.6±5.9 vs. 21.3±2.7 kg/m²; P<0.001). Although energy intake was comparable between populations (UK, 25.3±1.5Kcal/kg/d; China, 23.0 ±1.3 kcal/kg/d, P=0.12), UK patients reported higher Ph intake on both dialysis (0.91g/d vs 0.72g/d, P=0.039) and non-dialysis days (0.90g/d vs. 0.73g/d, P=0.004) than their Chinese counterparts. Despite higher dietary intake, serum Ph levels in UK patients were lower compared to those in China (1.59±0.44 mmol/L vs 2.11±0.53 mmol/L, P<0.001). There was no difference in the number of patients prescribed Ph binders between two groups (UK, n=8; China, n=9, P=0.567).

Conclusion

Despite higher BMI and dietary intake, and with no difference in prescribed Ph binding medications, UK patients had lower serum Ph concentrations than their Chinese counterparts. Strategies to improve compliance with medications and increasing dialysis phosphate removal would have a greater impact on hyperphosphataemia than increased nutritional support in Chinese HD patients.