Abstract: SA-PO792
Dietary Modification Improves FGF-23, KLOTHO, PTH, and Serum Phosphorous Levels in CKD Stages 1 and 2
Session Information
- Health Maintenance, Nutrition, Metabolism - II
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance, Nutrition, and Metabolism
- 1300 Health Maintenance, Nutrition, and Metabolism
Author
- Saxena, Anita, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
Group or Team Name
- SGPGI Renal Nutrition Group
Background
Dietary phosphorus restriction is a potential therapy for improving cardiovascular outcomes.
Aim: To examine effect of dietary counselling and dietary modifications on FGF-23, klotho, PTH levels and phosphorous in CKD Stage 1 and Stage 2 patients.
Methods
100 subjects aged 35.37 ± 10.98 years with eGFR 83.55+16.53 ml/minute and BMI 24.74 ±2.18 were recruited in the study. 24 hour dietary recall was taken at baseline, Based on dietary phosphorous intake patients were divided into two groups. Group 1: low phosphorous diet and Group 2: high. phosphorous diet. Controls were 30 healthy subjects, aged 43.83±10.11 ml/min with eGFR 126.11+10.26 ml/min and BMI 24.06 ±2.09. FGF-23, soluble α-Klotho, iPTH were measured (ELISA)
Results
The independent t test showed that iPTH, serum creatinine, FGF-23, serum phosphorous, total cholesterol and VLDL were significantly higher in CKD patients compared to controls(p=0.000),. Hemoglobin (p=0.046) , vitamin D(p=0.008) , klotho (p=0.000) and HDL (p=0.000) were lower in CKD patients compared to controls (n=30).
GFR showed a positive significant correlation with klotho (r=0.696,p=0.000) and a negative significant correlation with serum phosphorous (r=-0.494,p=0.000), iPTH (r=-0.751, p=0.000), FGF-23 (r=-0.638,p=0.000), urinary phosphorous (r=-0.476,p=0.000) and dietary phosphorous intake (r=-0.678,p=0.000) .
Urinary phosphorous showed a significant positive correlation with dietary phosphorous (r=0.488, p=0.000)
After dietary counselling and diet modifications in group 2, dietary phosphorous decreased from 1384.74±117.32 to 1027.69±101.39 (p=0.008; serum phosphorus 3.89±0.57 to3.59±0.63 p 0.008), FGF-23 (169.80±50.96 to 159.45±58.66; p 0.023), klotho (351.77±134.88 to 316.83±167.25 p 0.037) and iPTH decreased from 88.48±10.55 to 85.49±15.25; p 0.033. There was decline in protein intake from 0.67±0.130.to 60±0.11g/kg/d p 0.010. FGF-23 showed a strong significant negative correlation with klotho (r=0.754,p=0.000) i.e. as the levels of FGF-23 decreases, the levels of klotho increases after the diet modification in group 2 when they were advised to be strictly on a low phosphorous diet.
Conclusion
Both diet counselling and diet modification can bring down levels of FGF-23,Klotho, iPTH, serum phosphorous, urinary phosphorous which can be instrumental in slowing the progression of CKD and preventing cardiovascular disease.