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Abstract: TH-PO930

Phosphorous Balance Calculator, an Individualized Tool for Treatment of Hyperphosphatemia in Hemodialysis Patients: A Randomized Clinical Trial

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1500 Health Maintenance, Nutrition, and Metabolism


  • Wang, Mengjing, Huashan Hospital, Fudan University, Shanghai, China
  • Chen, Jing, Huashan Hospital, Fudan University, Shanghai, China

Lack of evaluations of the dietary phosphorus and dialysis phosphorus removal in daily clinical practice are the common obstacle to assess phosphorus balance and control phosphorus in hemodialysis patients. We aimed to investigate whether the individualized therapy using phosphorus balance calculator improves phosphorus control.


A randomized, open-lable, multicenter, 4-week clinical trial was conducted. 119 patients aged 18 to 85 years old and with serum phosphorus level higher than 1.45mmol/l from 3 university teaching hospitals in Shanghai were enrolled and randomized in a 1:1 ratio to individualized (n=60) or conventional therapy (n=59). The primary outcome was the serum phosphorus concentration after 4-week treatment.


Among 119 randomized participants (mean age, 62 years; 68 male[57%]), 116 completed the trial. By using the phosphorus balance calculator, the individualized group achieved a better phosphorus equilibrium state, significantly reduced the serum phosphorus (1.62±0.45mmol/l versus 1.85±0.45 mmol/l, P=0.006), increased the proportions of patients achieving target serum phosphorus range (41% versus 18%, P=0.006), and had greater adjusted mean difference in change in serum phosphorus over the 4 weeks (-0.47 versus -0.23mmol/l, P=0.010) when compared to conventional therapy.


Phosphorus balance calculator was proved to improve serum phosphorus control in patients undergoing maintenance hemodialysis, offering a new tool for managing refractory hyperphosphatemia.

Figure 1. Changes in serum phosphorus, calcium and PTH over 4 weeks in response to individualized and conventional treatment in hemodialysis patients

Figure 2. Percentage of in target of serum phosphorus, calcium and PTH during the study period in two groups


  • Government Support – Non-U.S.