Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2018, vol. 27, nr 2, February, p. 217–224

doi: 10.17219/acem/67050

Publication type: original article

Language: English

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Nutrient intake assessed with Diet History Questionnaire II, in relation to long-term calcium-phosphate control in hemodialysis patients with end-stage renal failure

Katarzyna Wyskida1,A,B,C,D,E,F, Jarosław Wajda2,B, Dariusz Klein3,4,B, Joanna Witkowicz5,B, Rafał Ficek6,B, Sylwia Rotkegel7,B, Urszula Spiechowicz-Zatoń8,B, Joanna Kocemba-Dyczek9,10,B, Jarosław Ciepał11,B, Magdalena Olszanecka-Glinianowicz1,C,D,E,F, Andrzej Więcek6,E,F, Jerzy Chudek7,12,A,C,D,E,F

1 Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical University of Silesia, Poland

2 Dialysis Center, Provincial Specialist Hospital No. 3 in Rybnik, Poland

3 Dialysis Center in Tychy, Centrum Dializa Sp. z o.o., Poland

4 Dialysis Center in Pszczyna, Centrum Dializa Sp. z o.o., Poland

5 Dialysis Center in Siemianowice Śląskie, Nefrolux, Poland

6 Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Poland

7 Dialysis Center in Katowice, Centrum Dializa Sp. z o.o., Poland

8 Dialysis Center in Chorzów, Centrum Dializa Sp. z o.o., Poland

9 Dialysis Center in Żory, Centrum Dializa Sp. z o.o., Poland

10 Dialysis Center in Wodzisław Śląski, Centrum Dializa Sp. z o.o., Poland

11 Dialysis Center in Sosnowiec, Centrum Dializa Sp. z o.o., Poland

12 Department of Internal Medicine and Oncological Chemotherapy, Medical University of Silesia, Katowice, Poland

Abstract

Background. Diet is a key factor that determines proper alignment of calcium-phosphate and nutritional status among hemodialysis (HD) patients.
Objectives. To assess the nutrient intake in relation to long-term calcium-phosphate control in HD patients with end-stage renal failure.
Material and Methods. The study included 107 patients (66 men, 41 women) from 10 dialysis centers in the Upper Silesia region of Poland. To analyze the diet composition during the previous year, a portion-sized version of the Diet History Questionnaire II (DHQ-II) from National Institutes of Health was used. The nutrient intake was assessed in accordance with the most complex recommendations on HD patients’ nutrition – K/DOQI Clinical Practice Guidelines for nutrition in chronic renal failure. Poor long-term alignment of calcium-phosphate homeostasis was defined as the presence of over 50% monthly phosphorus concentrations exceeding 5 mg/dL, and for calcium 10.2 mg/dL, during the last 6-month period.
Results. Lower than recommended protein intake was found in 63% of HD patients (average consumption: 0.9 ±0.5 g/kg/day). Most of the patients consumed too much fat (33.5 ±6.7% of daily energy intake) and sodium (2912 ±1542 mg/day). In 42% of patients, dietary phosphorus intake was consistent with the recommendations (13.3 ±7.5 mg/kg/day). Protein intake over 1.2 g/kg/day resulted in an increased consumption of phosphorous, but did not increase the risk of misalignment of phosphorus concentrations (OR = 1.15 [0.40–3.27]); p = 0.8). Poor control of serum phosphorus concentrations was observed in 69% of patients (they were on average 8 years younger). The average intake of protein and phosphate in the groups with good or not satisfactory serum phosphorus alignment did not differ significantly.
Conclusion. Adequate control of protein intake is not sufficient to obtain phosphorus alignment, especially in younger HD patients.

Key words

diet, hemodialysis, food frequency questionnaire, calcium-phosphate control, nutrient intake

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