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High dietary phosphorus density ups risk of CKD in patients with DM

01 Aug 2017

An association exists between high dietary phosphorus density and an increased risk of developing chronic kidney disease (CKD) in diabetes mellitus (DM) patients with normal renal function, a recent study has found.

Researchers retrieved data from the Korean Genome and Epidemiology Study to assess the impact of dietary phosphorus density, defined as the ratio of a single-day dietary phosphorus amount to the total daily calorie intake, on the development of incident CKD in a cohort of individuals with normal renal function.

Included in the final analysis were 873 individuals with DM (mean age 55.6 years; 52.0 percent men) and 5,846 without DM (non-DM; mean age 51.4 years; 47.6 percent men) who were followed up biennially from 2001 to 2014. The primary endpoint of incident CKD is defined as a composite of estimated glomerular filtration rate <60 mL · min−1 · 1.73 m−2 and/or the development of proteinuria.

The mean estimated glomerular filtration rates were 91.6±14.0 mL · min−1 · 1.73 m−2 in the DM group and 94.5±14.0 mL · min−1 · 1.73 m−2 for the non-DM group. The mean values of dietary phosphorus density were 0.51±0.08 and 0.51±0.07 mg/kcal in the DM and non-DM groups, respectively.

There were 283 (32.4 percent) and 792 (13.5 percent) individuals who developed CKD in the DM and non-DM groups, respectively, during follow-up.

After dividing participants into quartiles according to the dietary phosphorus density in each group, the highest quartile correlated with the development of incident CKD by multiple Cox proportional hazard analysis in the DM group (p=0.02) but not in the non-DM group (p=0.72).

Researchers suggested the need to test the causality in this association in a randomized controlled trial.

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