Browse Ideas with tag 'phosphate':

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  CKD »

  Targeting phosphate metabolism in CKD to improve survival

  Disordered phosphate metabolism is associated with increased risk of death in ESRD, CKD, following kidney transplantation, and in the general population. FGF23 is an early marker of disordered phosphate metabolism that could be used to identify participants for an RCT in which one or a combination of phosphate binders, dietary manipulation or niacin could be used versus placebo to examine impact on CKD progression and ...more »

  Disordered phosphate metabolism is associated with increased risk of death in ESRD, CKD, following kidney transplantation, and in the general population. FGF23 is an early marker of disordered phosphate metabolism that could be used to identify participants for an RCT in which one or a combination of phosphate binders, dietary manipulation or niacin could be used versus placebo to examine impact on CKD progression and mortality.

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  Submitted by M Wolf 2 years ago

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  How does diet affect progression of CKD?

  Diets may impact CKD progression in several ways. A vegetarian diet lowers colon-derived uremic toxins such as indoxyl sulfate and p-cresol (Patel, J Am Soc Nephrol (Nov) 19:488A 2008). Diets high in advanced glycosylated end products are associated with evidence of glycation of body tissues. Phosphate restriction in CKD lowers serum FGF levels. A study is proposed using a 2 x 2 factorial design to study progression ...more »

  Diets may impact CKD progression in several ways. A vegetarian diet lowers colon-derived uremic toxins such as indoxyl sulfate and p-cresol (Patel, J Am Soc Nephrol (Nov) 19:488A 2008). Diets high in advanced glycosylated end products are associated with evidence of glycation of body tissues. Phosphate restriction in CKD lowers serum FGF levels. A study is proposed using a 2 x 2 factorial design to study progression of CKD in patients eating a vegetarian vs. meat-based diet, with or without restriction of phosphate and high-AGE foods. Outcomes would be 50% reduction of cystatin-estimated GFR or progression to dialysis/transplantation.

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  Submitted by John Daugirdas 2 years ago

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  ESRD/DIALYSIS »

  Effect of low sodium and low phosphate diet on outcomes in ESRD

  Data by Ozkahya et al (NDT 1988) suggested that sodium restriction and volume control could markedly reduce left ventricular mass index (LVMI). Ayus et al. (JASN 2005) found that LVMI reduction with daily dialysis correlated with better control of serum phosphate (P). Guida et al found that serum P could be reduced in 3/week patients using a low P, whey-substituted diet. The ability to maintain a low sodium (e.g., ...more »

  Data by Ozkahya et al (NDT 1988) suggested that sodium restriction and volume control could markedly reduce left ventricular mass index (LVMI). Ayus et al. (JASN 2005) found that LVMI reduction with daily dialysis correlated with better control of serum phosphate (P). Guida et al found that serum P could be reduced in 3/week patients using a low P, whey-substituted diet. The ability to maintain a low sodium (e.g., ~1.0 g/day) or low P (~0.6 g/day) diet in ESRD patients, or the effect of such diets on either surrogate outcomes (e.g. LVMI) or hard outcomes (survival, hospitalizations) has not been examined in a randomized trial. Proposed is a study, with patients randomized to either low Na / normal Na, and low P / normal P diets using a 2 x 2 factorial design in 3/week hemodialysis patients; a pilot study to look at feasibility with a main surrogate outcome of LVMI (200 patients), and a hard outcomes study (2000 patients) to look at mortality and hospitalizations.

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  Submitted by John Daugirdas 2 years ago

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