Recent Advances in the Role of Diet in Bone and Mineral Disorders in Chronic Kidney Disease

Overview

Journal Curr Osteoporos Rep

Publisher Current Science

Specialties Endocrinology
Orthopedics

Date 2021 Nov 3

PMID 34729692

Citations 2

Authors

Orlando M Gutierrez

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: Chronic kidney disease mineral and bone disease (CKD-MBD) is a common complication of kidney disease and is strongly influenced by diet. The purpose of this manuscript is to review recent advances in the role of diet in CKD-MBD over the last 5 years.

Recent Findings: Many of the recent studies examining the role of diet in CKD-MBD have focused on the adverse effects of high phosphorus consumption on bone health and metabolism. In general, the studies have shown that high phosphorus consumption worsens markers of bone and mineral metabolism but that eating a diet with a calcium to phosphorus ratio closer to 1:1 can attenuate some of these effects. Recent studies also showed that dietary counseling is efficacious for improving markers of CKD-MBD. High consumption of phosphorus aggravates CKD-MBD. Dietary counseling may ameliorate these effects, for example, by consuming diets with higher calcium to phosphorus ratios.

Citing Articles

Association of hyperphosphatemia with renal prognosis in patients with autosomal dominant polycystic kidney disease.

Nitta K, Kataoka H, Manabe S, Makabe S, Akihisa T, Ushio Y Clin Exp Nephrol. 2024; 29(1):75-82.

PMID: 39322826 DOI: 10.1007/s10157-024-02568-6.

The Impact of Medical Nutrition Intervention on the Management of Hyperphosphatemia in Hemodialysis Patients with Stage 5 Chronic Kidney Disease: A Case Series.

Morosan E, Popovici V, Elian V, Daraban A, Rusu A, Licu M Int J Environ Res Public Health. 2023; 20(6).

PMID: 36981958 PMC: 10049720. DOI: 10.3390/ijerph20065049.

References

Stremke E, McCabe L, McCabe G, Martin B, Moe S, Weaver C . Twenty-Four-Hour Urine Phosphorus as a Biomarker of Dietary Phosphorus Intake and Absorption in CKD: A Secondary Analysis from a Controlled Diet Balance Study. Clin J Am Soc Nephrol. 2018; 13(7):1002-1012. PMC: 6032595. DOI: 10.2215/CJN.00390118. View

Pazianas M, Miller P . Osteoporosis and Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD): Back to Basics. Am J Kidney Dis. 2021; 78(4):582-589. DOI: 10.1053/j.ajkd.2020.12.024. View

Byrne F, Gillman B, Kiely M, Palmer B, Shiely F, Kearney P . Pilot Randomized Controlled Trial of a Standard Versus a Modified Low-Phosphorus Diet in Hemodialysis Patients. Kidney Int Rep. 2020; 5(11):1945-1955. PMC: 7609990. DOI: 10.1016/j.ekir.2020.08.008. View

Gutierrez O, Porter A, Viggeswarapu M, Roberts J, Beck Jr G . Effects of phosphorus and calcium to phosphorus consumption ratio on mineral metabolism and cardiometabolic health. J Nutr Biochem. 2020; 80:108374. PMC: 7242166. DOI: 10.1016/j.jnutbio.2020.108374. View

Moe S . Rationale to reduce calcium intake in adult patients with chronic kidney disease. Curr Opin Nephrol Hypertens. 2018; 27(4):251-257. PMC: 6454891. DOI: 10.1097/MNH.0000000000000416. View

Oliveira R, Cancela A, Graciolli F, Dos Reis L, Draibe S, Cuppari L . Early control of PTH and FGF23 in normophosphatemic CKD patients: a new target in CKD-MBD therapy?. Clin J Am Soc Nephrol. 2009; 5(2):286-91. PMC: 2827593. DOI: 10.2215/CJN.05420709. View

Watanabe A, Koizumi T, Horikawa T, Sano Y, Uki H, Miyajima K . Impact of altered dietary calcium-phosphorus ratio caused by high-phosphorus diets in a rat chronic kidney disease (CKD) model created by partial ligation of the renal arteries. J Toxicol Pathol. 2020; 33(2):77-86. PMC: 7218233. DOI: 10.1293/tox.2019-0086. View

Lim E, Hyun S, Lee J, Kim S, Lee M, Lee S . Effects of education on low-phosphate diet and phosphate binder intake to control serum phosphate among maintenance hemodialysis patients: A randomized controlled trial. Kidney Res Clin Pract. 2018; 37(1):69-76. PMC: 5875578. DOI: 10.23876/j.krcp.2018.37.1.69. View

Wang L, Tang R, Zhang Y, Liu Z, Chen S, Song K . A Rat Model with Multivalve Calcification Induced by Subtotal Nephrectomy and High-Phosphorus Diet. Kidney Dis (Basel). 2021; 6(5):346-354. PMC: 7745662. DOI: 10.1159/000506013. View

10.

Lafage M, Combe C, Fournier A, Aparicio M . Ketodiet, physiological calcium intake and native vitamin D improve renal osteodystrophy. Kidney Int. 1992; 42(5):1217-25. DOI: 10.1038/ki.1992.407. View

11.

Moe S, Drueke T, Cunningham J, Goodman W, Martin K, Olgaard K . Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2006; 69(11):1945-53. DOI: 10.1038/sj.ki.5000414. View

12.

Yamada S, Leaf E, Chia J, Cox T, Speer M, Giachelli C . PiT-2, a type III sodium-dependent phosphate transporter, protects against vascular calcification in mice with chronic kidney disease fed a high-phosphate diet. Kidney Int. 2018; 94(4):716-727. PMC: 6211801. DOI: 10.1016/j.kint.2018.05.015. View

13.

Gutierrez O, Luzuriaga-McPherson A, Lin Y, Gilbert L, Ha S, Beck Jr G . Impact of Phosphorus-Based Food Additives on Bone and Mineral Metabolism. J Clin Endocrinol Metab. 2015; 100(11):4264-71. PMC: 4702463. DOI: 10.1210/jc.2015-2279. View

14.

Slatopolsky E, Caglar S, Gradowska L, Canterbury J, Reiss E, Bricker N . On the prevention of secondary hyperparathyroidism in experimental chronic renal disease using "proportional reduction" of dietary phosphorus intake. Kidney Int. 1972; 2(3):147-51. DOI: 10.1038/ki.1972.84. View

15.

Moe S, Zidehsarai M, Chambers M, Jackman L, Radcliffe J, Trevino L . Vegetarian compared with meat dietary protein source and phosphorus homeostasis in chronic kidney disease. Clin J Am Soc Nephrol. 2010; 6(2):257-64. PMC: 3052214. DOI: 10.2215/CJN.05040610. View

16.

Sax L . The institute of medicine's "dietary reference intake" for phosphorus: a critical perspective. J Am Coll Nutr. 2001; 20(4):271-8. DOI: 10.1080/07315724.2001.10719047. View

17.

Slatopolsky E, Caglar S, Pennell J, Taggart D, Canterbury J, Reiss E . On the pathogenesis of hyperparathyroidism in chronic experimental renal insufficiency in the dog. J Clin Invest. 1971; 50(3):492-9. PMC: 291955. DOI: 10.1172/JCI106517. View

18.

Gutierrez O . The connection between dietary phosphorus, cardiovascular disease, and mortality: where we stand and what we need to know. Adv Nutr. 2013; 4(6):723-9. PMC: 3823521. DOI: 10.3945/an.113.004812. View

19.

St-Jules D, Rozga M, Handu D, Carrero J . Effect of Phosphate-Specific Diet Therapy on Phosphate Levels in Adults Undergoing Maintenance Hemodialysis: A Systematic Review and Meta-Analysis. Clin J Am Soc Nephrol. 2020; 16(1):107-120. PMC: 7792658. DOI: 10.2215/CJN.09360620. View

20.

Khairallah P, Nickolas T . Management of Osteoporosis in CKD. Clin J Am Soc Nephrol. 2018; 13(6):962-969. PMC: 5989687. DOI: 10.2215/CJN.11031017. View