The DOI matches its Crossref record; 37 of the 37 references it cites were found in a registry or an index.
Is controlling phosphorus by decreasing dietary protein intake beneficial or harmful in persons with chronic kidney disease?
Open accessAbstract
Background Dietary restrictions to control serum phosphorus, recommended routinely to individuals with chronic kidney disease, are usually associated with a reduction in protein intake. This may lead to protein-energy wasting and poor survival. We hypothesized that decline in serum phosphorus with concomitant decline in protein intake is associated with increased death risk. Methods In a 3-year (7/2001–6/2004) cohort of 30,075 prevalent maintenance hemodialysis (MHD) patients, we examined changes in serum phosphorus and in normalized protein nitrogen appearance (nPNA), a surrogate of dietary protein intake, during the first 6 months and subsequent mortality. Four groups of MHD patients were defined based on the direction of the changes in serum phosphorus and nPNA. Results Baseline phosphorus had a J-shaped association with mortality, whereas higher baseline nPNA was linearly associated with greater survival. Compared to MHD patients whose serum phosphorus and nPNA both rose over 6 months, those whose serum phosphorus decreased but nPNA increased had the greatest survival with a case-mix adjusted death risk ratio (RR) of 0.90 (95% confidence limits: 0.86, 0.95, p<0.001), whereas those whose phosphorus increased but nPNA decreased or those whose phosphorus and nPNA both decreased had worse mortality with RR of 1.11 (1.05,1.17) and 1.06 (1.01,1.12), respectively (P <0.001 and 0.02). Conclusions The risk of controlling serum phosphorus by restricting dietary protein intake may outweigh its benefit and lead to increased mortality. Additional studies including randomized controlled trials need to examine whether non-dietary control of phosphorus or restricting non-protein sources of phosphorus is safer and more effective.
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Cites
Flexible regression models with cubic splines
Durrleman, S., & Simon, R. (1989) · Statistics in Medicine · doi:10.1002/sim.4780080504 · Cited by 2,689
Mineral Metabolism, Mortality, and Morbidity in Maintenance Hemodialysis
Block, G. A., Klassen, P. S., Lazarus, J. M., Ofsthun, N., Lowrie, E. G., & Chertow, G. M. (2004) · Journal of the American Society of Nephrology · doi:10.1097/01.asn.0000133041.27682.a2 · Cited by 2,687
Block, G., Hulbert-Shearon, T., Levin, N., & Port, F. (1998) · American Journal of Kidney Diseases · doi:10.1053/ajkd.1998.v31.pm9531176 · Cited by 2,354
Fouque, D., Kalantar-Zadeh, K., Kopple, J., Cano, N., Chauveau, P., Cuppari, L., Franch, H., Guarnieri, G., Ikizler, T. A., Kaysen, G., et al. (2008) · Kidney International · doi:10.1038/sj.ki.5002585 · Cited by 2,000
Self-citationMoe, S., Drüeke, T., Cunningham, J., Goodman, W., Martin, K., Olgaard, K., Ott, S., Sprague, S., Lameire, N., & Eknoyan, G. (2006) · Kidney International · doi:10.1038/sj.ki.5000414 · Cited by 1,993
Levin, A., Bakris, G. L., Molitch, M., Smulders, M., Tian, J., Williams, L. A., & Andress, D. L. (2007) · Kidney International · doi:10.1038/sj.ki.5002009 · Cited by 1,513
Serum Phosphate Levels and Mortality Risk among People with Chronic Kidney Disease
Kestenbaum, B., Sampson, J. N., Rudser, K. D., Patterson, D. J., Seliger, S. L., Young, B., Sherrard, D. J., & Andress, D. L. (2005) · Journal of the American Society of Nephrology · doi:10.1681/asn.2004070602 · Cited by 1,226
Malnutrition-inflammation complex syndrome in dialysis patients: causes and consequences
Kalantar-Zadeh, K., Ikizler, T. A., Block, G., Avram, M. M., & Kopple, J. D. (2003) · American Journal of Kidney Diseases · doi:10.1016/j.ajkd.2003.07.016 · Cited by 1,040
Self-citationGutierrez, O., Isakova, T., Rhee, E., Shah, A., Holmes, J., Collerone, G., Ju[Combining Diaeresis]ppner, H., & Wolf, M. (2005) · Journal of the American Society of Nephrology · doi:10.1681/asn.2005010052 · Cited by 921
Kalantar-Zadeh, K., Kuwae, N., Regidor, D. L., Kovesdy, C. P., Kilpatrick, R. D., Shinaberger, C. S., McAllister, C. J., Budoff, M. J., Salusky, I. B., & Kopple, J. D. (2006) · Kidney International · doi:10.1038/sj.ki.5001514 · Cited by 905
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KDOQI clinical practice guideline for nutrition in CKD: 2020 update
Ikizler, T. A., Burrowes, J. D., Byham-Gray, L. D., Campbell, K. L., Carrero, J.-J., Chan, W., Fouque, D., Friedman, A. N., Ghaddar, S., Goldstein-Fuchs, D. J., et al. (2020) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2020.05.006 · Cited by 1,960
Self-citationAlp Ikizler, T., Cano, N. J., Franch, H., Fouque, D., Himmelfarb, J., Kalantar-Zadeh, K., Kuhlmann, M. K., Stenvinkel, P., TerWee, P., Teta, D., et al. (2013) · Kidney International · doi:10.1038/ki.2013.147 · Cited by 722
Self-citationNutrition and chronic kidney disease
Fouque, D., Pelletier, S., Mafra, D., & Chauveau, P. (2011) · Kidney International · doi:10.1038/ki.2011.118 · Cited by 190
Turner, M. E., Beck, L., Hill Gallant, K. M., Chen, Y., Moe, O. W., Kuro-o, M., Moe, S. M., & Aikawa, E. (2024) · Arteriosclerosis, Thrombosis, and Vascular Biology · doi:10.1161/atvbaha.123.319198 · Cited by 54
Metadata
- Authors
- Shinaberger, C. S., Greenland, S., Kopple, J. D., Van Wyck, D., Mehrotra, R., Kovesdy, C. P., & Kalantar-Zadeh, K.
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2008-12
- Volume
- 88
- Issue
- 6
- Pages
- 1511-1518
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2130381721
- Cited by
- 339
- References
- 37
- FWCI
- 12.00
- Type
- journal article
- Language
- en
- Open access
- bronze
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