A New Disease Concept in the Age of Processed Foods—Phosphorus-Burden Disease; including CKD–MBD Concrete Analysis and the Way to Solution

In 2012, the Japanese Society for Dialysis Therapy (JSDT) established the order of correction of P, corrected Ca (cCa), and whole PTH (w-PTH) in the treatment of Chronic Kidney Disease-Metabolic Bone Disorder (CKD-MBD) as P-first. However, there is no report that analyzes whether this rule is in lin...

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Bibliographic Details
Published in:Nutrients 2021-08, Vol.13 (8), p.2874
Main Authors: Nishime, Keizo, Sugiyama, Noriko, Okada, Koichi
Format: Article
Language:English
Subjects:
Additives
Binders
Bone diseases
Calcification
Calcium phosphates
Care and treatment
Chronic kidney failure
CKD–MBD
Dialysis
Disease
fibroblast growth factor 23(FGF23)
Food
Food additives
Food processing
Health services
Hemodialysis
Kidney diseases
Minerals
Mortality
Parathyroid hormone
Patients
Phosphorus
phosphorus additives
phosphorus binders
phosphorus burden
Processed foods
Small intestine
Smooth muscle
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Summary:In 2012, the Japanese Society for Dialysis Therapy (JSDT) established the order of correction of P, corrected Ca (cCa), and whole PTH (w-PTH) in the treatment of Chronic Kidney Disease-Metabolic Bone Disorder (CKD-MBD) as P-first. However, there is no report that analyzes whether this rule is in line with reality and what the adequate rate of P is. Therefore, we analyzed the test values of our 48 patients during the year of 2019 and examined the validity of the results. The results showed that the adequate range rates were 70.8% for P, 100% for cCa, and 89.6% for w-PTH. This result is better than the JSDT Web-based Analysis of Dialysis Data Archives (WADDA) P adequacy rate of 66.2%. Although the guideline is P-first, it is often the case that we cannot reach the adequate level; therefore, healthcare professionals and patients often blame each other. We believe that this is due to the mismatch between the modern era of processed foods covered with P additives and treatment methods (P intake restriction and P-binders). The development of processed foods with P additives has brought light and darkness to mankind. The light side is freedom from starvation, and the dark side is a new condition caused by P burden: P burden disease including CKD-MBD.
ISSN:2072-6643
2072-6643
DOI:10.3390/nu13082874