A 14-year-old male, with chronic kidney disease stage 4 (glomerular filtration rate
20 mL/min/1.73 m
2) secondary to reflux nephropathy required dietary modification with evidence of renal
osteodystrophy, presented with elevated serum phosphorus and parathyroid hormone.
He was educated using a novel phosphorus point system where 1 point is equivalent
to ∼50 mg of phosphorus. Dietary counseling was provided by a pediatric renal dietitian
on phosphorus content of foods the patient typically consumed and converted to point
system for daily tracking. The family reported limiting daily phosphorus points to
less than 20 points daily for 15 months. The family completed a 3-day food record
and provided points assigned to each food item. A Spearman’s correlation of 0.7 (
P < .001) was found between the family's and the dietitian's assignment of phosphorus
points. The patient's recorded phosphorus intake remained below 1000 mg each day and
met estimated calorie and protein needs. The patient also continued with age-appropriate
weight gain and linear growth. Laboratory values showed phosphorus and intact parathyroid
hormone remained within desired range. A phosphorus point system tool can be used
to maintain normal serum phosphorus levels and subsequently prevent secondary hyperparathyroidism
in patients with pediatric chronic kidney disease.
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References
-
Chronic kidney disease: mineral and bone disorder in children.
Semin Nephrol. 2013; 33: 169-179
-
KDOQI clinical practice guideline for nutrition in children with CKD: 2008 update. Executive summary.
Am J Kidney Dis. 2009; 53: S11-S104
-
The prevalence of phosphorus containing food additives in top-selling foods in grocery stores.
J Ren Nutr. 2013; 23: 265-270
-
A food Labeling Guide: Guidance for Industry.
(Available at:)
-
Dietary sources of energy and nutrient intake among children and adolescents with chronic kidney disease.
Pediatr Nephrol. 2017; 32: 1233-1241
-
Intensive dietary Education Using the Phosphorus Point System Tool to improve hyperphosphatemia in Patients with Chronic Kidney Disease.
(Available at:)
-
USDA food composition databases.
(Available at:) (Accessed July 24, 2016)
-
The Food Processor® nutrition and fitness software.
2017 (Version 11.5)
Article Info
Publication History
Published online: August 01, 2020
Publication stage
In Press Journal Pre-Proof
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Support: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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Copyright
© 2020 by the National Kidney Foundation, Inc. All rights reserved.