TY  - SER
TI  - Short-Term Effects of a Therapeutic Diet on Biochemical Parameters in Hemodialysis Patients: A Randomized Crossover Trial / 
SN  - 1051-2276
KW  - dialysis
KW  - FGF23
KW  - inflammation
KW  - therapeutic diet
KW  - uremic toxin
N1  - Bibliografía: p 739
N2  - Objective: Although unhealthy diets exacerbate nutritional and metabolic derangements in patients with end-stage kidney disease
(ESKD), how therapeutic diets that possess a variety of different dietary strategies acutely modify diverse biochemical parameters
related to cardiovascular disease remains underexplored.
Methods: Thirty-three adults with end-stage kidney disease undergoing thrice-weekly hemodialysis participated in a randomized
crossover trial comparing a therapeutic diet with their usual diets for 7 days, separated by a 4-week washout period. The therapeutic
diet was characterized by adequate calorie and protein amounts, natural food ingredients with a low phosphorus-to-protein ratio, higher
portions of plant-based food, and high fiber content. The primary outcome measure was the mean difference in the change-from-
baseline intact fibroblast growth factor 23 (FGF23) level between the 2 diets. The other outcomes of interest included changes in mineral
parameters, uremic toxins, and high-sensitivity C-reactive protein (hs-CRP) levels.
Results: Compared with the usual diet, the therapeutic diet lowered intact FGF23 levels (P 5 .001), decreased serum phosphate
levels (P , .001), reduced intact parathyroid hormone (PTH) levels (P 5 .003), lowered C-terminal FGF23 levels (P 5 .03), increased
serum calcium levels (P 5 .01), and tended to lower total indoxyl sulfate levels (P 5 .07) but had no significant effect on hs-CRP levels.
Among these changes, reduction in serum phosphate level achieved in 2 days, modifications of intact PTH and calcium levels in 5 days,
and reductions in intact and C-terminal FGF23 levels in 7 days of therapeutic diet intervention.
Conclusion: Within the 1-week intervention period, the dialysis-specific therapeutic diet rapidly reversed mineral abnormalities and
tended to decrease total indoxyl sulfate levels in patients undergoing hemodialysis but had no effect on inflammation. Future studies to
assess the long-term effects of such therapeutic diets are recommended

ER  -