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008 171219t2023 sp ||||| |||| 00| 0 spa |
022 _a1051-2276
040 _cSalus Infirmorum
245 0 _aShort-Term Effects of a Therapeutic Diet on Biochemical Parameters in Hemodialysis Patients: A Randomized Crossover Trial /
_cWan-Chuan Tsai, Shih-Ping Hsu, Yen-Ling Chiu, Hon-Yen Wu, Chia-Chin Luan, Ju-Yeh Yang Mei-Fen Pai, Cheng-Jui Lin, Wan-Yu Lin Wen-Huei Sun, and Yu-Sen Peng
504 _aBibliografía: p 739
520 8 _aObjective: 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.
653 1 4 _adialysis
653 1 4 _aFGF23
653 1 4 _ainflammation
653 1 4 _atherapeutic diet
653 1 4 _auremic toxin
773 _g-- 2023, v. 33, n 6, p.731-739
_tJournal of Renal Nutrition 
942 _2udc
_cARTÍCULO
999 _c15315
_d15315