| Summary: | Hyperphosphoremia is one of the most important risk factors for morbidity and mortality not only for CKD but also for general population. Excessive dietary intake of phosphate (P) is one of the key factors. In particular, P in its inorganic form, which is contained in food additives, is more readily absorbed. Unfortunately, these food additives are mostly present in convenience fast foods, soft drinks, which is the typical food consumed by our hemodialysis population, composed by elderly people, mostly low-socio economic class, who often live alone.
To explore the association between socio-economic factors and serum phosphorus levels, we enrolled 100 patients on periodic hemodialysis treatment from 3 different units. Information, on social, cultural, economic, diet habits, therapy for hyperphosphoremia and haematological and clinical parameters had been collected through specific questionnaires administered by a physician. Statistical analysis was performed using correlation between variables with the linear regression analysis, and the stepwise logistic regression analysis, either analysis preceded by log-10 transformation if the distribution of the variables was non-gaussian. The level of statistical significance was always set at P < 0.05 Results showed serum phosphorus level was reduced in patients who live alone compared to patients in family (P=0,04), in self-sufficient (P=0,05) and in patients belonging to medium-higher versus lower socio-economic groups (P=0,003). Fast foods intakes correlates with increase in phosphorus serum levels (P=0,002), whilst the same correlation was not found for cheese intake. Our data show that socio-economic status and food habits are useful predictors of phosphorus serum levels . In conclusion, dietary counselling of patients on hemodialysis is mandatory. Interventions that consider the socio-economic situation allow to deliver important messages on foods with the least amount of phosphates, and adequate protein content, and they may be a successful strategy in targeting patients at a higher risk of hyperphosphoremia.
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