Palabras clave
Enfermedad renal crónica
hiperfosfatemia
aditivos alimentarios
cociente fósforo/proteínas
etiquetado de los alimentos.
hiperfosfatemia
aditivos alimentarios
cociente fósforo/proteínas
etiquetado de los alimentos.
Cómo citar
1.
Garcia Ospina CA, Holguín MC, Cáceres Escobar D, Restrepo Valencia CAV. Importancia de la hiperfosfatemia en la enfermedad renal crónica, como evitarla y tratarla por medidas nutricionales. Rev. Colomb. Nefrol. [Internet]. 7 de febrero de 2017 [citado 3 de julio de 2024];4(1):38-56. Disponible en: https://revistanefrologia.org/index.php/rcn/article/view/270
Resumen
El manejo de los pacientes con enfermedad renal crónica (ERC) en todos los niveles de atención en salud es un reto frecuente y que amerita del mejor conocimiento y equipo de profesionales. El consumo de fósforo en la dieta y sus implicaciones sobre la función renal ha sido ampliamente descrita en la literatura, sin embargo, nuestros pacientes carecen de estrategias sencillas y de alto impacto sobre sus hábitos de alimentación y dentro de sus posibilidades económicas. Los objetivos de la presente revisión son proporcionar un conocimiento actualizado acerca de la hiperfosfatemia en la ERC y compartir los resultados de una estrategia emprendida por un grupo multidisciplinario de profesionales para identificar el contenido de fósforo en los alimentos más consumidos por nuestros pacientes y adaptar una herramienta educativa para implementar en la consulta.
Citas
1. Martinez I, Saracho R. El fósforo, ¿héroe o villano?. NefroPlus (2009);2:1-8.
2. Johnson RJ, Feehally J, Floege Jurgen. Comprehensive Clinical Nephrology. 5th ed. Amsterdam: Elsevier Saunders; 2015. Chapter 10, Disorders of Calcium, Phosphate, and Magnesium Metabolism; p. 132
3. Penido MG, Alon US. Phosphate homeostasis and its role in bone health. Pediatr Nephrol [Internet]. 2012 [accedido 01 Jun 2000];27(11):2039-48. Available from: https://doi.org10.1007s00467-012-2175-z
4. Blaine J, Chonchol M, Levi M. Renal Control of Calcium, Phosphate, and Magnesium Homeostasis. Clin J Am Soc Nephrol [Internet]. 2015 [accedido 01 Jun 2000];10(7):1257-72. Available from: https://doi.org10.2215/CJN.09750913 .
5. Kestenbaum B. Phosphate Metabolism in the Setting of Chronic Kidney Disease: Significance and Recommendations for Treatment. Sem Dial [Internet]. 2007 [accedido 01 Jan 2000];20(4):286-94. Available from: https://doi.org/10.1111/j.1525-139X.2007.00303.
6. Blaine J, Weinman EJ, Cunningham R. The regulation of renal phosphate transport. Adv Chronic Kidney Dis [Internet]. 2011 [accedido 01 Jan 2000];18(2):77-84. Available from: https://doi.org10.1053j.ackd.2011.01.005.
7. Biber J, Hernando N, Forster I, Murer H. Regulation of phosphate transport in proximal tubules. Pflugers Arch [Internet]. 2009 [accedido 01 Jan 2000];458(1):39-52. Available from: https://doi.org10.1007s00424-008-0580-8
8. Dusso AS, Brown AJ, Slatopolsky E. Vitamin D. Am J Physiol Renal -Physiol [Internet]. 2005 [accedido 01 Jan 2000];289(1):F8-F28. Available from: https://doi.org/10.1152/ajprenal.00336.2004
9. Komaba H, Kakuta T, Fukagawa M. Disease of the parathyroid gland in chronic kidney disease. Clin Exp Nephrol [Internet]. 2011 [accedido 01 Jan 2000];15(6):797-809. Available from: https://doi.org10.1007s10157-011-0502-5
10. Restrepo CA. Nefrología Básica. 2da ed. Manizales. Editorial La Patria; 2012. Capítulo 26; p. 251: Desordenes óseos y minerales en la enfermedad renal crónica.
11. Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG, Chertow GM. Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol [Internet]. 2004 [accedido 01 Jan 2000];15(8):2208-18. Available from: https://doi.org10.109701.ASN.0000133041.27682.A2
12. Huang CL, Moe OW. Clinical assessment of phosphorus status, balance and renal handling in normal individuals and in patients with chronic kidney disease. Curr Opin Nephrol Hypertens [Internet]. 2013 [accedido 01 Jan 2000];22(4):452-8. Available from: https://doi.org10.1097/MNH.0b013e328362483a
13. Ori Y, Herman M, Tobar A, Chernin G, Gafter U, Chagnac A, Izhak OB, Korzets A. Acute phosphate nephropathy: An emerging threat. Am J Med Sci [Internet]. 2008 [accedido 01 Jan 2000];336(4):309.
14. Available from: https://doi.org/10.1097/MAJ.0b013e318167410c 14. Markowitz GS, Nasr SH, Klein P, Anderson H, Stack JI, Alterman L, Price B, Radhakrishnan J, D’Agati VD. Renal failure due to acute nephrocalcinosis following oral sodium phosphate bowel cleansing. Hum Pathol [Internet]. 2004 [accedido 01 Jan 2000];35(6):675-84. Available from: https://doi.org/10.1016/j.humpath.2003.12.005
15. Lien YH. Is bowel preparation before colonoscopy a risky business for the kidney?. Nat Clin Pract Nephrol [Internet]. 2008 [accedido 01 Jan 2000];4(11):606-14. Available from:
https://doi.org/10.1038/ncpneph0939
16. Caravaca F, Villa J, Garcia de Vinuesa E, Martinez del Viejo C, Martinez Gallardo R, Macias R, Ferreira F, Cerezo I, Hernandez-Gallego R. Relationship between serum phosphorus and the progression of advanced chronic kidney disease. Nefrología [Internet]. 2011 [accedido 01 Jan 2000];31(6):707-15. Available from: https://doi.org10.3265Nefrologia.pre2011.Sep.11089
17. Voormolen N, Noordzij M, Grootendorst DC, Beetz I, Sijpkens YW, van Manen JG, et al. High plasma phosphate as a risk factor for decline in renal function and mortality in pre-dialysis patients. Nephrol Dial Transplant [Internet]. 2007 [accedido 01 Jan 2000];22(10):2909-16. Available from: https://doi.org/10.1093/ndt/gfm286
18. Chue CD, Edwards NC, Davis LJ, Steeds RP, Townend JN, Ferro CJ. Serum phosphate but not pulse wave velocity predicts decline in renal function in patients with early chronic kidney disease. Nephrol Dial Transplant [Internet]. 2011 [accedido 01 Jan 000];26(8):2576-82. Available from: https://doi.org/10.1093/ndt/gfq787
19. Kuzela DC, Huffer WE, Conger JD, Winter SD, Hammond WS. Soft tissue calcification in chronic dialysis patients. Am J Pathol [Internet]. 1977 [accedido 01 Jan 2000];86(2):403-24. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2032079/
20. Tonelli M, Sacks F, Pfeffer M, Gao Z, Curhan G; Cholesterol and Recurrent Events Trial Investigators. Relation between serum phosphate level and cardiovascular event rate in people with coronary disease. Circulation [Internet]. 2005 [accedido 01 Jan 2000];112(17):2627-33. Available from: https://doi.org/10.1161/CIRCULATIONAHA.105.553198
21. Foley RN, Collins AJ, Herzog CA, Ishani A, Kalra PA. Serum Phosphorus Levels Associate with Coronary Atherosclerosis in Young Adults. J Am Soc Nephrol [Internet]. 2009 [accedido 01 Jan 2000];20(2):397-404. Available from: https://doi.org10.1681ASN.2008020141
22. Murtaugh MA, Filipowicz R, Baird BC, Wei G, Greene T, Beddhu S. Dietary phosphorus intake and mortality in moderate chronic kidney disease: NHANES III. Nephrol Dial Tarnsplant [Internet]. 2012 [accedido 01 Jan 2000];27(3):990-6. Available from:
https://doi.org/10.1093 ndt/gfr367
23. Takeda E, Yamamoto H, Yamanaka-Okumura H, Taketani Y. Dietary phosphorus in bone health and quality of life. Nutr Rev [Internet]. 2012 [accedido 01 Jan 2000];70(6):311-21. Available from: https://doi.org10.1111/j.1753-4887.2012.00473.x
24. Adeney KL, Siscovick DS, Ix JH, Seliger SL, Shlipak MG, Jenny NS, Kestenbaum BR. Association of serum phosphate with vascular and valvular calcification in moderate CKD. J Am Soc Nephrol [Internet]. 2009 [accedido 01 Jan 2000];20(2):381-7. Available from: https://doi.org10.1681/ASN.2008040349
25. Chue CD, Edwards NC, Moody WE, Steeds RP, Townend JN, Ferro CJ. Serum phosphate is associated with left ventricular mass in patients with chronic kidney disease: a cardiac magnetic resonance study. Heart [Internet]. 2012 [accedido 01 Jan 2000];98(3):219-24. Available from: https://doi.org/10.1136/heartjnl-2011-300570
26. Yamamoto KT, Robinson-Cohen C, de Oliveira MC, Kostina A, Nettleton JA, Ix JH, Nguyen H, Eng J, Lima JA, Siscovick DS, Weiss NS, Kestenbaum B. Dietary phosphorus is associated with greater left ventricular mass. Kidney Int [Internet]. 2013 [accedido 01 Jan 2000];83(4):707-14. Available from: https://doi.org/10.1038ki.2012.303
27. Kestenbaum B, Sampson JN, Rudser KD, Patterson DJ, Seliger SL, Young B, Sherrard DJ, Andress DL. Serum Phosphate Levels and Mortality Risk among People with Chronic Kidney Disease. J Am Soc Nephrol [Internet] 2005 [accedido 01 Jan 2000];16(2):520-58. Available from: https://doi.org/10.1681/ASN.2004070602
28. Vervloet MG, van Ittersum FJ, Buttler RM, Heijboer AC, Blankenstein MA, ter Wee PM. Effects of dietary phosphate and calcium intake on fibroblast growth factor-23. Clin J Am Soc Nephrol [Internet]2011 [accedido 01 Jan 2000];6(2):383-9. Available from: https://doi.org10.2215/CJN.04730510
29. Kuro-o M. A phosphate-centric paradigm for pathophysiology and therapy of chronic kidney disease. Kidney Int Suppl [Internet]. 2013 [accedido 01 Jan 2000];3(5),420-6. Available from: http://dx.doi.org10.1038/kisup.2013.88
30. Goto S, Nakai K, Kono K, Yonekura Y, Ito J, Fujii H, Nishi S. Dietary phosphorus restriction by a standard low-protein diet decreased serum fibroblast growth factor 23 levels in patients with early and advanced stage chronic kidney disease. Clin Exp Nephrol [Internet]. 2014 [accedido 01 Jan 2000];18(6):925-31. Available from: https://doi.org10.1007s10157-014-0947-4
31. Mehrotra R, Peralta CA, Chen SC, Li S, Sachs M, Shah A, Saab G, Whaley-Connell A, Kestenbaum B, McCullough PA; Kidney Early Evaluation Program Investigators. No independent association of serum phosphorus with risk for death or progression to end-stage renal disease in a large screen for chronic kidney disease. Kidney Int [Internet]. 2013 [accedido 01 Jan 2000];84(5):989-97. Available from: https://doi.org10.1038/ki.2013.145
32. Noori N, Sims JJ; Kopple JD, Shah A, Colman S, Shinaberger CS, Bross R, Mehrotra R, Kovesdy C, Kalantar-Zadeh K. Organic and inorganic dietary phosphorus and its management in chronic kidney disease. Iran J Kidney Dis [Internet]. 2010 [accedido 01 Jan 2000];4(2):89-100. Available from: http://www.ijkd.org/index.php/ijkd/article/view/345/176
33. Kalantar-Zadeh K, Gutekunst L, Mehrotra R, Kovesdy CP, Bross R, Shinaberger CS, Noori N, Hirschberg R, Benner D, Nissenson AR, Kopple JD. Understanding sources of dietary phosphorus in the treatment of patients with chronic kidney disease. Clin J Am Soc Nephrol [Internet]. 2010 [accedido01 Jan 2000];5(3):519-30. Available from: https://doi.org10.2215/CJN.06080809
34. Lou-Arnal LM, Arnaudas-Casanova L, Caverni-Muñoz A, Vercet-TormoA, Caramelo-Gutierrez R, Munguia-Navarro P, Campos-Gutierrez B, Garcia-Mena M, Moragrera B, Moreno-Lopez R, Bielsa-Gracia S, Cuberes-Izquierdo M; Grupo de Investigación ERC Aragón. Fuentes ocultas de fósforo:presencia de aditivos con contenido en fósforo en los alimentos procesados. Nefrología [Internet].2014 [accedido 01 Jan 2000];34(4):498-506. Available from:
https://doi.org/10.3265Nefrologia.pre2014.Apr.12406
35. Moe SM, Zidehsarai MP, Chambers MA, Jackman LA, Radcliff JS, Trevino LL, Donahue SE, Asplin JR. Vegetarian compared with meat dietary protein source and phosphorus homeostasis in chronic kidney disease. Clin J Am Soc Nephrol [Internet]. 2011 [accedido 01 Jan 2000];6(2):257-64.
Available from: https://doi.org/10.2215 CJN.05040610
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38. REGLAMENTO (UE) No 1129/2011 DE LA COMISIÓN de 11 de noviembre de 2011 por el que semodifica el anexo II del Reglamento (CE) no 1333/2008 del Parlamento Europeo y del Consejo para establecer una lista de aditivos alimentarios de la Unión.
39. Resolución 333 de 2011 Por la cual se establece el reglamento técnico sobre los requisitos de rotulado o etiquetado nutricional que deben cumplir los alimentos envasados para consumo humano. (Ministerio de la Protección Social 10 de Febrero de 2011)
40. Moore LW, Nolte JV, Gaber AO, Suki WN. Association of dietary phosphate and serum phosphorus concentration by levels of kidney function. Am J Clin Nutr [Internet]. 2015 [accedido 01 Jan 2000];102(2):444-53. Available from: https://doi.org10.3945ajcn.114.102715
41. Sullivan C, Sayre SS, Leon JB, Machekano R, Love TE, Porter D, Marbury M, Sehgal AR. Effect of Food Additives on Hyperphosphatemia Among Patients With End-stage Renal Disease A Randomized Controlled Trial. JAMA [Internet]. 2009 [accedido 01 Jan 2000];301(6):629-35. Available from:https://doi.org/10.1001/jama.2009.96
42. Selamet U, Tighiouart H, Sarnak MJ, Beck G, Levey AS, Block G, Ix JH. Relationship of dietary phosphate intake with risk of end-stage renal disease and mortality in chronic kidney disease stages 3–5: The Modification of Diet in Renal Disease Study. Kidney Int [Internet]. 2016 [accedido 01 Jan 2000];89(1):176-84. Available from: https://doi.org10.1038/ki.2015.284
43. Shinaberger CS, Greenland S, Kopple JD, Van Wyck D, Mehrotra R, Kovesdy CP, Kalantar-Zadeh K. Is controlling phosphorus by decreasing dietary protein intake beneficial or harmful in persons with chronic kidney disease?. Am J Clin Nutr [Internet]. 2008 [accedido 01 Jan 2000];88(6):1511-18. Available from: https://doi.org/10.3945ajcn.2008.26665
44. D’Alessandro C, Piccoli GB, Cupisti A. The “phosphorus pyramid”: a visual tool for dietary phosphate management in dialysis and CKD patients. BMC Nephrol [Internet]. 2015 [accedido 01 Jan 2000];16:9. Available from: https://doi.org/10.1186/1471-2369-16-9
45. Cupisti A, Comar F, Benini O, Lupetti S, D’Alessandro C, Barsotti G, Gianfaldoni D. Effect of boiling on dietary phosphate and nitrogen intake. J Renal Nutr [Internet]. 2006 [accedido 01 Jan 2000];16(1):36-40. Available from: https://doi.org/10.1053/j.jrn.2005.10.005
46. Jones WL. Demineralization of a wide variety of foods for the renal patient. J Renal Nutr [Internet]. 2001 [accedido 01 Jan 2000];11(2):90-6. Available from: https://doi.org/10.1016/S1051-2276(01)38751-4
47. Reddy V, Symes F, Sethi N, Scally AJ, Scott J, Mumtaz R, Stoves J. Dietitian-Led education program to improve phosphate control in a single-center hemodialysis population. J Renal Nutr [Internet]. 2009 [accedido 01 Jan 2000];19(4):314-20. Available from: https://doi.org10.1053/j.jrn.2008.11.001
48. Gonzales-Parra E, Gracia-Iguacel C, Egido J, Ortiz A. Phosphorus and nutrition in chronic kidney disease. Int J Nephrol [Internet]. 2012 [accedido 01 Jan 2000];2012:[5 p.]. Available from: https://doi.org10.1155/2012/597605
49. Kalantar-Zadeh K. Patient education for phosphorus management in chronic kidney disease. Patient Prefer Adherence [Internet]. 2013 [accedido 01 Jan 2000];7:379-90. Available from: https://doi.org10.2147PPA.S43486
50. Tonelli M. Serum Phosphorus in people with chronic kidney disease: you are what you eat. Kidney Int [Internet]. 2013 [accedido 01 Jan 2000];84(5):871-3. Available from: https://doi.org/10.1038/ki.2013.258
2. Johnson RJ, Feehally J, Floege Jurgen. Comprehensive Clinical Nephrology. 5th ed. Amsterdam: Elsevier Saunders; 2015. Chapter 10, Disorders of Calcium, Phosphate, and Magnesium Metabolism; p. 132
3. Penido MG, Alon US. Phosphate homeostasis and its role in bone health. Pediatr Nephrol [Internet]. 2012 [accedido 01 Jun 2000];27(11):2039-48. Available from: https://doi.org10.1007s00467-012-2175-z
4. Blaine J, Chonchol M, Levi M. Renal Control of Calcium, Phosphate, and Magnesium Homeostasis. Clin J Am Soc Nephrol [Internet]. 2015 [accedido 01 Jun 2000];10(7):1257-72. Available from: https://doi.org10.2215/CJN.09750913 .
5. Kestenbaum B. Phosphate Metabolism in the Setting of Chronic Kidney Disease: Significance and Recommendations for Treatment. Sem Dial [Internet]. 2007 [accedido 01 Jan 2000];20(4):286-94. Available from: https://doi.org/10.1111/j.1525-139X.2007.00303.
6. Blaine J, Weinman EJ, Cunningham R. The regulation of renal phosphate transport. Adv Chronic Kidney Dis [Internet]. 2011 [accedido 01 Jan 2000];18(2):77-84. Available from: https://doi.org10.1053j.ackd.2011.01.005.
7. Biber J, Hernando N, Forster I, Murer H. Regulation of phosphate transport in proximal tubules. Pflugers Arch [Internet]. 2009 [accedido 01 Jan 2000];458(1):39-52. Available from: https://doi.org10.1007s00424-008-0580-8
8. Dusso AS, Brown AJ, Slatopolsky E. Vitamin D. Am J Physiol Renal -Physiol [Internet]. 2005 [accedido 01 Jan 2000];289(1):F8-F28. Available from: https://doi.org/10.1152/ajprenal.00336.2004
9. Komaba H, Kakuta T, Fukagawa M. Disease of the parathyroid gland in chronic kidney disease. Clin Exp Nephrol [Internet]. 2011 [accedido 01 Jan 2000];15(6):797-809. Available from: https://doi.org10.1007s10157-011-0502-5
10. Restrepo CA. Nefrología Básica. 2da ed. Manizales. Editorial La Patria; 2012. Capítulo 26; p. 251: Desordenes óseos y minerales en la enfermedad renal crónica.
11. Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG, Chertow GM. Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol [Internet]. 2004 [accedido 01 Jan 2000];15(8):2208-18. Available from: https://doi.org10.109701.ASN.0000133041.27682.A2
12. Huang CL, Moe OW. Clinical assessment of phosphorus status, balance and renal handling in normal individuals and in patients with chronic kidney disease. Curr Opin Nephrol Hypertens [Internet]. 2013 [accedido 01 Jan 2000];22(4):452-8. Available from: https://doi.org10.1097/MNH.0b013e328362483a
13. Ori Y, Herman M, Tobar A, Chernin G, Gafter U, Chagnac A, Izhak OB, Korzets A. Acute phosphate nephropathy: An emerging threat. Am J Med Sci [Internet]. 2008 [accedido 01 Jan 2000];336(4):309.
14. Available from: https://doi.org/10.1097/MAJ.0b013e318167410c 14. Markowitz GS, Nasr SH, Klein P, Anderson H, Stack JI, Alterman L, Price B, Radhakrishnan J, D’Agati VD. Renal failure due to acute nephrocalcinosis following oral sodium phosphate bowel cleansing. Hum Pathol [Internet]. 2004 [accedido 01 Jan 2000];35(6):675-84. Available from: https://doi.org/10.1016/j.humpath.2003.12.005
15. Lien YH. Is bowel preparation before colonoscopy a risky business for the kidney?. Nat Clin Pract Nephrol [Internet]. 2008 [accedido 01 Jan 2000];4(11):606-14. Available from:
https://doi.org/10.1038/ncpneph0939
16. Caravaca F, Villa J, Garcia de Vinuesa E, Martinez del Viejo C, Martinez Gallardo R, Macias R, Ferreira F, Cerezo I, Hernandez-Gallego R. Relationship between serum phosphorus and the progression of advanced chronic kidney disease. Nefrología [Internet]. 2011 [accedido 01 Jan 2000];31(6):707-15. Available from: https://doi.org10.3265Nefrologia.pre2011.Sep.11089
17. Voormolen N, Noordzij M, Grootendorst DC, Beetz I, Sijpkens YW, van Manen JG, et al. High plasma phosphate as a risk factor for decline in renal function and mortality in pre-dialysis patients. Nephrol Dial Transplant [Internet]. 2007 [accedido 01 Jan 2000];22(10):2909-16. Available from: https://doi.org/10.1093/ndt/gfm286
18. Chue CD, Edwards NC, Davis LJ, Steeds RP, Townend JN, Ferro CJ. Serum phosphate but not pulse wave velocity predicts decline in renal function in patients with early chronic kidney disease. Nephrol Dial Transplant [Internet]. 2011 [accedido 01 Jan 000];26(8):2576-82. Available from: https://doi.org/10.1093/ndt/gfq787
19. Kuzela DC, Huffer WE, Conger JD, Winter SD, Hammond WS. Soft tissue calcification in chronic dialysis patients. Am J Pathol [Internet]. 1977 [accedido 01 Jan 2000];86(2):403-24. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2032079/
20. Tonelli M, Sacks F, Pfeffer M, Gao Z, Curhan G; Cholesterol and Recurrent Events Trial Investigators. Relation between serum phosphate level and cardiovascular event rate in people with coronary disease. Circulation [Internet]. 2005 [accedido 01 Jan 2000];112(17):2627-33. Available from: https://doi.org/10.1161/CIRCULATIONAHA.105.553198
21. Foley RN, Collins AJ, Herzog CA, Ishani A, Kalra PA. Serum Phosphorus Levels Associate with Coronary Atherosclerosis in Young Adults. J Am Soc Nephrol [Internet]. 2009 [accedido 01 Jan 2000];20(2):397-404. Available from: https://doi.org10.1681ASN.2008020141
22. Murtaugh MA, Filipowicz R, Baird BC, Wei G, Greene T, Beddhu S. Dietary phosphorus intake and mortality in moderate chronic kidney disease: NHANES III. Nephrol Dial Tarnsplant [Internet]. 2012 [accedido 01 Jan 2000];27(3):990-6. Available from:
https://doi.org/10.1093 ndt/gfr367
23. Takeda E, Yamamoto H, Yamanaka-Okumura H, Taketani Y. Dietary phosphorus in bone health and quality of life. Nutr Rev [Internet]. 2012 [accedido 01 Jan 2000];70(6):311-21. Available from: https://doi.org10.1111/j.1753-4887.2012.00473.x
24. Adeney KL, Siscovick DS, Ix JH, Seliger SL, Shlipak MG, Jenny NS, Kestenbaum BR. Association of serum phosphate with vascular and valvular calcification in moderate CKD. J Am Soc Nephrol [Internet]. 2009 [accedido 01 Jan 2000];20(2):381-7. Available from: https://doi.org10.1681/ASN.2008040349
25. Chue CD, Edwards NC, Moody WE, Steeds RP, Townend JN, Ferro CJ. Serum phosphate is associated with left ventricular mass in patients with chronic kidney disease: a cardiac magnetic resonance study. Heart [Internet]. 2012 [accedido 01 Jan 2000];98(3):219-24. Available from: https://doi.org/10.1136/heartjnl-2011-300570
26. Yamamoto KT, Robinson-Cohen C, de Oliveira MC, Kostina A, Nettleton JA, Ix JH, Nguyen H, Eng J, Lima JA, Siscovick DS, Weiss NS, Kestenbaum B. Dietary phosphorus is associated with greater left ventricular mass. Kidney Int [Internet]. 2013 [accedido 01 Jan 2000];83(4):707-14. Available from: https://doi.org/10.1038ki.2012.303
27. Kestenbaum B, Sampson JN, Rudser KD, Patterson DJ, Seliger SL, Young B, Sherrard DJ, Andress DL. Serum Phosphate Levels and Mortality Risk among People with Chronic Kidney Disease. J Am Soc Nephrol [Internet] 2005 [accedido 01 Jan 2000];16(2):520-58. Available from: https://doi.org/10.1681/ASN.2004070602
28. Vervloet MG, van Ittersum FJ, Buttler RM, Heijboer AC, Blankenstein MA, ter Wee PM. Effects of dietary phosphate and calcium intake on fibroblast growth factor-23. Clin J Am Soc Nephrol [Internet]2011 [accedido 01 Jan 2000];6(2):383-9. Available from: https://doi.org10.2215/CJN.04730510
29. Kuro-o M. A phosphate-centric paradigm for pathophysiology and therapy of chronic kidney disease. Kidney Int Suppl [Internet]. 2013 [accedido 01 Jan 2000];3(5),420-6. Available from: http://dx.doi.org10.1038/kisup.2013.88
30. Goto S, Nakai K, Kono K, Yonekura Y, Ito J, Fujii H, Nishi S. Dietary phosphorus restriction by a standard low-protein diet decreased serum fibroblast growth factor 23 levels in patients with early and advanced stage chronic kidney disease. Clin Exp Nephrol [Internet]. 2014 [accedido 01 Jan 2000];18(6):925-31. Available from: https://doi.org10.1007s10157-014-0947-4
31. Mehrotra R, Peralta CA, Chen SC, Li S, Sachs M, Shah A, Saab G, Whaley-Connell A, Kestenbaum B, McCullough PA; Kidney Early Evaluation Program Investigators. No independent association of serum phosphorus with risk for death or progression to end-stage renal disease in a large screen for chronic kidney disease. Kidney Int [Internet]. 2013 [accedido 01 Jan 2000];84(5):989-97. Available from: https://doi.org10.1038/ki.2013.145
32. Noori N, Sims JJ; Kopple JD, Shah A, Colman S, Shinaberger CS, Bross R, Mehrotra R, Kovesdy C, Kalantar-Zadeh K. Organic and inorganic dietary phosphorus and its management in chronic kidney disease. Iran J Kidney Dis [Internet]. 2010 [accedido 01 Jan 2000];4(2):89-100. Available from: http://www.ijkd.org/index.php/ijkd/article/view/345/176
33. Kalantar-Zadeh K, Gutekunst L, Mehrotra R, Kovesdy CP, Bross R, Shinaberger CS, Noori N, Hirschberg R, Benner D, Nissenson AR, Kopple JD. Understanding sources of dietary phosphorus in the treatment of patients with chronic kidney disease. Clin J Am Soc Nephrol [Internet]. 2010 [accedido01 Jan 2000];5(3):519-30. Available from: https://doi.org10.2215/CJN.06080809
34. Lou-Arnal LM, Arnaudas-Casanova L, Caverni-Muñoz A, Vercet-TormoA, Caramelo-Gutierrez R, Munguia-Navarro P, Campos-Gutierrez B, Garcia-Mena M, Moragrera B, Moreno-Lopez R, Bielsa-Gracia S, Cuberes-Izquierdo M; Grupo de Investigación ERC Aragón. Fuentes ocultas de fósforo:presencia de aditivos con contenido en fósforo en los alimentos procesados. Nefrología [Internet].2014 [accedido 01 Jan 2000];34(4):498-506. Available from:
https://doi.org/10.3265Nefrologia.pre2014.Apr.12406
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