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Low-protein rice, low-phosphorus whey may improve hyperphosphatemia

ByKristine Houck, MA, ELS

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Song Wang

WASHINGTON — For patients on hemodialysis who eat rice as a main source of calories, low-protein rice plus low-phosphorus whey can reduce serum phosphorus and improve serum albumin, according to study results presented at ASN Kidney Week.

“Some patients sometimes don’t eat high-phosphorous foods, like meat and eggs. In Asia, most people eat rice. Although the phosphorus is not very high, but if they eat a lot of rice, then their phosphorous intake is high,” Song Wang, MD, of Peking University Third Hospital, Beijing, China, said.

In the self-controlled study, Wang and colleagues enrolled 29 patients on hemodialysis with average serum phosphorus of at least 5.5 mg/dL for 3 consecutive months. Patients initially received 4 weeks of low-phosphorus diet instruction, followed by 10 weeks of low-protein rice plus low-phosphorus whey to replace the protein gap. After 10 weeks, patients ate normal rice for 8 weeks. Researchers measured the changes in serum phosphorus, serum albumin, calcium, intact parathyroid hormone and nutritional evaluation.

Baseline serum phosphorus was 6.66±0.87 mg/dL. After diet instruction, serum phosphorus was 6.27±1.54 mg/dL. After patients changed to low-protein rice, serum phosphorus decreased to 5.43±1.71 mg/dL after 2 weeks, 5.36±1.50 mg/dL after 6 weeks and 5.79±1.35 mg/dL after 10 weeks. When patients returned to eating normal rice, serum phosphorus increased to 6.05±0.98 mg/dL. Researchers found phosphorus intake was low for low-protein rice compared with normal rice and serum albumin increased with low-protein rice combined with low-phosphorus whey.

“For those patients who eat rice as their main food, using the low-protein rice and low-phosphorus whey can decrease serum phosphorus and maintain nutritional status,” Wang said.

Researchers observed no change in serum calcium, intact parathyroid hormone levels, dialysis strategy and phosphorus-binding agents. – by Kristine Houck, MA, ELS

Reference:

Wang S, et al. Abstract FR-PO152. Presented at: ASN Kidney Week; Nov. 7-10, 2019; Washington D.C.

Disclosure: Wang reports no relevant financial disclosures.