Association of dietary patterns with serum phosphorus in maintenance haemodialysis patients: a cross-sectional study
Ban‐Hock Khor, Ayesha Sualeheen, Sharmela Sahathevan, Karuthan Chinna, Abdul Halim Abdul Gafor, Sunita Bavanandan, Bak Leong Goh, Zaki Morad, Zulfitri Azuan Mat Daud, Pramod Khosla, Angela Yee‐Moon Wang, Tilakavati Karupaiah, PaTCH Investigators, Boon Cheak Bee, Ghazali Ahmad, Soo Kun Lim, Mohammad Zaimi Abdul Wahab, Ravindran Visvanathan, Rosnawati Yahya
Abstract
Abstract Sources of dietary phosphate differentially contribute to hyperphosphatemia in maintenance haemodialysis (MHD) patients. This cross-sectional study in Malaysia investigated association between dietary patterns and serum phosphorus in MHD patients. Dietary patterns were derived by principal component analysis, based on 27 food groups shortlisted from 3-day dietary recalls of 435 MHD patients. Associations of serum phosphorus were examined with identified dietary patterns. Three dietary patterns emerged: Home foods (HF dp ), Sugar-sweetened beverages (SSB dp ), and Eating out noodles (EO-N dp ). The highest tertile of patients in HF (T3-HF dp ) pattern significantly associated with higher intakes of total protein ( p = 0.002), animal protein ( p = 0.001), and animal-based organic phosphate ( p < 0.001), whilst T3-SSB dp patients had significantly higher intakes of total energy ( p < 0.001), inorganic phosphate ( p < 0.001), and phosphate:protein ratio ( p = 0.001). T3-EO-N dp patients had significantly higher intakes of total energy ( p = 0.033), total protein ( p = 0.003), plant protein ( p < 0.001), but lower phosphate:protein ratio ( p = 0.009). T3-SSB dp patients had significantly higher serum phosphorus ( p = 0.006). The odds ratio of serum phosphorous > 2.00 mmol/l was significantly 2.35 times higher ( p = 0.005) with the T3-SSB dp . The SSB dp was associated with greater consumption of inorganic phosphate and higher serum phosphorus levels.