J Nutr Health.  2014 Feb;47(1):33-44.

Association of food intake with serum levels of phosphorus and potassium in hemodialysis patients

  • 1Department of Food and Nutrition, Hanyang University, Seoul 133-791, Korea. leess@hanyang.ac.kr
  • 2Department of Nephrology, Seoul Hospital, Hanyang University, Seoul 133-792, Korea.


Elevated serum phosphorus and potassium levels are a major problem for hemodialysis (HD) patients. Hyperphosphatemia and hyperkalemia are closely related to intake of dietary phosphorus and potassium.
This study was conducted in order to investigate the effects of food consumed on serum phosphorus and potassium levels in 48 HD patients (20 males and 28 females). We collected anthropometric data, biochemical parameters, and dietary data of the subjects. Dietary data for usual intake were obtained by use of a food-frequency questionnaire (FFQ) consisting of 21 food items.
The mean body mass index (BMI) was 22.2 +/- 3.0 kg/m2, mean serum phosphorus level was 4.50 +/- 1.52 mg/dl, and mean serum potassium level was 4.74 +/- 0.73 mEq/l. Hyperphosphatemia (> 4.5 mg/dl) was found in 45.8% of subjects, and hyperkalemia (> 5.0 mEq/l) in 35.4%. Subjects who took medication only were 56% of total, and those who took medication with dietary therapy were 27%. Patients with medication and dietary therapy showed significantly lower serum phosphorus levels compared to patients with medication only (p < 0.05). Mean duration of HD was 7.9 +/- 7.3 years and it showed positive correlation with serum potassium levels (p < 0.05). Serum phosphorus levels showed positive correlation with intake of mixed grains and soybean milk (p < 0.05). Serum potassium levels showed positive correlation with intake of mixed grains (p < 0.01), potatoes, fish, and high-potassium vegetables (p < 0.05). On the other hand, intake of white rice showed negative correlation with serum potassium levels (p < 0.05).
The results of our study suggest that intake of white rice rather than mixed grains is an important factor in sustaining normal serum phosphorus and potassium levels. In addition, limiting intake of soybean milk, potatoes, and fish to under three serving per week is recommended. Finally, conduct of a strict dietary therapy along with medical treatment is desirable because inappropriate food intake increases serum phosphorus and potassium levels to a higher than normal range.


hemodialysis; hyperphosphatemia; hyperkalemia; food frequency questionnaire (FFQ)

MeSH Terms

Body Mass Index
Edible Grain
Phosphorus, Dietary
Surveys and Questionnaires
Reference Values
Renal Dialysis*
Solanum tuberosum
Phosphorus, Dietary


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