Therapy options - the 3 D's
Diet: In a clinical setting, there are different options to counteract the problem of hyperphosphataemia. First, it is important that the patient restricts dietary phosphate intake. High amounts of phosphate are to be found in processed food and in food with a high protein content. Unfortunately, dialysis patients must take care not to develop protein malnutrition. It is thus important to choose food with a high protein content which has as low phosphate content as possible, i.e. a low phosphate/protein ratio.
Dialysis: The second and clearly most efficient method to reduce phosphate levels in CKD patients is regular and modern haemodialysis treatment. Depending on the chosen procedure, a normal dialysis treatment is capable of eliminating more phosphate in one session than the average daily intake. However, as the most common dialysis schedule involves three therapy sessions per week, versus seven days of nutritional intake, the patient's phosphate balance is positive, resulting in net phosphate accumulation.
Drugs: The amount of absorbed phosphate can be additionally reduced with the third option: medication.