The 'Phosphorus Week': involvement of Spanish nephrologists in the control of phosphorus blood levels.

BACKGROUND: The adequate control of phosphorus levels is a major concern for professionals involved in the care of patients with chronic kidney disease (CKD), since high phosphorus levels are directly related to an increase in mortality. OBJECTIVES: To know the perception and involvement of Spanish nephrologists on the control of phosphorus levels, the so-called 'Phosphorus Week' was organized (November 13-17, 2017). METHODS: All members of the Spanish Society of Nephrology were invited to participate in an online survey, which included questions on aspects related to phosphorus control in patients with advanced CKD (aCKD) (glomerular filtration rate <30 ml/min/1, 73 m2) and in the different modalities of renal replacement therapies [peritoneal dialysis (PD), hemodialysis (HD) and renal transplantation (KT)]. RESULTS: 72 data entries were obtained in the survey with an inclusion of 7463 patients. Of them, 35.4% were on HD, 34.8% were KT, 24.2% had aCKD and 5.5% were on PD. The serum phosphorus level target for the four groups of patients was 4.5 mg/dl, with minimal variations depending on the area of ​​the national territory. The patients with better control of phosphataemia were patients with KT (93.3% had phosphorus values ​​<4.5 mg/dl), followed by patients with aCKD (65.6% with phosphorus <4.5 mg/dl). Only 53.6% of the patients on HD and 39.4% of those on PD reached the phosphorus goal <4.5 mg/dl. The group of patients on dialysis was the one in whom phosphorus binders prescribed the most (73.5% and 75.6% in HD and PD, respectively), being less frequent in patients with patients with aCKD (39.9%) and only 4.5 % in KT. CONCLUSIONS: The objectives of the Spanish nephrologists are in line with those recommended by the national and international clinical guidelines; however, there is still a wide room for improvement to achieve these goals, especially in HD and PD patients.

La dieta en el paciente litiásico: una guía práctica / Diet in the lithiasic patient: A practical guide

La incidencia y prevalencia de la enfermedad litiásica en los países desarrollados ha aumentado en los últimos años. Debido a que la dieta es uno de los factores de riesgo de la urolitiasis, y tanto esta como el estilo de vida han evolucionado en las últimas décadas, dichos cambios podrían explicarnos el aumento en la causística de la litiasis renal. En el presente trabajo analizamos cuál ha sido el proceder del urólogo en cuanto al papel preventivo de la dieta en el paciente litiásico, qué evidencias científicas existen en cuanto a la relación entre dieta y litiasis y, en base a ello, qué recomendaciones generales dietéticas podemos dar actualmente a nuestros pacientes

The incidence and prevalence of lithiasic disease in developed countries has increased over the last years. Being diet one of the risk factors for urolithiasis, and having it evolved in conjunction with lifestyle over the last decades, such changes could explain the increase in lithiasis case-load. In this article, we analyze how the exercise of the urologist has been regarding the preventive role of diet in the lithiasis patient, what are the scientific evidences on the relationship of diet and lithiasis, and, on this base, what general dietetic recommendations we can give currently to our patients