Example of Coronary Calcification Age y Dietary Calcium Limit mgd 1930 2500 31 50 2500 5170 2000 gt 70 2000 IOM website 1 Upper Level Calcium Intake Adults Many raw meats now contain phosphate additives to enhance their ID: 369725
Download Presentation The PPT/PDF document "Helical noncontrast-enhanced CT showing ..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Helical noncontrast-enhanced CT showing calcification involving the left main coronary artery.
Example of Coronary CalcificationSlide2
Age, y
Dietary Calcium Limit, mg/d19-30250031-50250051-702000
> 70
2000
IOM website.[1]
Upper Level Calcium
Intake: AdultsSlide3
*Many raw meats now contain phosphate additives to enhance their
flavor. Phosphorus content may vary depending on the product brand or manufacturer.Sullivan K, et al. J Renal Nutr. 2007;17:350-354[3]; NKF. 2014[4]; Kalanter-Zadeh RA, et al.
Clin
J Am Soc Nephrol 2010;5:519-530[5]
; Sherman RA, et al. Clin J Am Soc Nephrol. 2009;4:1370-1373.
[6]
Phosphorus in Foods
Phosphorus-Rich
Foods
Phosphorus Level,
mg
Lower-Phosphorus Substitutes
Phosphorus Level, mg
Chicken breast, breaded, flavor-enhanced (3.5 oz)*
242
Chicken breast
, fresh, not flavor-enhanced (3.5 oz)
182
Pork chop, flavor-enhanced
(3.5
oz
)*
340
Pork chop, not flavor-enhanced
(3.5
oz
)
210
Milk (8 oz)
230
Nondairy creamer (8 oz)
100
Peanuts (2 oz)
200
Popcorn (1.5
c)
35
Hard
cheese (1 oz)
145
Cream cheese (1 oz)
30
Oatmeal (2/3 c)
130
Cream
of wheat or grits
(2/3 c)
40
Pinto beans (1/2 c)
100
Green
beans (1
/2 c)
35
Ice cream (1/2
c)
80
Sherbet (1/2
c)
0
Egg (1 large)
72
Egg
white (1 large)
5
Dark cola (12 oz)
55
Ginger
ale
(12 oz)
3Slide4
Phosphate Binder
Available FormsAluminum hydroxide*Liquid, capsule, tablet
Calcium acetate
†
Capsule, tabletCalcium carbonate
†
Liquid, tablet, capsule, chewable, gum
Lanthanum carbonateWafer, chewableSevelamer hydrochlorideTabletSevelamer carbonate Tablet,
powder
Sucroferric oxyhydroxideTablet
*Prolonged administration may increase the risk for aluminum intoxication.†May increase risk of soft-tissue calcification.KDIGO. CKD-MBD Work Group. Kidney Int. 2009;76:S1-S130.[2]
Phosphate Binders Commonly Used to Manage Hyperphosphatemia in Patients
With
CKDSlide5
Patient Education Resources
Sources (clockwise from left): Medscape Education[7]; USDHHS. 2009. Reproduced with permission.[8]; NKDEP. 2012. Reproduced with permission.[9]; NKDEP. 2010. Reproduced with permission.[10] Slide6
Making Food Choices
Convenience and fast foods often contain phosphorus additivesThe breading on many fried foods may substantially increase phosphorus contentDietitians should work closely with patients to help them make appropriate food choicesSullivan K, et al. J Renal Nutr. 2007;17:350-354.[3]Slide7
Kalanter-Zadeh RA, et al.
Clin J Am Soc Nephrol 2010;5:519-530[5] Dicalcium phosphateDisodium phosphateMonosodium phosphatePhosphoric acidSodium hexameta-phosphateSodium tripolyphosphateTetrasodium pyrophosphateTrisodium
phosphate
P-H-O-S-
phorus
-containing Food Additives Common in Processed, Preserved, or Enhanced Foods and Soft DrinksSlide8
Motivational Interviewing: Steps for Success
Engage the patientBuild rapportPartner to set goalsIdentify barriers to changeSupport self-efficacyAffirm successesMartino S. Blood Purif. 2011;31:77-81.[13]