LAUSR

Dietary intake patterns in hemodialysis (HD) patients in Korea are diverse and unique comparing with those of other countries. Hyperphosphatemia and hyperkalemia are closely related to intake of dietary phosphorus and potassium. Dietary intake of Korean HD patients was analyzed using newly developed semi-FFQ for Korean food in order to get the baseline data for improving a dietary management guide for Korean HD patients. We investigate the effects of consumed food on serum phosphorus and potassium levels of 128 HD patients(74 males and 54 females) in 6 tertiary referral hospitals using semi-FFQ consisting of 23 food meal items based on the Korean usual diets. The mean age was 59.7±11.6 years for males and 58.9± 9.3 years for females and the hemodialysis duration was 5.4±5.6 years for men and 5.4±3.9 years for women, respectively. Mean serum phosphorus level was 4.50±1.52 mg/dl and mean serum potassium level was 4.74±0.73 mEq/L. Hyperphosphatemia was found in 45.8% of the subjects, and hyperkalemia in 35.4%. Energy, protein and other nutrients intake were significantly lower than the recommended intakes for HD patients (p<0.05). Serum phosphorus levels showed positive correlation with intake of mixed grain meals (p<0.05). There was a significant difference in the daily intake frequency of cooked rice between males (2.5±0.76/day) and females (2.15±0.86/day)(p<0.001). The noodle intake frequency also showed a significant difference between males (0.09±0.14/day) and females (0.04±0.06/day) (p<0.001). Serum potassium level showed positive correlation with intake of potatoes, high-potassium vegetables & fruits and Kimchi (p<0.05). There was a significant gender difference in the daily intake frequency of Kimchi between males (1.28±0.11/day) and females (1.07±0.99/day)(p<0.05). In case of medium and high potassium vegetables & fruits, consumption was higher in females than in males (p<0.05). Intake of white rice showed negative correlation with serum potassium levels (p<0.05). Intake of white rice meals rather than mixed grains meals is an important factor for maintaining normal serum phosphorus and potassium levels. Intake of potatoes, medium and high potassium vegetables & fruits is recommended to be reduced to less than three serving per week. Considering abundance of potassium and phosphorus in Korean food pattern, customized dietary management as well as medical treatment is essential in all HD patients.