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Phosphate Bioavailability Diet — ESENeph MCQ

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ModerateChronic Kidney DiseasePhosphate Bioavailability DietESENeph

A 55-year-old man on HD has persistently elevated phosphate despite dietary counselling and Sevelamer. What is the most important dietary distinction for phosphate management?

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Correct answer: C — Inorganic phosphate additives in processed food have 80-100% absorption vs 40-60% for organic phosphate in natural food – reducing processed food is the priority

Phosphate bioavailability differs critically: organic phosphate in natural foods is 40-60% absorbed; phytate-bound phosphate in plants is 20-40%; but inorganic phosphate additives in processed foods (E-numbers) have 80-100% absorption. KDIGO 2017 CKD-MBD emphasises reducing processed food phosphate additives as the most impactful dietary intervention. Boiling can reduce food phosphate by 30-50%.

Reference: KDIGO 2017 – CKD-MBD; Kalantar-Zadeh et al 2010