Calcium carbonate-enriched cheese to improve nutrition, compliance and phosphorus control in patients on kidney replacement therapy

Ardissino, Gianluigi; Matta, Roberto; Patricelli, Mariagrazia; Capone, Valentina; Leoni, Antonio; Groppelli, Antonio; Vettoretti, Simone; Pavone, Laura; Margiotta, Elisabetta; Brancadoro, Annamaria; Grimaldi, Emanuele; Cropanese, Isabella; Raffiotta, Francesca; Messa, Piergiorgio; Montini, Giovanni

BACKGROUND: Patients on renal replacement therapy face many dietary limitations, and cheese is often limited because of its high phosphate content; we have developed cheese with added calcium carbonate (CaCO(3)) to provide patients with a nutritional opportunity while improving their phosphate control. METHODS: The present double-blind crossover study was aimed to compare the new modified cheese with an equivalent standard product in 16 patients. The increase in inter-dialysis phosphorus (ΔP) and pre-dialysis calcium were used as the primary endpoints for efficacy and safety. RESULTS: The median ΔP (and IQR) was significantly lower with the modified cheese compared with the standard product: 2.5 (1.9–2.9) mg/dL vs. 2.7 (2.2–3.4) mg/dL, respectively (p < 0.02). No difference was observed in pre-dialysis serum calcium levels. CONCLUSIONS: The described modified cheese may represent an interesting means of overcoming some of the dietary limitations in patients on dialysis to help them achieve better nutrition and quality of life. GRAPHIC ABSTRACT: [Image: see text]