Abstract
The control of phosphorus and calcium metabolism is one of the objectives in treatment protocol for CKD patients. The levels of these minerals in serum are affected by dietary patterns and nutritional status of the patients. India being a large country, diet patterns vary from one state to another. Thus, we suspect a close association between dietary intake and alterations in homeostasis of calcium and phosphorus in CKD patients. Therefore, we conduct this study to describe the effect of dietary factors and nutritional status on serum calcium and phosphorus levels in CKD patients on treatment in a tertiary care setting in North India. In the present study 330 CKD patients coming to dialysis unit, were recorded with detailed Medical history as well as baseline demographic data. Also, biochemical analysis of serum albumin corrected, calcium, phosphorus, and serum albumin of all cases were done using fully automated equipment. All statistical analyses were performed using SPSS statistical software, version 17. Majority (58.2 %) of the study patients were vegetarians with a mean value of BMI (Mean ± SD = 23.75 ± 4.70 kg/m2). A negative but significant correlation was found between corrected calcium and phosphorus with 0.05 level of confidence interval (r=-0.149, p= 0.007). It was found that the well-nourished patients were more likely to be hyperphosphatemic as compared to poorly nourished patients, but statistically the values were found to be non significant (Statistically p-value was not less than 0.05). 
 Peer Review History: 
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 Received file 
 
 Average Peer review marks at initial stage: 6.5/10
 Average Peer review marks at publication stage: 8.5/10
 Reviewer(s) detail:
 Name: Dina Abd Elfattah Eldakhs
 Affiliation: Pharos university (PUA), Egypt
 E-mail: dina_eldakhs@yahoo.com
 
 Name: Dr. Mohammad Tauseef 
 Affiliation: Department of Pharmaceutical Sciences College of Pharmacy, Chicago State University
 E-mail: mtauseef@csu.edu
 
 Comments of reviewer(s): 
 
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Highlights
Effect of dietary factors and nutritional status on serum calcium and phosphorus levels in Chronic kidney disease (CKD) patients on treatment in a tertiary care setting in North India
It was observed that the percentage of vegetarians who were hyperphosphatemic was more than non vegetarians and found that the well nourished patients were more likely to be hyperphosphatemic as compared to poorly nourished patients, but statistically the values were found to be nonsignificant (Table 2) The Figure 5 clearly shows hyperphosphatemia as a constant finding in all baseline demographic parameters of the CKD patients
The inability of the CKD Patients to achieve the above said target range may be on account of implementing different modalities for regulation of calcium and phosphorus levels in Indian dialysis population as given below: 1. Patients were using calcium based phosphate binders only in our centre as compared to noncalcium based phosphate binders
Summary
Research Setting: The study was conducted at the Gian Sagar Medical Hospital, Ramnagar, Patiala, under the Department of Physiology and dialysis unit, department of Medicine. Study Population and Study Period: 330 Chronic Kidney Disease Patients>18 years of age and belonging to both sexes were on maintenance hemodialysis in dialysis unit of Gian Sagar Medical College and Hospital, Ramnagar (Patiala) over a period from December, 2012 to December, 2016. Each patient was considered only once for the study. Ethical approval and informed consent: After approval by ethical committee of Gian Sagar medical College and Hospital, this study was initiated. An informed consent was taken from all the subjects before inclusion in the study. Data Collection and statistical analysis: The study was started after proper approval from Institutional Research Ethics Committee. Patients were selected based upon the inclusion and exclusion criteria
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