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

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 (CaCO3) 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.