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Background and Aims In chronic kidney disease (CKD) patients, phosphate (P) restriction is crucial for the control of mineral metabolism. Many reports indicate that P intake doesnot correlate with 24-hour phosphaturia. Different sources of P (organic or inorganic) have different intestinal absorption rates. Different proportions of organic and inorganic P in diet might be the reason for the lack of correlation between phosphorus intake and phosphaturia. Therefore, we aimed to evaluate if the source of dietary P rather than the total amount of P ingested determines total phosphaturia and it was accessed to what extent inorganic P intake modifies phosphaturia Method A 3-day dietary survey was performed in 71 stages G2-3 CKD patients with metabolic syndrome to estimate the amount and source of P in the diet. Blood and 24-hour urine-samples were collected. Total phosphaturia, fractional excretion of P (FeP%), urinary P/eGFR ratio (mg/day/GFR that reflects the urine P excretion relative to renal function), P/creatinine ratio, urinary urea /Cr ratio, and urinary P/urea ratio (that reflects daily intestinal absorption of P relative to the amount of proteins absorbed and metabolized) were evaluated. P/urea ratio was categorized into tertiles and contrasted in terms of the other variables analyzed (T1=&amp;lt;0.027 mg/mg, T2=0.027-0.033 mg/mg, T3= &amp;gt;0.033 mg/mg). Statistics were performed using R 3.6.2, RStudio, Tidyverse, and tableone v0.10.0 packages. Results Patients` age was 61±9 years, and eGFR was 68±21 ml/min/1.73m2. Estimated P intake was 869±289 mg/day. According to sources, P intake was 64% from animal sources, 22% from vegetable sources, and 14% from inorganic P. Total P intake did not correlate with urinary P (r=0.18, p=0.12), urinary P/eGFR (r=-0.32, p=0.79), or FeP (r=-0.08, p=0.48). Figure 1 shows that patients ingesting more P have a greater intake of inorganic P. There was a correlation between P intake and P/Urea ratio (p=0.008). Patients in the upper urinary P/urea tertile showed the highest daily P intake (p=0.04), and inorganic P (p=0.03). These patients from tertile 3 also showed the highest amount of urinary P excretion (p=0.04). Conclusion Urinary P/urea reflects the total P intake and, more importantly, provides information about the amount of inorganic P. Therefore, the P/urea ratio may be used to guide the appropriate nutritional advice for CKD patients.

MO022URINARY PHOSPHATE/UREA RATIO, A NEW TOOL TO EVALUATE ADHERENCE TO PHOSPHATE DIETARY INTERVENTIONS IN CKD PATIENTS