Effects of education on low-phosphate diet and phosphate binder intake to control serum phosphate among maintenance hemodialysis patients: A randomized controlled trial.
10.23876/j.krcp.2018.37.1.69
- Author:
Eunsoo LIM
1
;
Sunah HYUN
;
Jae Myeong LEE
;
Seirhan KIM
;
Min Jeong LEE
;
Sun Mi LEE
;
Ye Sung OH
;
Inwhee PARK
;
Gyu Tae SHIN
;
Heungsoo KIM
;
Donald E MORISKY
;
Jong Cheol JEONG
Author Information
1. Department of Nephrology, Ajou University School of Medicine, Suwon, Korea. jcj0425@empal.com
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
Compliance;
Hemodialysis;
Hyperphosphatemia;
Phosphates
- MeSH:
Body Weight;
Compliance;
Dialysis;
Diet*;
Dietary Proteins;
Education*;
Humans;
Hyperphosphatemia;
Patient Education as Topic;
Phosphates;
Renal Dialysis*
- From:Kidney Research and Clinical Practice
2018;37(1):69-76
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: For phosphate control, patient education is essential due to the limited clearance of phosphate by dialysis. However, well-designed randomized controlled trials about dietary and phosphate binder education have been scarce. METHODS: We enrolled maintenance hemodialysis patients and randomized them into an education group (n = 48) or a control group (n = 22). We assessed the patients’ drug compliance and their knowledge about the phosphate binder using a questionnaire. RESULTS: The primary goal was to increase the number of patients who reached a calcium-phosphorus product of lower than 55. In the education group, 36 (75.0%) patients achieved the primary goal, as compared with 16 (72.7%) in the control group (P = 0.430). The education increased the proportion of patients who properly took the phosphate binder (22.9% vs. 3.5%, P = 0.087), but not to statistical significance. Education did not affect the amount of dietary phosphate intake per body weight (education vs. control: −1.18 ± 3.54 vs. −0.88 ± 2.04 mg/kg, P = 0.851). However, the dietary phosphate-to-protein ratio tended to be lower in the education group (−0.64 ± 2.04 vs. 0.65 ± 3.55, P = 0.193). The education on phosphate restriction affected neither the Patient-Generated Subjective Global Assessment score (0.17 ± 4.58 vs. −0.86 ± 3.86, P = 0.363) nor the level of dietary protein intake (−0.03 ± 0.33 vs. −0.09 ± 0.18, P = 0.569). CONCLUSION: Education did not affect the calcium-phosphate product. Education on the proper timing of phosphate binder intake and the dietary phosphate-to-protein ratio showed marginal efficacy.