A randomized controlled trial of an educational intervention to improve phosphate levels in hemodialysis patients.
OBJECTIVE
To determine the effect of a dietetic educational intervention on phosphate and calcium levels of hemodialysis patients.


METHODS
Parallel-group randomized controlled trial.


METHODS
Teaching hospital hemodialysis unit in London, England.


METHODS
Fifty-six stable adult hemodialysis patients with hyperphosphatemia.


METHODS
An educational intervention and one-to-one teaching session given by a renal dietitian, attempting to improve patients' knowledge of phosphate management and their compliance with diet and medication.


METHODS
Patients' serum phosphate, calcium, and calcium x phosphate products in the 3 months after the intervention, compared with those before the intervention. Results were also compared with a control group that had not undergone the intervention.


RESULTS
In the intervention group, serum phosphate was significantly reduced after the education session, as compared with the results previously. In the control group, there was no significant change in serum phosphate level. The improved results were sustained over a period of 3 months. Serum calcium increased in the intervention group, but this result was not significant. There was an improvement in the calcium-phosphate product in the intervention group, but again this was not significant.


CONCLUSIONS
Dietetic educational intervention can favorably alter patients' serum phosphate levels, with potential impact on morbidity and mortality.
Ashurst
Ione de Brito
Ide B
Nutrition and Dietetics Department, Middlesex Hospital, London, England, UK. ione.ashurst@uclh.org
Dobbie
Hamish
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000097:blood / Q000378:metabolism; D004045:Dietary Services; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008499:Medical Records; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000378:metabolism; D010349:Patient Compliance; D010353:Patient Education as Topic; D010358:Patient Participation; D010710:Phosphates / Q000097:blood* / Q000378:metabolism; D006435:Renal Dialysis; D013664:Teaching Materials; D014807:Vitamin D / Q000378:metabolism
D010281:Parathyroid Hormone; D010710:Phosphates; D014807:Vitamin D; D002118:Calcium