Hyperphosphatemia in children receiving peritoneal dialysis--an educational program.
Hyperphosphatemia has been associated with the development of secondary hyperparathyroidism, renal osteodystrophy, cardiovascular calcification and increased risk of death. Using a one group, pretest-posttest study design, we sought to evaluate changes in serum phosphorus, calcium, parathyroid hormone and subject knowledge in response to a 3-month educational intervention. Mean serum phosphorus levels did not differ significantly between the three evaluation periods: pretreatment (5.69 mg/dl), treatment (5.84 mg/dl) and posttreatment (6.17 mg/dl). Mean serum calcium, calcium-phosphorus product and PTH values also did not differ significantly between the treatment periods. We observed no difference between the subject test scores between the two testing periods. Calcium-phosphorus product, serum phosphorus and PTH values on average, despite the education program, remained outside the K/DOQI target guidelines 44, 56 and 81% of the time, respectively. The results of this study suggest that an aggressive 3-month patient education program targeting dietary phosphorus knowledge, phosphate binder name and dosing, and knowledge of medical consequences associated with non-compliance had no effect on the serum phosphorus, calcium, PTH or phosphate binder need.
Blaszak
Richard T
RT
Division of Nephrology, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, 800 Marshall Street, Little Rock, AR 72202-3591, USA. blaszakrichardt@uams.edu
Mitsnefes
Mark M
MM
Ilyas
Mohammad
M
Salman
Scarlett D
SD
Belcher
Sue M
SM
Brady
Debbie R
DR
D000293:Adolescent; D000328:Adult; D002118:Calcium / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D010353:Patient Education as Topic / Q000592:standards; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D010710:Phosphates / Q000097:blood*; D010758:Phosphorus / Q000097:blood; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires
D010281:Parathyroid Hormone; D010710:Phosphates; D010758:Phosphorus; D002118:Calcium