title: Patient education: an efficient adjuvant therapy for hyperphosphatemia in hemodialysis patients.
abstract: BACKGROUND
  Hemodialysis and phosphate (P) binder therapy are the major methods to reduce the phosphate level in dialysis patients. However, dietary P restriction is necessary for adequate control. The successful dietary control is based on patient compliance. Patient education is the best method to assure the knowledge and drive of dietary control, which are the key features for patient compliance. The aim of the study is to investigate quantitatively the effect of patient education on serum P levels in hyperphosphatemic hemodialysis patients.
  
  
  METHODS
  We conducted a prospective self-control study. Fifty hemodialysis patients with a pre-dialysis serum P level greater than 6.0 mg/dL were studied. Intensified patient education was given. Serum P, calcium (Ca), and intact parathyroid hormone (iPTH) were evaluated before and one month after patient education.
  
  
  RESULTS
  Thirty-six (72%) patients had improved pre-dialysis P level (pre-education: 7.50 +/- 1.33; post-education: 5.85 +/- 1.20 mg/dL, p < 0.001) and Ca x P product (pre-education: 68.17 +/- 12.70; post-education: 54.70 +/- 11.87 mg(2)/dL(2), p < 0.001). The effect lasted for at least three months. There is no significant change on calcium levels. The only predictor of a successful patient education is the iPTH level (improved: 348.8 +/- 277.6; non-improved: 668.0 +/- 674.1 ng/mL, p = 0.021).
  
  
  CONCLUSIONS
  Patient education could be helpful and efficient in hyperphosphatemic control in dialysis patients. The patient education should be given before the serum iPTH level getting high.
authors.affiliation: School of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chiao-Yin
authors.initials: CY
authors.lastname: Sun
authors.forename: Kuo-Chuan
authors.initials: KC
authors.lastname: Chang
authors.forename: Sue-Hsien
authors.initials: SH
authors.lastname: Chen
authors.forename: Chiz-Tzung
authors.initials: CT
authors.lastname: Chang
authors.forename: Mai-Szu
authors.initials: MS
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D054559:Hyperphosphatemia / Q000097:blood / Q000178:diet therapy*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010353:Patient Education as Topic; D010710:Phosphates / Q000097:blood; D006435:Renal Dialysis
chemical_list: D010281:Parathyroid Hormone; D010710:Phosphates; D002118:Calcium