title: Education for dialysis patients lowers long-term phosphate levels and maintains health-related quality of life.
abstract: OBJECTIVE
  This study aims at biological, knowledgeable, behavioral and health-related quality of life effects of self-dosing of phosphate binders before and after an education program in patients with CKD.
  
  
  METHODS
  The following 12-month study included 43 patients with CKD Stage 4 - 5 and plasma phosphate levels repeatedly above recommended maximum level. Patients underwent a structured educational program regarding calcium and phosphate balance, food intake and phosphate binders comprising a 60-min session, 3 - 5 times during a 2-month period (intervention). Patients' knowledge on the topics included in the program was assessed before and after the program as well as phosphate levels.
  
  
  RESULTS
  The mean plasma phosphate level had decreased significantly directly after the intervention (1.87 mmol/l, p < 0.05) and remained low over time; 1.78 mmol/l at 12 months follow-up (p < 0.001). The patients' self-reported knowledge regarding food intake, calcium/phosphate balance and self-dosing of phosphate binders increased significantly after instruction (p < 0.001).
  
  
  CONCLUSIONS
  A structured education program focusing on calcium and phosphate balance and self-dosing of phosphate binders significantly increased the patients' self-reported knowledge regarding these issues which in turn led to changes in behaviors reflected in decreased long-term plasma phosphate levels.
authors.affiliation: The Department of Laboratory Medicine, Section of Clinical Immunology, Karolinska Institute at Karolinska University Hospital, Stockholm, Sweden. ann.gardulf@ki.se
authors.forename: A
authors.initials: A
authors.lastname: Gardulf
authors.forename: M
authors.initials: M
authors.lastname: Pålsson
authors.forename: U
authors.initials: U
authors.lastname: Nicolay
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002614:Chelating Agents / Q000627:therapeutic use*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D054559:Hyperphosphatemia / Q000188:drug therapy* / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010758:Phosphorus / Q000097:blood*; D011788:Quality of Life; D006435:Renal Dialysis; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D002614:Chelating Agents; D010758:Phosphorus