title: Additional benefit of dietitian involvement in dialysis staffs-led diet education on uncontrolled hyperphosphatemia in hemodialysis patients.
abstract: BACKGROUND
  Sustained adherence to dietary phosphorus (P) restriction recommendations among hemodialysis patients is questionable. The aim of this study was to evaluate the effectiveness of additional diet education delivered by a dietitian on the control of hyperphosphatemia.
  
  
  METHODS
  We conducted an 8-month prospective observational study in hemodialysis patients who had uncontrolled hyperphosphatemia. In the first half of the study (experimental) period, the dialysis nurses and physicians provided the routine dietetic education with the control group (n = 31), while the experimental group (n = 30) received the routine dietetic education plus an additional diet education delivered by dietitians. Both groups received the routine dietetic education in the rest of the study period to test whether the improvement of serum P level was sustained. The primary outcomes were changes in serum P level.
  
  
  RESULTS
  At baseline, there was no significant difference in serum P levels between groups (P = 0.27). In the experimental period, monthly serum P levels decreased significantly in both groups (P < 0.001) and the magnitudes of reduction were 1.81 ± 1.46 and 0.94 ± 1.33 mg/dL in the experimental and control groups, respectively (P = 0.02), at the end. The experimental group maintained such improvement for one more month (P = 0.02), but faded out over time.
  
  
  CONCLUSIONS
  Renal diet education guided either by dietitians plus dialysis staffs or dialysis staffs alone reduces serum P level and dietitian-guided diet education provides an additional benefit on controlling hyperphosphatemia in hemodialysis patients.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, Banqiao District, New Taipei City 220, Taiwan, China.
authors.forename: Wan-Chuan
authors.initials: WC
authors.lastname: Tsai
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, Banqiao District, New Taipei City 220, Taiwan, China.
authors.forename: Ju-Yeh
authors.initials: JY
authors.lastname: Yang
authors.affiliation: Dietary Department, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, Banqiao District, New Taipei City 220, Taiwan, China.
authors.forename: Chia-Chin
authors.initials: CC
authors.lastname: Luan
authors.affiliation: Dietary Department, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, Banqiao District, New Taipei City 220, Taiwan, China.
authors.forename: Yuh-Jiun
authors.initials: YJ
authors.lastname: Wang
authors.affiliation: Dietary Department, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, Banqiao District, New Taipei City 220, Taiwan, China.
authors.forename: Yu-Chuan
authors.initials: YC
authors.lastname: Lai
authors.affiliation: Dietary Department, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, Banqiao District, New Taipei City 220, Taiwan, China.
authors.forename: Lie-Chuan
authors.initials: LC
authors.lastname: Liu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, Banqiao District, New Taipei City 220, Taiwan, China. taan70@yahoo.com.tw.|Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan, China. taan70@yahoo.com.tw.
authors.forename: Yu-Sen
authors.initials: YS
authors.lastname: Peng
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D054559:Hyperphosphatemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D064686:Nutritionists; D010348:Patient Care Team; D010349:Patient Compliance; D010353:Patient Education as Topic; D010710:Phosphates / Q000097:blood; D016226:Phosphorus, Dietary / Q000009:adverse effects* / Q000097:blood; D010819:Physician's Role; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D010710:Phosphates; D016226:Phosphorus, Dietary
keywords: Diet; Dietitian; Education; Hemodialysis; Hyperphosphatemia