title: The impact of education and cooking methods on serum phosphate levels in patients on hemodialysis: 1-year study.
abstract: Control of serum phosphate is important for patients on hemodialysis. The aim of the study was to determine if education based on phosphorus-reducing techniques in food preparation and thermal processing, and accordingly prepared and applied diets, will lead to better outcomes than a standard education program to improve phosphate control in patients on hemodialysis.
  
  
  
  Forty-seven patients on hemodialysis were divided between an intervention and a control group. All subjects received training about nutrition for hemodialysis patients by trained dietitian. In addition, subjects in the intervention group received additional training in phosphorus-reducing techniques in food preparation and received two hospital meals prepared using suggested cooking methods to reduce the phosphate content of food during dialysis treatment. Serum phosphate, serum albumin, and anthropometric parameters were measured, while nPCR was calculated, at the baseline and during the 1-year study.
  
  
  
  No differences in serum phosphate levels were observed between intervention (1.68 mmol/L [1.48-2.03]) and control group (1.88 mmol/L [1.57-2.2]) at baseline (P = 0.130). Although not statistically significant between groups the mean reduction was more apparent in the intervention group (-0.3 mmol/L (-0.4 to 0.1) vs. -0.2 (-0.5 to 0.1)), and lead to significantly reduction of phosphate binder therapy. During the study, the nPCR and anthropometric status of the patients did not change significantly.
  
  
  
  Providing additional education to hemodialysis patients on the specific cooking methods and accordingly prepared meals may decrease serum phosphate levels without significantly affecting nutritional status which may be useful in helping to prevent and treat hyperphosphatemia.
authors.affiliation: Department of Dietetics and Nutrition, General Hospital "Dr Josip Benčević", Slavonski Brod, Croatia.
authors.forename: Ivica
authors.initials: I
authors.lastname: Vrdoljak
authors.affiliation: Faculty of Food Technology and Biotechnology, Department of Food Quality Control, University of Zagreb, Zagreb, Croatia.
authors.forename: Ines
authors.initials: I
authors.lastname: Panjkota Krbavčić
authors.affiliation: Faculty of Food Technology and Biotechnology, Department of Food Quality Control, University of Zagreb, Zagreb, Croatia.
authors.forename: Martina
authors.initials: M
authors.lastname: Bituh
authors.affiliation: Department of Nephrology and Dialysis, General Hospital "Dr Josip Benčević", Slavonski Brod, Croatia.
authors.forename: Ninoslav
authors.initials: N
authors.lastname: Leko
authors.affiliation: Department of Nephrology and Dialysis, Sestre Milosrdnice University Hospital, Zagreb, Croatia.
authors.forename: Draško
authors.initials: D
authors.lastname: Pavlović
authors.affiliation: Department of Nephrology and Dialysis, General Hospital "Dr Josip Benčević", Slavonski Brod, Croatia.
authors.forename: Tea
authors.initials: T
authors.lastname: Vrdoljak Margeta
mesh_terms: D000368:Aged; D003296:Cooking; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D010758:Phosphorus / Q000097:blood*; D006435:Renal Dialysis / Q000379:methods*
chemical_list: D010758:Phosphorus
keywords: Phosphorus; cooking methods; hemodialysis; hyperphosphatemia