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Effects of education on low-phosphate diet and phosphate binder intake to control serum phosphate among maintenance hemodialysis patients: A randomized controlled trial

Lim, E  | Hyun, S | Lee, JM | Kim, S | Lee, MJ  | Lee, SM | Oh, YS | Park, I  | Shin, GT  | Kim, H  | Morisky, DE | Jeong, JC
Kidney research and clinical practice, 37(1). : 69-76, 2018
Journal Title
Kidney research and clinical practice
BACKGROUND: For phosphate control, patient education is essential due to the limited clearance of phosphate by dialysis. However, well-designed randomized controlled trials about dietary and phosphate binder education have been scarce.
METHODS: We enrolled maintenance hemodialysis patients and randomized them into an education group (n = 48) or a control group (n = 22). We assessed the patients' drug compliance and their knowledge about the phosphate binder using a questionnaire.
RESULTS: The primary goal was to increase the number of patients who reached a calcium-phosphorus product of lower than 55. In the education group, 36 (75.0%) patients achieved the primary goal, as compared with 16 (72.7%) in the control group (P = 0.430). The education increased the proportion of patients who properly took the phosphate binder (22.9% vs. 3.5%, P = 0.087), but not to statistical significance. Education did not affect the amount of dietary phosphate intake per body weight (education vs. control: -1.18 +/- 3.54 vs. -0.88 +/- 2.04 mg/kg, P = 0.851). However, the dietary phosphate-to-protein ratio tended to be lower in the education group (-0.64 +/- 2.04 vs. 0.65 +/- 3.55, P = 0.193). The education on phosphate restriction affected neither the Patient-Generated Subjective Global Assessment score (0.17 +/- 4.58 vs. -0.86 +/- 3.86, P = 0.363) nor the level of dietary protein intake (-0.03 +/- 0.33 vs. -0.09 +/- 0.18, P = 0.569).
CONCLUSION: Education did not affect the calcium-phosphate product. Education on the proper timing of phosphate binder intake and the dietary phosphate-to-protein ratio showed marginal efficacy.

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Journal Papers > School of Medicine / Graduate School of Medicine > Emergency Medicine
Journal Papers > School of Medicine / Graduate School of Medicine > Nephrology
Ajou Authors
김, 흥수  |  박, 인휘  |  신, 규태  |  이, 민정  |  임, 은수  |  정, 종철
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