Managing serum phosphate in haemodialysis patients: time for an innovative approach?

Collinson, Avril; McMullan, Mirjam; Tse, W. Y.; Sadler, H.

doi:10.1038/ejcn.2013.283

Cited by 19 publications

(19 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our study the positive correlation between phosphorus nutritional knowledge and serum phosphorus levels adds to the argument that dietary knowledge seems to help to affect serum phosphorus levels only when patients are ready to make nutrition changes and to follow dietary advice (23). Similarly to our results, other studies have reported that better knowledge does not always translate to better adherence to dietary advice and recommended serum phosphate levels (20,24). Moreover, other studies have found that the hemodialysis patients with higher level of phosphorus food content knowledge and those who exhibit high serum phosphorus complications are the ones with the poorest compliance (18,24).…”

Section: Accepted Manuscriptsupporting

confidence: 81%

“…Similarly to our results, other studies have reported that better knowledge does not always translate to better adherence to dietary advice and recommended serum phosphate levels (20,24). Moreover, other studies have found that the hemodialysis patients with higher level of phosphorus food content knowledge and those who exhibit high serum phosphorus complications are the ones with the poorest compliance (18,24).…”

Section: Accepted Manuscriptsupporting

confidence: 80%

“…Based to the findings of the current study, it seems that the phosphorus-related knowledge score is lower that the respective score related to potassium, sodium and protein. This may be due to the fact that phosphorus is widely spread in nature and foods, and is ingested both as a natural component and as a food additive (7,11,23,24). In addition, the recommendations for higher protein intake are often difficult to dissociate from recommendations for low phosphorus intake, since dietary phosphate restriction has the potential to compromise adequate intake of protein (25)(26)(27).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

See 2 more Smart Citations

Phosphorus nutritional knowledge among dialysis health care providers and patients: A multicenter observational study

Pafili

Maridaki

Giannaki

et al. 2019

Clinical Nutrition ESPEN

View full text Add to dashboard Cite

Background-Aims: Phosphorus nutritional knowledge level of hemodialysis patients and renal nurses has been found to be low, while respective knowledge of nephrologists has not been studied yet. There are equivocal results regarding the association of phosphorus nutritional knowledge level and serum phosphorus values. The aim of this study was to assess phosphorus nutritional knowledge of hemodialysis patients, nephrologists and renal nurses and seek potential interventions to improve patients' adherence to phosphorus and overall nutritional guidelines. Methods: This cross-sectional observational study was conducted on sixty eight hemodialysis patients, 19 renal nurses and 11 nephrologists who were recruited from 3 hemodialysis units in Greece. Phosphorus nutritional knowledge of the participants was assessed by a 25-item item questionnaire (CKDKAT-N) which included 15 questions on phosphorus and 10 questions on protein, sodium, and potassium knowledge. Results: Nephrologists had higher CKDKAT-N total (19.1 ± 3.6 vs 14.1 ± 2.8 and 13.2± 2.8, P<0.01) and phosphorus knowledge scores (10.6 ± 2.7 vs 7.6 ± 2.2 and 7.3 ± 2.0, P<0.01) compared to renal nurses and patients respectively. There were no differences in total and phosphorus knowledge scores between nurses and patients. Patients and nurses answered correctly significantly less questions regarding phosphorus compared with the rest of the questions (P<0.01) while no such difference was found in nephrologists. Serum phosphorus was positively correlated with phosphorus knowledge score (r=0.31, P=0.02), and negatively correlated with patient age (r=−0.34, P<0.

show abstract

Section: Accepted Manuscriptsupporting

confidence: 81%

Section: Accepted Manuscriptsupporting

confidence: 80%

Section: Accepted Manuscriptmentioning

confidence: 99%

See 1 more Smart Citation

Phosphorus nutritional knowledge among dialysis health care providers and patients: A multicenter observational study

Pafili

Maridaki

Giannaki

et al. 2019

Clinical Nutrition ESPEN

View full text Add to dashboard Cite

show abstract

“…However, hemodialysis has some drawbacks, and electrolyte disorders such as hyperphosphatemia are common in patients on this treatment [20]. It has been reported that increased serum phosphate levels are independently associated with increased morbidity and mortality in patients on hemodialysis [21, 22].…”

Section: Discussionmentioning

confidence: 99%

Effect of Lanthanum Carbonate on All-Cause Mortality in Patients Receiving Maintenance Hemodialysis: a Meta-Analysis of Randomized Controlled Trials

Wang

Zhang

et al. 2018

Kidney Blood Press Res

View full text Add to dashboard Cite

Background/Aims: Hyperphosphatemia is common in patients on hemodialysis. The efficacy of lanthanum carbonate (LC) in the treatment of hyperphosphatemia in these patients remains controversial. The objective of this meta-analysis was to evaluate the effect of LC on all-cause mortality in patients on maintenance hemodialysis. Methods: We electronically searched the PubMed, EMBASE, and Cochrane Library databases for all randomized controlled trials (RCTs) comparing LC with other phosphate binders used in adult hemodialysis patients, including calcium carbonate, calcium acetate, and sevelamer. Results: Nine RCTs involving 2813 patients were suitable for inclusion. Our results showed that all-cause mortality was significantly lower in patients who received LC than in those who received standard therapy (odds ratio [OR]: 0.45, 95% confidence interval [CI]: 0.32–0.63, P<0.00001). Compared with the controls, patients who received LC had significantly lower serum calcium and higher serum intact parathyroid hormone levels. However, there was no significant difference between the groups in the cardiovascular event rate (OR: 0.58, 95% CI: 0.31–1.06, P=0.07) or in serum phosphorus levels. Conclusion: Compared with standard therapy, LC reduced all-cause mortality in patients on hemodialysis but did not decrease the risk of cardiovascular events. The decrease in serum phosphorus level was similar between LC and the other phosphate binders, but the risk of hypercalcemia was lower in patients who received LC.

show abstract

“…5 Dietary and medication non-adherence in HDPs could cause serious negative consequences including poor health outcomes and increased morbidity and mortality. 6 Several precipitating factors were suggested to affect medical advice adherence including HDPs' educational level and health literacy, their socio-economic status, presence of multiple comorbidities, 7 complexities of the medication regimen and inadequate education of the HDPs about the prescribed lifestyle change or medicines. [8][9][10] To empower patients with chronic disorders several educational interventions were designed and implemented throughout the world to enhance the patients' knowledge or psychological preparedness for maintaining the recommended changes or adherence to prescribed medications.…”

Section: Introductionmentioning

confidence: 99%

<p>Enhancement of Adherence to Therapeutic and Lifestyle Recommendations Among Hemodialysis Patients: An Umbrella Review of Interventional Strategies</p>

Zhianfar¹,

Nadrian²,

Shaghaghi³

2020

TCRM

View full text Add to dashboard Cite

Objective: To systematically retrieve and condense the best possible evidence on the successful interventions that targeted enhancement of therapeutic and lifestyle recommendations adherence in hemodialysis patients (HDPs). Design: An umbrella review of interventional studies. Data Sources: A comprehensive search of the Cochrane Database of Systematic Reviews, Ovid, PubMed, Scopus, EMBASE and Web of science databases to identify relevant publications in 2000-2018 (June) timeframe. Study Selection: Two reviewers independently applied inclusion criteria to select potential systematic reviews assessing the successful interventions that targeted enhancement of therapeutic and lifestyle recommendations adherence in HDPs. Data were summarized for information about the first author(s)' names, year of publication, type(s) of the intervention and output variables, main findings and also the applied quality appraisal tools in the retrieved research evidence. Data Extraction: Eligible studies were selected and data were extracted independently by two reviewers. The Joanna Briggs Institute (JBI)'s critical appraisal tool for systematic reviews was used to assess the quality of the identified publications, and discrepancies were resolved by consensus with a third reviewer. Data Synthesis: Thirteen systematic reviews (12 solely systematic reviews and 1 systematic review with meta-analyses) were eligible to be enrolled in the study. The range of interventions that had been reported to boost therapeutic and lifestyle recommendations adherence in HDPs' included psycho-educational programs, physical activity enhancement initiatives, information technology (IT)-based interventions and aromatherapy. Depression, diet biomarkers and interdialytic weight gain (IDWG) were among the myriad of output variables that had been measured as proxies to assess impacts of the implemented interventions. Psycho-educational interventions were among the prevalent initiatives to boost therapeutic and lifestyle recommendations adherence among the HDPs. Conclusion: This umbrella review revealed that various intervention approaches and strategies can be used for HDPs' better therapeutic and lifestyle recommendations adherence with considerable methodological heterogeneity. The pinpointed research evidence is also supporting application of multifaceted interventional modalities to reach an improved acquiescence form the patients' side and their families. Further studies are recommended to address the interactions across various interventions in discordant socio-cultural contexts.

show abstract

Managing serum phosphate in haemodialysis patients: time for an innovative approach?

Cited by 19 publications

References 26 publications

Phosphorus nutritional knowledge among dialysis health care providers and patients: A multicenter observational study

Phosphorus nutritional knowledge among dialysis health care providers and patients: A multicenter observational study

Effect of Lanthanum Carbonate on All-Cause Mortality in Patients Receiving Maintenance Hemodialysis: a Meta-Analysis of Randomized Controlled Trials

<p>Enhancement of Adherence to Therapeutic and Lifestyle Recommendations Among Hemodialysis Patients: An Umbrella Review of Interventional Strategies</p>

Contact Info

Product

Resources

About