The effect of diet education on the laboratory values and knowledge of hemodialysis patients with hyperphosphatemia

Ford, Joellen Carroll; Pope, J.; Hunt, Alice E.; Gerald, Bonnie

doi:10.1053/j.jrn.2003.09.008

Cited by 116 publications

(159 citation statements)

References 10 publications

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“…[7] Similarly, Ford et al showed that serum phosphorus levels and the calcium-phosphorus product were improved after six months when patients were given a 20-30 minute diet education program each month specifically targeting phosphorus. [8] Conversely, Schlatter et al found that a teaching intervention in a group of 29 hemodialysis patients with high phosphorus levels had a weak affect on serum phosphorus levels, despite an increase in phosphorus knowledge. In their analysis, the relationship between a decrease in serum phosphorus and increases in phosphorus knowledge did not reach statistical significance after a single education session utilizing a teaching booklet, osteodystrophy tool, and medication diary.…”

Section: Discussionmentioning

confidence: 98%

“…In addition, there is conflicting data regarding the utility of educational counseling to alter patient knowledge of dietary phosphorus. [7][8][9] Low health literacy (the ability to read, understand, and act on health care information) affects more than 90 million adults in the US [10][11][12] and is associated with a variety of adverse outcomes, including sub-optimal chronic disease self-management. [13][14][15][16][17] Although no definitive association between these variables has been established, Jain et al recently reported that of 92 MD patients, no association between health literacy and serum phosphate was identified.…”

Section: Introductionmentioning

confidence: 99%

“…Despite this, knowledge of phosphorus remains poor, especially in HD patients. [7,8,19] The purpose of our study was to assess the knowledge of phosphorus compared with other nutrients (sodium, potassium, protein) in the MD population. We further sought to assess for differences in nutrition knowledge in patients utilizing different dialysis modalities (PD vs. HD).…”

Section: Introductionmentioning

confidence: 99%

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Knowledge of Phosphorus Compared With Other Nutrients in Maintenance Dialysis Patients

Pollock

Jaffery²

2007

Journal of Renal Nutrition

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Objective: To assess knowledge of phosphorus compared with other nutrients in patient undergoing maintenance dialysis (MD). Design:We compared knowledge of phosphorus versus other nutrients important to the MD diet (potassium, sodium, protein) in hemodialysis (HD) and peritoneal dialysis (PD) patients. We further measured gender, age, education level and functional health literacy to assess correlations in patient nutrient knowledge. Nutrient knowledge was measured using a 25-item chronic kidney disease knowledge assessment tool for nutrition (CKDKAT-N), and functional health literacy was measured using the short-form of the test of functional health literacy in adults (STOFHLA). Results: Forty-seven MD patients participated in the study (29 HD, 18 PD, 30 males and 17 females, average age 58.6 (SD 13.8) years, average grade level 1.4 (SD 2.6) years of post-secondary education). 35 participants had adequate, 4 marginal and 8 inadequate health literacy. CKDKAT-N scores ranged from 6 to 21 of 25 items, mean score of 13 (SD 2.91). Knowledge of phosphorus compared with knowledge of other nutrients was poor (0.38 versus 0.72, p = 0.003). Comparing HD to PD patient knowledge, both phosphorus (0.37 versus 0.42, p=0.231) and other nutrients (0.69 versus 0.80, p=0.115) were the same. Conclusion:Despite regular dietary instruction, patients undergoing MD have a poor knowledge of dietary phosphorus content, compared with knowledge of other nutrients important in chronic kidney disease. Interestingly, there was no difference in nutrition knowledge when comparing PD and HD patients, despite differences in education level and health literacy between the groups.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Knowledge of Phosphorus Compared With Other Nutrients in Maintenance Dialysis Patients

Pollock

Jaffery²

2007

Journal of Renal Nutrition

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“…2,3 Thus, controlling hyperphosphatemia, highly prevalent in dialysis patients, is of paramount relevance and is one of the major objectives of health care professionals involved with dialysis patients. 4 The following three strategies help controlling serum phosphorus: adequate dialysis; dietary phosphorus restriction; and use of phosphorus binders. 5 The nutritional guidance about phosphorus intake is very delicate, because severe restrictions are contraindicated and, in addition, a great part of the food that is a source of phosphorus is also a source of protein.…”

Section: Introductionmentioning

confidence: 99%

Adesão e conhecimento sobre o tratamento da hiperfosfatemia de pacientes hiperfosfatêmicos em hemodiálise

Nerbass¹,

Morais²,

Santos³

et al. 2010

J. Bras. Nefrol.

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“…[7] Moreover, phosphorus in additives is almost entirely absorbed while only 60% of naturally occurring phosphorus is absorbed. [8] Education regarding high phosphorus foods is a key component of hyperphosphatemia management, [9,10] but the use of phosphorus containing additives may make it difficult for patients and dietitians to accurately estimate the phosphorus content of foods.…”

Section: Introductionmentioning

confidence: 99%

Phosphorus-Containing Food Additives and the Accuracy of Nutrient Databases: Implications for Renal Patients

Sullivan

León

Sehgal

2007

Journal of Renal Nutrition

149

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Objective-Phosphorus containing additives are increasingly added to food products. We sought to determine the potential impact of these additives. We focused on chicken products as an example.Methods-We purchased a variety of chicken products, prepared them according to package directions, and performed laboratory analyses to determine their actual phosphorus content. We used ESHA Food Processor SQL Software to determine the expected phosphorus content of each product.Results-Of 38 chicken products, 35 (92%) had phosphorus containing additives listed among their ingredients. For every category of chicken products containing additives, the actual phosphorus content was greater than the content expected from nutrient database. For example, actual phosphorus content exceeded expected phosphorus content by an average of 84 mg/100g for breaded breast strips. There was also a great deal of variation within each category. For example, the difference between actual and expected phosphorus content ranged from 59 to 165 mg/100g for breast patties. Two 100 g servings of additive containing products contain an average of 440 mg of phosphorus, or about half the total daily recommended intake for dialysis patients.Conclusion-Phosphorus containing additives significantly increase the amount of phosphorus in chicken products. Available nutrient databases do not reflect this higher phosphorus content, and the variation between similar products makes it impossible for patients and dietitians to accurately estimate phosphorus content. We recommend that dialysis patients limit their intake of additive containing products and that the phosphorus content of food products be included on nutrition facts labels.

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The effect of diet education on the laboratory values and knowledge of hemodialysis patients with hyperphosphatemia

Cited by 116 publications

References 10 publications

Knowledge of Phosphorus Compared With Other Nutrients in Maintenance Dialysis Patients

Knowledge of Phosphorus Compared With Other Nutrients in Maintenance Dialysis Patients

Adesão e conhecimento sobre o tratamento da hiperfosfatemia de pacientes hiperfosfatêmicos em hemodiálise

Phosphorus-Containing Food Additives and the Accuracy of Nutrient Databases: Implications for Renal Patients

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