Effect Of Dietary Intervention On Hyperphosphatemia In Hemodialysis Patients

Background:Hyperphosphatemia is a common complication in hemodialysis patients,which causes various complications for them,seriously affects their quality of life,increases their disability and mortality.As one of the main ways to control hyperphosphatemia in patients with hemodialysis,low phosphoras diet has brought many challenges to them,and its current situation is not good.The "phosphorus pyramid" which is scientific,comprehensive and intuitive is a visual tool for dietary phosphate management in patients with kidney disease,provides a new idea for low phosphorus diet in hemodialysis patients.Therefore,the aim of this study is to explore the effect of Low phosphorus dietary intervention using "phosphorus pyramid" in hemodialysis patients.Objective:To explore the effect of low phosphorus dietary intervention for hemodialysis patients on biochemical indicators of phosphorus metabolism,phosphorus diet and knowledge of phosphorus diet.Methods:This was a quasi-experimental study,74 hemodialysis patients with hyperphosphatemia were recruited from January to May 2017 in hemodialysis center of Peking Union Medical College Hospital and General Hospital of PLA by convenience sampling method.Patients who underwent hemodialysis on Monday,Wednesday,Friday were enrolled in the intervention group(n=37),patients who underwent hemodialysis on Tuesday,Thursday,Saturday were enrolled in the control group(n=37).At baseline,to patients in the intervention group,assessment of dietary habit was carried out by the researcher and individualized dietary counseling about 30-40 Min.was given to them and their main caregiver,the contents of the education included phosphorus metabolism,harm of hyperphosphatemia and how to properly eat low phosphorus diet,they were also given a handbook about low phosphorus diet and a picture of the phosphorus pyramid,patients in the control group were given routine low phosphorus dietary education.During 2-4 months of the intervention,patients in both group were followed up monthly,patients in the intervention group were given intensive dietary education,however,patients in the control group received no special education.The biochemical indicators of phosphorus metabolism,dietary status and dietary knowledge of phosphorus were collected at baseline,2 months after intervention and 4 months after intervention separately to evaluate the effect of dietary intervention.Results:71 participants(36 in the intervention group,35 in the control group)completed the intervention.Results showed that:(1)in terms of biochemical indicators,after 4 months of dietary intervention,the levels of serum phosphorus and calcium phosphorus product for patients in intervention group were significantly lower than those before intervention(P<0.017),and significantly lower than those for patients in control group(P<0.01),(2)in terms of diet,after intervention,the levels of phosphate and processed food intake for patients in intervention group were significantly lower than those before intervention(P<0.017),and significantly lower than those for patients in control group(P<0.05),(3)in terms of knowledge of phosphorus diet,after intervention,the score of both groups were significantly higher than that before intervention(P<0.017),and the score for patients in the intervention group were significantly higher than that for patients in the control group(P<0.01).Conclusions:Dietary intervention using "phosphorus pyramid" is better than the routine dietary intervention,it can effectively reduce the serum phosphorus level,the phosphate and processed food intake of of hemodialysis patients,it can also improve the knowledge of phosphorus diet in hemodialysis patients.