Background/Aim: A randomized controlled trial was conducted involving 67 stable adult haemodialysis patients with hyperphosphataemia. The objective was to determine the effect of monthly dietetic consultations on patients’ serum phosphate concentrations and calcium × phosphate product. Methods: The intervention group received monthly dietetic consultations for 6 months using advanced counselling skills aimed at limiting phosphate intake in the diet and improving compliance with phosphate binders, whereas standard care with dietetic consultations every 6 months was provided to the control group. Results: Serum phosphate concentrations decreased in the intervention group from 2.05 ± 0.48 to 1.80 ± 0.48 mmol/l by month 3 (p < 0.05). However, this subsequently increased and by month 6 there was no significant difference from baseline. After controlling for confounding variables, the difference between the groups was approaching significance at month 3, but there was no difference by month 6, or following conclusion of the study. The calcium × phosphate product similarly decreased in both groups, achieving K/DOQI standards, but was not sustained either during the remainder of the study but decreased further by the 12-month follow-up and, although it was not significantly different, it did improve significantly from baseline in both the intervention and control groups. Conclusion: Increased frequency of dietetic consultations can result in improved phosphate control in the short term, and therefore more innovative strategies appear necessary to sustain longer-term control.

Hemodialysis patients (HD) present inflammation, metabolic acidosis and anorexia which contribute to loss of functional capacity, muscle mass and strength. Resistance training (RT) is recognized to reduce these effects on the musculoskeletal system. This study aimed to evaluate the effects of intradialytic RT on the functional capacity, strength and muscle mass in HD patients. Eighteen HD patients (50% men, 49.3711.5 years, BMI 22.773.9 kg/m 2 , 63.2746.3 months on dialysis) exercised 3 times a week for 6 months. All parameters were evaluated before and after 6 months of RT. There were significant changes in the functional tests 10-TSS (10 times Sit-to-Stand Test) and SS-60 (amount of sit to stand in 60 seconds), in the muscle mass and % of body fat after RT. The medial and proximal leg circumferences increased significantly and no differences were observed in torque extensor and flexor and distal leg circumferences. In conclusion, RT contributes to improving body composition and functional capacity of HD patients. ParametersBefore RT After RT

Cholesterol‐lowering treatment by statins is an important and costly issue; however, its role in stroke has not been well documented. The aim of the present study was to review literature and current practice regarding cholesterol‐lowering treatment for stroke patients. A literature review was conducted on lipids in stroke and their management with both statins and diet, including the cost‐effectiveness of medical nutrition therapy. Qualifying criteria and prescription procedures of the Pharmaceutical Benefits Scheme (PBS) were also reviewed. Data on lipid levels and statin prescriptions were analysed for 468 patients admitted to a stroke unit. The literature shows that management with both medication and diet can be effective, especially when combined; however, 60% of patients with an ischaemic event had fasting total cholesterol measures ≥4 mmol/L (n = 231), with only 52% prescribed statins on discharge (n = 120). Hypercholesterolaemia is an underdiagnosed and undertreated risk factor within the stroke population. It appears that the PBS has not kept pace with advances in the evidence in terms of statin use in the stroke population, and review is needed. The present review should address the qualifying criteria for the stroke population and recommendations on referral to dietitians for dietary advice. Cholesterol‐lowering treatment for both stroke patients and the wider population is an area that needs awareness raising and review by the PBS, medical practitioners and dietitians. The role of dietary and pharmacological treatments needs to be clearly defined, including adjunct therapy, and the cost‐effectiveness of medical nutrition therapy realised.

Hemodialysis patients (HD) present inflammation, metabolic acidosis and anorexia which contribute to loss of functional capacity, muscle mass and strength. Resistance training (RT) is recognized to reduce these effects on the musculoskeletal system. This study aimed to evaluate the effects of intradialytic RT on the functional capacity, strength and muscle mass in HD patients. Eighteen HD patients (50% men, 49.3711.5 years, BMI 22.773.9 kg/m 2 , 63.2746.3 months on dialysis) exercised 3 times a week for 6 months. All parameters were evaluated before and after 6 months of RT. There were significant changes in the functional tests 10-TSS (10 times Sit-to-Stand Test) and SS-60 (amount of sit to stand in 60 seconds), in the muscle mass and % of body fat after RT. The medial and proximal leg circumferences increased significantly and no differences were observed in torque extensor and flexor and distal leg circumferences. In conclusion, RT contributes to improving body composition and functional capacity of HD patients. ParametersBefore RT After RT