Educational Intervention for Metabolic Bone Disease in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Shi, Yu; Zhao, Yinning; Liu, Junduo; Hou, Ya-Hong; Zhao, Yue

doi:10.1053/j.jrn.2014.06.007

Cited by 5 publications

(4 citation statements)

References 40 publications

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“…Total dietary phosphorous intake did not change after the intervention in this study. In other reports, dietary nonadherence in patients undergoing maintenance hemodialysis ranged from 9% to 80.4% [ 16 , 17 ]. It is generally known that hemodialysis patients are less likely to adhere to dietary phosphate restrictions versus other restrictions such as those for sodium or potassium because they are less educated about diet itself and the consequences of hyperphosphatemia [ 15 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…In a previous report, 46% of hemodialysis patients did not know that preservatives that contain phosphate are added extensively to processed foods and only 25% of patients were aware of the presence of phosphate in soda [ 20 ]. In a previous study, dietitian-led education reduced consumption of phosphorus-containing food additives [ 21 ], while another study showed that reducing the intake of processed food was one of the most effective ways of controlling hyperphosphatemia [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Poor adherence to phosphate binder use and dietary restrictions is relatively common among maintenance hemodialysis patients [ 5 ]. Several studies revealed that overall medication nonadherence in these patients ranges from 9.7% to 49.5% and that as many as 87% of patients have reported not adhering to their phosphate binder prescriptions [ 16 , 17 ]. Many factors cause this poor adherence.…”

Section: Discussionmentioning

confidence: 99%

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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

Hyun

Lee

et al. 2018

Kidney Res Clin Pract.

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BackgroundFor 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.MethodsWe 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.ResultsThe 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).ConclusionEducation 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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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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

Hyun

Lee

et al. 2018

Kidney Res Clin Pract.

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“…It has also been estimated that adherence to binder use as prescribed may be less than 50%. [44][45][46][47][48][49] Recent research has shown that phosphorus absorption varies among foods. Current nutrition advice in phosphate control is moving toward a greater understanding by both patients and health care teams on newly understood mechanisms of phosphate content and absorption.…”

Section: Phosphorus Binders and Food Absorption Differencesmentioning

confidence: 99%

Strategies to promote adherence to nutritional advice in patients with chronic kidney disease: a narrative review and commentary

Beto¹,

Schury²,

Bansal³

2016

IJNRD

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Chronic kidney disease (CKD) requires extensive changes to food and lifestyle. Poor adherence to diet, medications, and treatments has been estimated to vary between 20% and 70%, which in turn can contribute to increased mortality and morbidity. Delivering effective nutritional advice in patients with CKD coordinates multiple diet components including calories, protein, sodium, potassium, calcium, phosphorus, and fluid. Dietary intake studies have shown difficulty in adhering to the scope and complexity of the CKD diet parameters. No single educational or clinical strategy has been shown to be consistently effective across CKD populations. Highest adherence has been observed when both diet and education efforts are individualized to each patient and adapted over time to changing lifestyle and CKD variables. This narrative review and commentary summarizes nutrition education literature and published strategies for providing nutritional advice in CKD. A cohort of practical and effective strategies for increasing dietary adherence to nutritional advice are provided that include communicating with "talking control" principles, integrating patient-owned technology, acknowledging the typical food pattern may be snacking rather than formal meals, focusing on a single goal rather than multiple goals, creating active learning and coping strategies (frozen sandwiches, visual hands-on activities, planting herb gardens), and involving the total patient food environment.

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An Evidence-Based Approach to Conducting Systematic Reviews on CKD

Mani

Ginier

2016

Advances in Chronic Kidney Disease

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Educational Intervention for Metabolic Bone Disease in Patients With Chronic Kidney Disease: A Systematic Review and Meta-Analysis

Cited by 5 publications

References 40 publications

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

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

Strategies to promote adherence to nutritional advice in patients with chronic kidney disease: a narrative review and commentary

An Evidence-Based Approach to Conducting Systematic Reviews on CKD

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