Effect of a Dietitian-managed Bone Algorithm on Serum Phosphorus Level in Maintenance Hemodialysis Patients

Blair, Debra; Byham‐Gray, Laura; Sweet, Stephen; Denmark, Robert; Parrott, J. Scott; Lewis, Emily; McCaffrey, Susan; Thomson, Susan

doi:10.1053/j.jrn.2012.05.002

Cited by 6 publications

(5 citation statements)

References 27 publications

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“…Contrarily, nutrition education delivered by dialysis nurses and physicians may also be equally effective in reducing serum phosphorus as reported in China [ 32 ]. Tsai et al [ 33 ] have shown that dietary education by dialysis staff alone resulted in reducing serum phosphorus levels of HD patients, but involvement of dietitians provided additional benefits on controlling hyperphosphatemia while Blair et al [ 34 ] did not observe significant difference in serum phosphorus level in HD patients managed by dietitians or non-dietitians (nephrologists and nurses).…”

Section: Discussionmentioning

confidence: 99%

The state of nutrition care in outpatient hemodialysis settings in Malaysia: a nationwide survey

Khor

Chinna

Gafor

et al. 2018

BMC Health Serv Res

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BackgroundThis study aimed to assess the situational capacity for nutrition care delivery in the outpatient hemodialysis (HD) setting in Malaysia by evaluating dietitian accessibility, nutrition practices and patients’ outcomes.MethodsA 17-item questionnaire was developed to assess nutrition practices and administered to dialysis managers of 150 HD centers, identified through the National Renal Registry. Nutritional outcomes of 4362 patients enabled crosscutting comparisons as per dietitian accessibility and center sector.ResultsDedicated dietitian (18%) and visiting/shared dietitian (14.7%) service availability was limited, with greatest accessibility at government centers (82.4%) > non-governmental organization (NGO) centers (26.7%) > private centers (15.1%). Nutritional monitoring varied across HD centers as per albumin (100%) > normalized protein catabolic rate (32.7%) > body mass index (BMI, 30.7%) > dietary intake (6.0%). Both sector and dietitian accessibility was not associated with achieving albumin ≥40 g/L. However, NGO centers were 36% more likely (p = 0.030) to achieve pre-dialysis serum creatinine ≥884 μmol/L compared to government centers, whilst centers with dedicated dietitian service were 29% less likely (p = 0.017) to achieve pre-dialysis serum creatinine ≥884 μmol/L. In terms of BMI, private centers were 32% more likely (p = 0.022) to achieve BMI ≥ 25.0 kg/m2 compared to government centers. Private centers were 62% less likely (p < 0.001) while NGO centers were 56% less likely (p < 0.001) to achieve serum phosphorus control compared to government centers. Patients from centers with a shared/visiting dietitian had 35% lower probability (p < 0.001) to achieve serum phosphorus levels below 1.78 mmol/L compared to centers without access to a dietitian.ConclusionsThere were clear discrepancies in nutritional care in Malaysian HD centers. Changes in stakeholder policy are required to ensure that dietitian service is available in Malaysian HD centers.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3702-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The state of nutrition care in outpatient hemodialysis settings in Malaysia: a nationwide survey

Khor

Chinna

Gafor

et al. 2018

BMC Health Serv Res

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“…Chronic pain can be related to renal osteodystrophy, one of the complications resulting from renal compromise, manifested by lack of control of the increase of phosphate which provokes bone mineralization. It is a painful condition, and is associated with an increased risk of fracture, with difficulty for self-care, as well as increasing mortality in patients receiving dialysis ( 17 ) .…”

Section: Discussionmentioning

confidence: 99%

The adaptation problems of patients undergoing hemodialysis: socio-economic and clinical aspects

Frazão

Sá

Medeiros

et al. 2014

Rev. Latino-Am. Enfermagem

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OBJECTIVES: to identify adaptation problems under Roy's Model in patients undergoing hemodialysis and to correlate them with the socioeconomic and clinical aspects. METHOD: a transversal study, undertaken using a questionnaire. The sample was made up of 178 individuals. The Chi-squared and Mann-Whitney U tests were undertaken. RESULTS: the adaptation problems and the socioeconomic and clinical aspects which presented statistical associations were: Hyperkalemia and age; Edema and income; Impairment of a primary sense: touch and income; Role failure and age; Sexual dysfunction and marital status and sex; Impairment of a primary sense: vision and years of education; Intolerance to activity and years of education; Chronic pain and sex and years of education; Impaired skin integrity and age: Hypocalcemia and access; Potential for injury and age and years of education; Nutrition below the organism's requirements and age; Impairment of a primary sense: hearing and sex and kinetic evaluation of urea; Mobility in gait and/or coordination restricted, and months of hemodialysis; and, Loss of ability for self-care, and months of hemodialysis and months of illness. CONCLUSION: adaptation problems in the clientele undergoing hemodialysis can be influenced by socioeconomic/clinical data. These findings contribute to the development of the profession, fostering the nurse's reflection regarding the care.

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“…This ND was related to renal osteodystrophy, which is manifested by uncontrolled increase of phosphate which promotes bone mineralization. Osteodystrophy is a painful condition that hinders the performance of a patient's daily activities and increases the risk of fractures and mortality (Blair et al., ). To minimize the pain in these patients, nurses’ intervention with nonpharmacological measures is recommended.…”

Section: Discussionmentioning

confidence: 99%

Association Between Nursing Diagnoses and Socioeconomic/Clinical Characteristics of Patients on Hemodialysis

Frazão

Sá

Paiva

et al. 2014

Int J of Nursing Knowl

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Effect of a Dietitian-managed Bone Algorithm on Serum Phosphorus Level in Maintenance Hemodialysis Patients

Cited by 6 publications

References 27 publications

The state of nutrition care in outpatient hemodialysis settings in Malaysia: a nationwide survey

The state of nutrition care in outpatient hemodialysis settings in Malaysia: a nationwide survey

The adaptation problems of patients undergoing hemodialysis: socio-economic and clinical aspects

Association Between Nursing Diagnoses and Socioeconomic/Clinical Characteristics of Patients on Hemodialysis

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