Education for dialysis patients lowers long-term phosphate levels and maintains health-related quality of life

Abstract

Aims: This study aims at biological, knowledgeable, behavioral and health-related quality of life effects of self-dosing of phosphate binders before and after an education program in patients with CKD.

Material and methods: The following 12-month study included 43 patients with CKD Stage 4 - 5 and plasma phosphate levels repeatedly above recommended maximum level. Patients underwent a structured educational program regarding calcium and phosphate balance, food intake and phosphate binders comprising a 60-min session, 3 - 5 times during a 2-month period (intervention). Patients' knowledge on the topics included in the program was assessed before and after the program as well as phosphate levels.

Results: The mean plasma phosphate level had decreased significantly directly after the intervention (1.87 mmol/l, p < 0.05) and remained low over time; 1.78 mmol/l at 12 months follow-up (p < 0.001). The patients' self-reported knowledge regarding food intake, calcium/phosphate balance and self-dosing of phosphate binders increased significantly after instruction (p < 0.001).

Conclusion: A structured education program focusing on calcium and phosphate balance and self-dosing of phosphate binders significantly increased the patients' self-reported knowledge regarding these issues which in turn led to changes in behaviors reflected in decreased long-term plasma phosphate levels.