Nutritional education for the management of osteodystrophy (nemo) in patients on haemodialysis: a randomised controlled trial

Abstract

Objective: To examine the effect of self-management dietary counselling (SMDC) on adherence to dietary management of hyperphosphatemia among haemodialysis patients.

Design: An eight-week cluster based randomised control trial.

Participants: 122 stable adult patients were recruited from an HD unit in Sidon, Lebanon. Study groups were: full intervention (A) (n = 41), partial intervention (B) (n = 41) and control (C) (n = 40).

Intervention: Group (A) received SMDC, Group (B) received educational games only and Group (C) did not receive any research intervention.

Main outcome measures: Serum phosphorus (P), Calcium Phosphate product (Ca × P) and two questionnaires: patient knowledge (PK) and dietary non-adherence (PDnA) to P reduced diet.

Results: Group A experienced a significant improvement in mean (± SD) P (6.54 ± 2.05 - 5.4 ± 1.97 mg/dl), Ca × P (58 ± 17 - 49 ± 12), PK scores (50 ± 17 - 69 ± 25%) and PDnA scores (21.4 ± 4.0 - 18.3 ± 2.0). Group B experienced a significant improvement in Ca × P (52 ± 14-45 ± 16). Group C did not experience any significant change post intervention.

Conclusion: Our findings demonstrate the importance of patient-tailored counselling on serum P management.