[Dialysis and cookers: a project for the empowerment of patients in managing their own chronic renal failure]

Abstract

The phosphate and potassium control is indispensable to dominate the secondary hyperparathyroidism and reduce cardiovascular mortality in dialysis patients. Most of them receive only theoretical nutritional information. We therefore organized a cooking workshop for dialysis patients, with a multidisciplinary team consisting of nurses, nephrologists, a dietitian and a professional chef, to directly teach the patients and their families how to realize a low phosphorus and potassium menu, assessing the proper use of phosphate binders, and blood tests at baseline and at three and six months. Twenty-four patients, out of 133, attended the workshop with a family member, filling out a questionnaire on eating habits, knowledge about phosphorus and potassium, and about binders. Theoretical and practical information about phosphorus and potassium metabolism, about binders, and cooking techniques were given during the evening, we then prepared a meal, eaten all together. The questionnaire was repeated at the end of the evening, and all the participants reported an improvement of the considered variables. Phosphorus and potassium plasma levels and the number of binders did not change after three and six months. Coping with the dietary changes related to the start of the dialytic therapy in an informal atmosphere, with a family member, is highly appreciated, clinically useful, logistically and economically sustainable. A customized and long-lasting counselling is probably required to modify plasma levels of phosphorus and potassium and binder's consumption. The poor dietary knowledge detected in our patients and the satisfaction about the course both confirm the training needs in this area.

Keywords: binders; counseling; dialysis; nutrition.