1. Managing serum phosphate in haemodialysis patients: time for an innovative approach?
- Author
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Collinson, A., McMullan, M., Tse, W.Y., and Sadler, H.
- Subjects
Chronic kidney failure -- Health aspects ,Hemodialysis patients -- Nutritional aspects ,Phosphates -- Health aspects ,Food/cooking/nutrition ,Health - Abstract
BACKGROUND/OBJECTIVES: Hyperphosphataemia, a common biochemical abnormality in chronic kidney disease, poses significant management challenges. This study aims to determine whether the reasons for this are multifactorial; including poor dietary knowledge, poor adherence to a low phosphate diet and phosphate-binding medications and the impact of age on these parameters. SUBJECTS/METHODS: In order to compare serum phosphate and other associated parameters to the UK Renal Association Clinical Practice Guidelines 2010 an audit and service evaluation questionnaire was carried out in May 2011 on 130 haemodialysis outpatients attending the Plymouth Dialysis Unit. RESULTS: Fifty-three percent of patients had serum phosphate within the target range of 1.1-1.7 mmol/l, 77% and 85% had serum calcium and parathyroid hormone within target ranges, respectively. Younger patients (18-45years) were significantly less likely to have serum phosphate within range [chi square] (2, n = 124) = 18.77, P< 0.001. Despite better knowledge of their own phosphate levels (P = 0.005), phosphorus-rich foods (P< 0.001), symptoms of hyperphosphataemia (P65 years (P CONCLUSIONS: In this population, despite better knowledge, younger patients have worse phosphate control than older patients. Using the same dietary education techniques may not be suitable for all ages, more innovative approaches supported by skilled health professionals are needed to motivate and engage with younger patients to promote self-management and adherence. European Journal of Clinical Nutrition (2014) 68, 392-396; doi:10.1038/ejcn.2013.283; published online 15 January 2014 Keywords: age; dialysis; adherence; serum phosphate, INTRODUCTION Hyperphosphataemia is one of the commonest biochemical abnormalities in chronic kidney disease and poses significant challenges for management. Epidemiological and observational studies have shown a strong association between hyperphosphataemia [...]
- Published
- 2014
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