Ford Joellen Carroll, Pope Janet F, Hunt Alice E, Gerald Bonnie
Renal Dietitian, DCI Inc, Shreveport, LA, USA.
J Ren Nutr. 2004 Jan;14(1):36-44. doi: 10.1053/j.jrn.2003.09.008.
The purpose of this study was to evaluate the effectiveness of 20 to 30 minutes per month of additional diet education on monthly laboratory values (phosphorus, calcium, parathyroid hormone, and calcium/phosphorus product) and knowledge of dietary phosphorus management in hemodialysis patients with hyperphosphatemia.
A quasi-experimental design.
Three outpatient dialysis centers owned by the same corporation in 1 southern state.
Based on a 3-month average serum phosphorus >6.0 mg/dL, 70 patients were selected for participation; 63 dialysis patients completed the study, 32 in the experimental group and 31 in the control group.
All patients completed a before-and-after knowledge test and had monthly blood samples drawn. Each month, the same registered dietitian provided the routine laboratory results review with control group. The experimental group received the routine laboratory review plus 20 to 30 minutes of additional diet education specifically targeting phosphorus. Main outcome measures Before-and-after knowledge test results and baseline and final serum calcium, phosphorus, parathyroid hormone, and calcium/phosphorus product levels.
At baseline, there were no significant differences in any of the laboratory values, but the knowledge level of the experimental group was greater (P <.05) After 6 months, gains in knowledge were significantly higher in the intervention group, and the serum phosphorus and calcium/phosphorus product levels were significantly lower (P <.01) than in the control group.
Based on this research, those patients who received extra education monthly showed positive changes, which may be beneficial in reducing hyperphosphatemia.
本研究旨在评估每月额外进行20至30分钟饮食教育对高磷血症血液透析患者每月实验室检查值(磷、钙、甲状旁腺激素和钙磷乘积)以及饮食磷管理知识的有效性。
准实验设计。
南方某州同一家公司旗下的三个门诊透析中心。
基于3个月平均血清磷>6.0mg/dL,选取70例患者参与研究;63例透析患者完成研究,其中实验组32例,对照组31例。
所有患者均完成前后知识测试并每月采集血样。每月,同一名注册营养师为对照组提供常规实验室结果复查。实验组在接受常规实验室复查的基础上,额外接受20至30分钟专门针对磷的饮食教育。主要观察指标:前后知识测试结果以及基线和最终血清钙、磷、甲状旁腺激素和钙磷乘积水平。
基线时,各项实验室检查值均无显著差异,但实验组的知识水平更高(P<.05)。6个月后,干预组的知识增长显著高于对照组,血清磷和钙磷乘积水平显著低于对照组(P<.01)。
基于本研究,每月接受额外教育的患者出现了积极变化,这可能有助于降低高磷血症。