Nephrology Section, Department of Internal Medicine, University of Pisa, Pisa, Italy.
J Ren Nutr. 2012 Nov;22(6):541-6. doi: 10.1053/j.jrn.2011.11.003. Epub 2012 Jan 31.
To assess the knowledge of adult hemodialysis patients and nurses working in dialysis units, specifically with regard to knowledge of phosphorus and other nutrients related to dietary management of end-stage renal disease.
Cross-sectional cohort study.
Hemodialysis unit.
One hundred ninety-one hemodialysis patients and 105 dialysis nurses, as well as 86 control hospital employees who are not health professionals.
Nutritional knowledge was assessed by a 25-item chronic kidney disease knowledge assessment tool for nutrition, which includes 15 questions on phosphorus and 10 questions on protein, sodium, and potassium knowledge.
The scores obtained by patients were much lower than those of nurses (11.6 ± 3.9 vs. 16.0 ± 2.2, P < .001) but slightly higher than those of controls (10.6 ± 3.2, P < .05). Patients with phosphorus serum level >5.5 mg/dL showed chronic kidney disease knowledge assessment tool for nutrition scores similar to those of patients with a serum phosphorus level <5.5 mg/dL. The prevalence of right answers to questions regarding knowledge of phosphorus was lower than that regarding knowledge of the other nutrients, both for patients (38.4% ± 17.8% vs. 57.3% ± 19.9%, P < .001) and nurses (55.6% ± 11.1% vs. 74.8% ± 11.7%, P < .001) as well as for controls (30.7% ± 14.5% vs. 60.1% ± 17.4%, P < .001).
Our study suggests that nutritional knowledge of hemodialysis patients, although higher than the general population, is lower for phosphorus with respect to the other nutrients, such as protein, sodium, and potassium. This occurs even in patients with hyperphosphatemia or those taking phosphate binder medications. Nurses showed the best scores; however, improvement is necessary, especially with regard to knowledge of phosphorus. Training programs on nutrition for nurses and on information for patients should be implemented. They can contribute to achievement of a more effective control of phosphate balance, reduction of costs, and improvement of the quality of care for hemodialysis patients.
评估成年血液透析患者和透析单位护士的知识水平，特别是与终末期肾病饮食管理相关的磷和其他营养素知识。
横断面队列研究。
血液透析室。
191 名血液透析患者和 105 名透析护士，以及 86 名非卫生专业的医院员工作为对照组。
采用 25 项慢性肾脏病营养知识评估工具评估营养知识，其中包括 15 个关于磷的问题和 10 个关于蛋白质、钠和钾知识的问题。
患者得分明显低于护士（11.6 ± 3.9 比 16.0 ± 2.2，P <.001），但略高于对照组（10.6 ± 3.2，P <.05）。磷血清水平>5.5mg/dL 的患者的慢性肾脏病营养知识评估工具评分与磷血清水平<5.5mg/dL 的患者相似。患者对磷知识的正确回答率低于对其他营养素知识的正确回答率，无论是对患者（38.4%±17.8%比 57.3%±19.9%，P <.001）还是对护士（55.6%±11.1%比 74.8%±11.7%，P <.001）以及对照组（30.7%±14.5%比 60.1%±17.4%，P <.001）。
我们的研究表明，血液透析患者的营养知识虽然高于一般人群，但对于磷的知识却低于蛋白质、钠和钾等其他营养素。这种情况甚至发生在高磷血症或服用磷结合剂的患者中。护士得分最高；然而，仍需要改进，特别是在磷知识方面。应实施针对护士的营养培训计划和针对患者的信息教育，这将有助于更有效地控制磷平衡，降低成本，并提高血液透析患者的护理质量。
