Doctor-led intensive diet education on health-related quality of life in patients with chronic renal failure and hyperphosphatemia.

BACKGROUND

Secondary hyperparathyroidism, renal osteodystrophy, and cardiovascular adverse events can occur if long-term hyperphosphatemia is not corrected, leading to the adverse prognosis of patients with chronic renal failure. Besides the use of phosphorus binders, clinical control measures for hyperphosphatemia in these patients should also incorporate diet control.

AIM

To observe doctor-led intensive diet education effects on health-related quality of life in patients with chronic renal failure and hyperphosphatemia.

METHODS

We assessed 120 patients with hyperphosphatemia and chronic renal failure on hemodialysis admitted to our hospital (July 2018 to March 2020). The control group ( = 60) was given routine nursing guidance, and the observation group ( = 60) was given doctor-led intensive diet education. The changes in EQ-5D-3L scores, disease-related knowledge, and compliance scores before intervention and 3 and 6 mo after intervention in the two groups were recorded. The levels of serum parathyroid hormone (iPTH), calcium (Ca), phosphorus (P), calcium-phosphorus product (Ca × P), serum creatinine (Scr), and blood urea nitrogen (BUN) before intervention and 3 and 6 mo after intervention in the two groups were assessed along with patient satisfaction.

RESULTS

There was no significant difference in blood iPTH, Ca, P, Ca × P, Scr, or BUN levels between the groups before intervention. After 3 and 6 mo of intervention, the blood iPTH, Ca, P, and Ca × P levels in the two groups decreased gradually ( < 0.05), but there were no significant differences in Scr or BUN. The blood iPTH, Ca, P, and Ca × P levels in the observation group were lower than those in the control group ( < 0.05). The satisfaction rate in the observation group after 3 mo was 93.33% and after 6, 90.00%, which was high compared with the 80.00% and 71.67%, respectively, in the control group ( < 0.05). There was no significant difference in EQ-5D-3L score between the two groups before intervention. After 3 and 6 mo of intervention, the visual analogue scale score of the two groups increased gradually ( < 0.05); and the scores of action ability, self-care, daily activities, pain and discomfort, and anxiety and depression decreased gradually ( < 0.05). The overall EQ-5D-3L score in the observation group was better than that in the control group ( < 0.05). There was no significant difference in disease-related knowledge or compliance scores between the groups before intervention. After 3 and 6 mo of intervention, the scores of disease, diet, and medication knowledge and compliance in the two groups increased gradually ( < 0.05). The scores of disease-related knowledge and compliance were higher in the observation group than in the control group ( < 0.05).

CONCLUSION

Doctor-led intensive diet education can improve patient satisfaction and the quality of life in patients with chronic renal failure and hyperphosphatemia and promote low-phosphorus diet behavior.