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논문분류	춘계학술대회 초록집
제목	RANDOMIZED CONTROLLED TRIAL OF LOW PHOSPHATE DIET EDUCATION AND PHOSPHATE BINDER INTAKE TO CONTROL SERUM PHOSPHATE LEVEL AMONG MAINTENANCE HEMODIALYSIS PATIENTS
저자	Eunsoo Lim* 1, Sunah Hyun1, Seirhan Kim1, Min-Jeong Lee2, Sun-Mi Lee3, Ye-Sung Oh4, In-Whee Park1, Gyu-Tae Shin1, Heungsoo Kim1, Jong Cheol Jeong1
출판정보	2016; 2016(1):
키워드	Dietary modifications, hemodilaysis, Hyperphosphatemia
초록	Background: Among dialysis patients, hyperphosphatemia is associated with increased incidence of cardiovascular diseases, and a mediator to the development of hyperparathyroidism and mineral bone disorder. Phosphate can be removed by hemodialysis, however, the efficacy of removal is limited so that dietary education and proper intake of phosphate binder is essential. Methods: We randomized 70 patients into education group (n=48) and control group (n=22). Phosphate binder intake education was given by pharmacists using standardized manual. Nutritional consultation and assessment was performed by dietitians. Drug compliance was assessed by Morisky Medication Adherence Scales-4 (MMAS-4) and bioequivalent dosage of prescribed phosphate binder. The patients' knowledge about when to take phosphate binder was assessed by questionnaire. Nutritional status was assessed by using Patient-Generated Subjective Global Assessment (PG-SGA). Results: Baseline characteristics of two groups were similar. (Table 1). Primary goal was the proportion of patients who reached calcium phosphorus product lower than 55. Among education group, 36 (75%) patients achieved primary goal, compared to the 16 (72.7%) of control group (P=0.430). The improvement of MMAS-8 score were not different between education and control group (for short term, 0.26 ± 1.12 vs 0.02 ± 1.30, education vs. control, P=0.445. for long term, 0.11 ± 1.17 vs 0.30 ± 1.29, P=0.555). Education increased patients' knowledge of when to take phosphate binder, although it was not statistically significant (22.9% vs. 3.5%, education vs. control, P=0.347). Education did not affect the amount of dietary phosphate intake per body weight. (-1.18 ± 3.54mg/kg vs. -0.88 ± 2.04 mg/kg, education vs. control, P=0.851) However, it decreased the phosphate to protein ratio of diet. (-0.64 ± 2.04 vs. 0.65 ± 3.55, education vs. control, P=0.193). Education on phosphate restriction did not affect the PG-SGA (0.17 ± 4.58 vs. -0.86 ± 3.86, education vs. control, P=0.363), nor dietary protein intake. (-0.03 ± 0.33g/kg vs. -0.09 ± 0.18g/kg, education vs. control, P=0.569) Conclusion: Education did not affect the calcium phosphate product compared with control group. However, education corrected proper timing of phosphate binder intake and lowered the phosphate to protein ratio of dietary intake, although it was not statistically significant. These findings imply the importance of continuous educational efforts. Table: Table 1. Baseline characteristics of study participants
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