The Effect of Dietician Education Program on Nutritional Knowledge, Dietary Intake and Phosphate Control in Patients with Renal Failure

Abstract

Background: Limited fluid and electrolyte intake are part of standard\xa0diet of patients with renal failure on maintenance hemodialysis (MHD).\xa0However, non-adherence is common and may be explained by patients’\xa0insufficient nutritional knowledge. Therefore, we investigated the\xa0influence of a dietary counseling on MHD patients’ knowledge about\xa0nutrients and their subsequent consumed diet, with particular attention\xa0to the intake of phosphates and the phosphorus to protein intake ratio(i.e., the phosphorus content per gram of dietary protein intake per day).Methods: Forty-five MHD patients participated in this experimental\xa0study. At baseline, participants were interviewed by a dietician to assess\xa0their dietary habits and knowledge about nutrients and health-related\xa0consequences of electrolyte imbalances. In addition, they completed\xa0a nutrient intake diary during three consecutive days. Subsequently,\xa0individual dietary counseling, by means of personal advice was reinforced\xa0with the use of printed tables addressing the composition of food products\xa0and the phosphorus to protein intake ratio. Dietary counseling was\xa0repeated at three, six and nine months of follow-up. The interview with\xa0the dietician was repeated after one year.Results: Forty-five MHD patients completed the study. Their knowledge\xa0about nutrients and their dietary habits and food preparation mode\xa0improved significantly after the counseling program. Especially, caloric\xa0intake and dietary composition became more adequate and balanced,\xa0respectively. Moreover, the phosphorus to protein intake ratio improved,\xa0as well as patients’ intake of phosphate binders.Conclusion: This study showed that nutritional counseling improved\xa0MHD patients’ knowledge about nutrients and subsequently diet\xa0composition and phosphate intake.