Nutritional intervention may stabilize serum phosphorus levels in adults on hemodialysis
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Key takeaways:
- Nutritional intervention helped to stabilize serum phosphorus levels.
- Patients also demonstrated improved overall nutritional status.
Results from a newly published study indicate that an adaptive nutritional and educational intervention may effectively stabilize serum phosphorus levels in adults receiving hemodialysis.
“Patients on [hemodialysis] HD are prone to malnutrition due to nutrient loss during HD, dietary restriction, decreased appetite and poor physical activity,” Moon Kyung Chung, BS, of the interdisciplinary program of medical informatics division at the Seoul National University College of Medicine in the Republic of Korea, and colleagues wrote.
“We designed an adaptive nutritional and educational intervention protocol ... to tailor to participant's serum potassium and phosphorus levels while maintaining a good nutritional status, develop an intervention method in a real-world setting using electronic health record, [and] adopt virtual elements of decentralized clinical trials.”
In a multicenter, decentralized clinical trial involving 153 patients from seven dialysis facilities, researchers examined patients on hemodialysis for at least 3 months and categorized them into four groups: control, education intervention, meal intervention, and education and meal interventions. Educational content was delivered digitally via mobile phones, while premade meals were delivered to households based on malnutrition inflammation score which composed of potassium, phosphate and sodium materials from the participant’s blood chemistry, prescription of binders and interdialytic weight, and laboratory findings.
Results showed that the meal intervention group experienced a statistically significant stabilization of serum phosphorus levels at week 8, with a reduction of 0.81 mg/dL. The group had an increased likelihood of maintaining serum phosphorus within the target value range, with an OR of 1.21, according to the findings.
The meal intervention group also showed better nutritional status at week 8 compared with the education group. The malnutrition inflammation score for that group was 3.65, vs. 5.10. for the education group. The difference was statistically significant. There were no substantial changes in serum potassium levels, depression or self-efficacy.
“It was demonstrated that an adaptive meal intervention in a real-world care setting may benefit serum phosphorus control and nutritional status of patients on HD, without negative effect on depression levels or self-efficacy,” the researchers wrote. “More work is needed to develop an effective educational intervention.”
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