Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 6, 2022; 10(4): 1217-1225
Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1217
Doctor-led intensive diet education on health-related quality of life in patients with chronic renal failure and hyperphosphatemia
Xian-Dong Feng, Xue Xie, Rui He, Fang Li, Gui-Zhong Tang
Xian-Dong Feng, Xue Xie, Rui He, Fang Li, Medical Department, Chengdu Second People’s Hospital, Chengdu 610021, Sichuan Province, China
Gui-Zhong Tang, Chongqing Medical University School of Public Health and Management, Medical and Social Development Research Center, and Collaborative Innovation Center for Social Risk Prediction and Governance in the Health Field, Chongqing 400016, China
Author contributions: Feng XD and Tang GZ design the experiment; Xie X drafted the work, Li F and He R collected the data; Feng XD, Li F and He R analysed and interpreted data, Feng XD and Tang GZ wrote the article.
Institutional review board statement: This study was approved by the Chengdu Second People’s Hospital Ethics Committee.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declared that there is no conflict of interest between them.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gui-Zhong Tang, MD, Assistant Technician, Chongqing Medical University School of Public Health and Management, Medical and Social Development Research Center, and Collaborative Innovation Center for Social Risk Prediction and Governance in the Health Field, No. 1 Yixueyuan Road, Yuzhong District, Chongqing 400016, China. tangguizhong968@163.com
Received: October 15, 2021
Peer-review started: October 15, 2021
First decision: December 1, 2021
Revised: December 12, 2021
Accepted: December 23, 2021
Article in press: December 23, 2021
Published online: February 6, 2022
Abstract
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 (n = 60) was given routine nursing guidance, and the observation group (n = 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 (P < 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 (P < 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 (P < 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 (P < 0.05); and the scores of action ability, self-care, daily activities, pain and discomfort, and anxiety and depression decreased gradually (P < 0.05). The overall EQ-5D-3L score in the observation group was better than that in the control group (P < 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 (P < 0.05). The scores of disease-related knowledge and compliance were higher in the observation group than in the control group (P < 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.

Keywords: Dietary education, Chronic renal failure, Hemodialysis, Hyperphosphatemia, Quality of life, Satisfaction

Core Tip: Clinical control of hyperphosphatemia in patients with chronic renal failure, can be improved with innovative diet interventions. Compared with conventional nursing interventions, doctor-led intensive diet education can better promote patients’ mastery of and compliance with health knowledge, and thereby, aid in effective regulation of the balance of calcium and phosphorus in patients’ bodies and further improve the quality of patients’ lives.