The importance of nutritional intervention by dietitians for hyperphosphatemia in maintained hemodialysis patients

Abstract

Hyperphosphatemia is a risk factor for cardiovascular disease and mortality in individuals with end-stage kidney disease (ESKD). Thus, it represents a potential target for interventions to improve clinical outcomes in ESKD. Phosphorus reduction therapy for maintained hemodialysis (MHD) patients encompasses phosphate binder medication, adequate dialysis, and also dietary phosphorus control. The main strategy in achieving dietary phosphorus reduction involves intensive education by a dietitian. The purposes of this patient education process are: (a) to obtain patient background information, (b) to assess patient knowledge, (c) to evaluate patient nutritional status, (d) to educate the patient using various approaches, and (e) to optimize the patient's nutritional state. Here, we review the management of dietary phosphorus by dietitians and summarize our strategy and the activities we use in diet counseling for MHD patients.