Impact of nutritional education in food intake concerning the phosphate of hemodialysis patients

Abstract

Chronic kidney disease (CKD) is a clinical syndrome that is the slow loss, progressive and irreversible renal functions (regulatory, endocrine and excretory) and is considered one of the major public health problems in the world. This loss leads to a number of disorders resulting in the accumulation of toxic substances not eliminated in the urine and inadequate concentration of solutes. Among these solutes, phosphate is found, and its accumulation can lead patients develop hyperphosphataemia in advanced stages of CKD. Excess phosphate leads to vascular calcification. Thus, prevention and correction of hyperphosphatemia control are important components of CKD. Objectives: To evaluate through dietary surveys the food profile of a population of patients with CKD on dialysis; Compare these estimates between groups that received either no continuing education in relation to phosphate restriction. Methods: A prospective cross-sectional study with all patients aged over 18 years, regularly treated by hemodialysis (HD), for at least 90 days in the Dialysis Unit of the Hospital das Clinicas, Botucatu Medical School - Univ Estadual Paulista - UNESP. Patients included will be randomly divided into two groups: intervention and control without the knowledge of the intern. The intervention group will receive conventional dietary guidelines and nutritional education focused on additives lasting about 30 minutes; and the control group will receive only conventional nutritional guidelines. The analysis of dietary surveys will be made through 3-day food records and Food Frequency Questionnaire (FFQ). Statistical analysis will be a characterization of the groups by calculating mean and standard deviation for quantitative variables and frequencies and percentages for categorical variables (descriptive analysis). The comparison between the groups will be done using the Student t-test for samples with normal distribution and using the gamma distribution in case of asymmetry. In all tests will be fixed at 5% significance level and the corresponding p-value and all analyzes will be done using SAS for Windows, v.9.3.