Nutritional education for management of osteodystrophy: Impact on serum phosphorus, quality of life, and malnutrition.

Introduction Osteodystrophy management includes dietary phosphorus restriction, which may limit protein intake, exacerbate malnutrition-inflammation syndrome and mortality among hemodialysis patients. Methods A multicenter randomized controlled trial was conducted in Lebanon, to test the hypothesis that intensive nutrition education focused on phosphorus-to-protein balance will improve patient outcomes. Six hemodialysis units were randomly assigned to the trained hospital dietitian (THD) protocol (210 patients).

Effect of behavioral stage-based nutrition education on management of osteodystrophy among hemodialysis patients, Lebanon.

Objective: Assess the effect of intensive nutrition education by trained dedicated dietitians on osteodystrophy management among hemodialysis patients.

Methods: Randomized controlled trial in 12 hospital-based hemodialysis units equally distributed over clusters 1 and 2. Cluster 1 patients were either assigned to usual care (n=96) or to individualized intensive staged-based nutrition education by a dedicated renal dietitian (n=88).

Dietary educational interventions for management of hyperphosphatemia in hemodialysis patients: a systematic review and meta-analysis.

Strategies to enhance knowledge of and adherence to dietary guidelines for management of hyperphosphatemia in hemodialysis patients have been studied extensively over the past decade. This review is the first to compile all of them (2003-2013) and conduct a meta-analysis through calculation of effect size, with the aim of identifying the optimal nutrition education methods for effective management of hyperphosphatemia in hemodialysis patients. The following strategies were identified as being effective in changing dietary behavior: 1) use of self-evaluation and self-regulation techniques within educational tools, along with easy-to-apply skills; 2) individualized counseling by a renal dietitian provided just before the hemodialysis session; 3) high-intensity education; and 4) long duration of interventions.

Nutritional education for management of osteodystrophy (NEMO) trial: Design and patient characteristics, Lebanon.

THIS STUDY AIMS TO DETERMINE THE EFFECT OF A TRAINED DEDICATED DIETITIAN ON CLINICAL OUTCOMES AMONG LEBANESE HEMODIALYSIS (HD) PATIENTS: and thus demonstrate a viable developing country model. This paper describes the study protocol and baseline data. The study was a multicenter randomized controlled trial with parallel-group design involving 12 HD units: assigned to cluster A (n = 6) or B (n = 6).

Behavioral modeling to guide adherence to fluid control in hemodialysis patients.

Objective: This study used the health belief model (HBM) and the transtheoretical model (TTM) to assess hemodialysis (HD) patients' readiness to comply with recommended fluid intake as it relates to their perceptions of therapy and disease.

Design: This was a multicenter, cross-sectional study.

Setting: The setting involved 3 hospital-based HD centers in Lebanon.

The effect of a change in epoetin alfa reimbursement policy on anemia outcomes in hemodialysis patients.

In 1997, the Health Care Financing Administration Hematocrit Measurement Audit (HMA) program initiated use of a 3-month rolling average hematocrit (Hct) level for reimbursement of epoetin claims in hemodialysis patients, with denial of payment when this value exceeded 36.5%. This study evaluated the impact of the HMA program on anemia-related outcomes in hemodialysis patients.

Impact of multidisciplinary, early renal education on vascular access placement.

Background: The Ochsner Clinic Foundation initiated the Healthy Start Clinic to identify, educate, and refer chronic kidney disease patients to nephrologists earlier in the course of their disease. This study investigated the impact of a structured educational session on the type and timing of permanent vascular access placement in patients receiving hemodialysis.

Methods: Before initiating dialysis, the HSC patient group received a general overview of the kidney and kidney disease, plus one-on-one instruction from a registered nurse, a dietitian, and a social worker.

Cytoprotection by darbepoetin/epoetin alfa in pig tubular and mouse mesangial cells.

Background: Erythropoietin has recently been found to have cytoprotective effects in the central nervous system (CNS) and retina. The purpose of this study was to determine if darbepoetin alfa (DA) has cytoprotective properties in renal tissues.

Methods: DA was studied in LLC/PK1 and mesangial cells.

Hemoglobin variability in epoetin-treated hemodialysis patients.

Background: Understanding the clinical variability of hemoglobin measurements in epoetin-treated hemodialysis patients is important, particularly when this therapy is aimed at maintaining patient hemoglobin levels within a narrow range, such as the 11 to 12 g/dL range recommended in National Kidney Foundation Kidney Dialysis Outcomes Quality Initiative (NKF-K/DOQI) guidelines. This study examines hemoglobin variability under conditions of standard clinical practice in epoetin-treated hemodialysis patients.

Methods: We studied 987 hemodialysis patients participating in an observational retrospective study that evaluated anemia management practices from October 1, 1996 to December 31, 1997 at 11 United States dialysis centers that were randomly selected from a pool of nearly all United States dialysis facilities.

Anemia in CKD: prevalence, diagnosis, and treatment. Case study of the anemic patient.

A point-in-time observational study was conducted in over 1,000 nephrology offices between November 1999 and December 2000 to determine the prevalence of anemia in patients with chronic kidney disease (CKD). Trends in hemoglobin (Hb) and serum creatinine (SCr) levels were assessed among 4,831 evaluable patients to determine the relationship between renal function and anemia. Results demonstrated that anemia is common in patients with CKD, with progressive increases in prevalence and severity as renal function deteriorates.