ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2018, Vol. 27 ›› Issue (2): 135-140.DOI: 10.3969/cndt.j.issn.1006-298X.2018.02.007

• Article • Previous Articles     Next Articles

Intensive education on hyperphosphatemia in maintenance hemodialysis patients: a systematic review and metaanalysis

  

  • Online:2018-04-28 Published:2018-05-02

Abstract:

Objective:Hyperphosphatemia, one of the most common complications of maintenance hemodialysis (MHD), significantly affected the outcomes of patients. Diet control was an important way to reduce serum phosphorus. The purpose of this study was to systematically evaluate the effect of intensive education on hyperphosphatemia in MHD patients.
Methodology:By searching on Medline, Embase and Cochrane library, the key words included “patient education”, “hemodialysis”, “hyperphosphatemia” and “randomized controlled trial”,  deadline was January 15, 2018.The methodological quality of the included literatures was evaluated by Jadad scale, and valid data was collected or extracted for the metaanalysis through using Revman 53 Software. The main outcome measures included serum calcium, phosphorus, calcium×phosphorus products and knowledge scores.
Results:Total 10 RCTs of 908 patients were included in this metaanalysis. The results showed that intensive education could significantly increase the level of serum calcium (WMD=007,95% CI:002-012,P<001); decrease the level of serum phosphorus (WMD=-020,95% CI: 032~-009,P<001) and the calcium × phosphate product (WMD=-062,95% CI: -086-038,P<001), and significantly improve the knowledge score of patients (SMD=078,95% CI: 006~151,P=003), while compared with the control group. The subgroup analysis was conducted according to the different educational implementers. The results showed that compared with nonnutritionist education, the dietitian education group was better in reducing serum phosphorus, the difference was statistically significant (P=003).
Conclusion:
Intensive education can significantly reduce serum phosphorus levels in patients with MHD, while increasing serum calcium levels and knowledge scores, nutritionist education has achieved remarkable results in patient education and could be further promoted in patient management.

Key words: patient education, hemodialysis, hyperphosphatemia, Meta-analysis