J Ren Nutr. 2023 Aug 14:S1051-2276(23)00114-0. doi: 10.1053/j.jrn.2023.07.004. Online ahead of print.
ABSTRACT
OBJECTIVE: This study aims to evaluate the effect of an adaptive nutritional and educational intervention for patients on hemodialysis in a routine care setting, using real-world data from electronic health records.
METHODS: Decentralized clinical trial of seven hemodialysis facilities recruited patients who have been on hemodialysis for over 3 months (N=153) for an 8-week adaptive intervention protocol. Patients were divided into four groups: (1) control (2) education intervention (3) meal intervention (4) education and meal interventions. Educational contents were digitally delivered via mobile phones and pre-made meals tailored on laboratory findings were home-delivered. Changes in serum electrolytes and malnutrition inflammation score (MIS) were analyzed.
RESULTS: Meal intervention statistically significantly stabilized serum phosphorus level (β = -0.81 mg/dL, 95% Confidence Interval (C.I.)=[-1.40, -0.22]) at week 8, with increased likelihood of being within target serum value range (Odds ratio = 1.21, 95% C.I.=[1.04, 1.40]). Meal group showed better nutritional status (MIS=3.65) than the education group (MIS=5.10) at week 8 (adjusted p<0.05). No significant changes were observed in serum potassium level, depression, and self-efficacy.
CONCLUSION: It was demonstrated that an adaptive meal intervention in a real-world care setting may benefit serum phosphorus control and nutritional status of patients on hemodialysis, without negative effect on depression levels or self-efficacy. More work is need to develop an effective educational intervention.
PMID:37586668 | DOI:10.1053/j.jrn.2023.07.004
