Primary strategies to manage elevated serum phosphorus in Chronic Kidney Disease (CKD) patients include hemodialysis (HD), dietary restriction, and the use of oral phosphate binders. Dietary compliance is often challenging; estimated adherence is 15%.

To determine the comprehension of the low phosphate diet among HD patients at SAH to inform registered dietitian (RD) professional practice and dietary education strategies.

A 10-item knowledge-based paper questionnaire was adapted with permission from two similar studies. Eligible participants were determined by the Primary Investigator using study inclusion criteria. Thirty-seven HD patients with previous low phosphate diet teaching from a RD and prescribed phosphate binders were invited to participate. During routine dialysis treatments in February 2021, recruited participants provided verbal responses which were recorded, coded and entered into Excel©, and quantitatively analyzed.

Of the 31 consenting patients, 84% understood factors that support optimal serum phosphorus (HD, diet, oral phosphate binders); 81% understood the importance of restricting phosphorus to prevent bone damage; and 77% understood a common symptom of high serum phosphorus levels. Yet when asked if the kidneys can properly clear phosphorus for individuals who require dialysis, 32% stated they did not know. When asked whether fruits such as apples and strawberries were high in phosphorus, 35% provided an incorrect response and 23% did not know. Almost half (42%) would like more advice regarding their diet and 10% were unsure whether they required more advice.

Results suggest most patients understood the rationale behind the low phosphorus diet, however food concepts remain unclear. Findings will be used to inform RD patient care and education.

The education provided by RDs help patients comprehend their prescribed renal diet and medications. Refined patient self-management support will enhance RD competency in providing high quality care, and encourage improved health outcomes for people with CKD.

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