Effectiveness of a nutritional mobile application for management of hyperphosphatemia in patients on hemodialysis: a multicenter open-label randomized clinical trial
This study aims to determine the effectiveness of a phosphate mobile app (PMA), MyKidneyDiet-Phosphate Tracker ©2019, on hemodialysis (HD) patients with hyperphosphatemia. A multicenter, open-label, randomized controlled trial design allowed randomization of patients with hyperphosphatemia to either...
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MDPI
2022
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author | Lee, Fang Teong Ban, Hock Khor Hi, Ming Ng Sahathevan, Sharmela Purba, Kristo Radion Narayanan, Sreelakshmi Sankara Abdul Gafor, Abdul Halim Bak, Leong Goh Boon, Cheak Bee Yahya, Rosnawati Bavanandan, Sunita Wahab, Zaimi Aqashiah Mazlan, Sadanah Chinna, Karuthan Morad, Zaki Mat Daud, Zulfitri Azuan Karupaiah, Tilakavati |
author_facet | Lee, Fang Teong Ban, Hock Khor Hi, Ming Ng Sahathevan, Sharmela Purba, Kristo Radion Narayanan, Sreelakshmi Sankara Abdul Gafor, Abdul Halim Bak, Leong Goh Boon, Cheak Bee Yahya, Rosnawati Bavanandan, Sunita Wahab, Zaimi Aqashiah Mazlan, Sadanah Chinna, Karuthan Morad, Zaki Mat Daud, Zulfitri Azuan Karupaiah, Tilakavati |
author_sort | Lee, Fang Teong |
collection | UPM |
description | This study aims to determine the effectiveness of a phosphate mobile app (PMA), MyKidneyDiet-Phosphate Tracker ©2019, on hemodialysis (HD) patients with hyperphosphatemia. A multicenter, open-label, randomized controlled trial design allowed randomization of patients with hyperphosphatemia to either the usual care group (UG; receiving a single dietitian-led session with an education booklet) or the PMA group (PG). Thirty-three patients in each intervention group completed the 12-week study. Post-intervention, serum phosphorus levels were reduced in both groups (PG: −0.25 ± 0.42 mmol/L, p = 0.001; UG: −0.23 ± 0.33 mmol/L, p < 0.001) without any treatment difference (p > 0.05). Patients in both groups increased their phosphate knowledge (PG: 2.18 ± 3.40, p = 0.001; UG: 2.50 ± 4.50, p = 0.003), without any treatment difference (p > 0.05). Dietary phosphorus intake of both groups was reduced (PG: −188.1 ± 161.3 mg/d, p < 0.001; UG: −266.0 ± 193.3 mg/d, p < 0.001), without any treatment difference (p > 0.05). The serum calcium levels of patients in the UG group increased significantly (0.09 ± 0.20 mmol/L, p = 0.013) but not for the PG group (−0.03 ± 0.13 mmol/L, p = 0.386), and the treatment difference was significant (p = 0.007). As per phosphate binder adherence, both groups reported a significant increase in Morisky Medication Adherence Scale scores (PG: 1.1 ± 1.2, p < 0.001; UGa: 0.8 ± 1.5, p = 0.007), without any treatment difference (p > 0.05). HD patients with hyperphosphatemia using the PMA achieved reductions in serum phosphorus levels and dietary phosphorus intakes along with improved phosphate knowledge and phosphate binder adherence that were not significantly different from a one-off dietitian intervention. However, binder dose adjustment with meal phosphate content facilitated by the PMA allowed stability of corrected calcium levels, which was not attained by UC patients whose binder dose was fixed. |
first_indexed | 2024-03-06T11:14:34Z |
format | Article |
id | upm.eprints-101057 |
institution | Universiti Putra Malaysia |
last_indexed | 2024-03-06T11:14:34Z |
publishDate | 2022 |
publisher | MDPI |
record_format | dspace |
spelling | upm.eprints-1010572023-06-17T23:38:34Z http://psasir.upm.edu.my/id/eprint/101057/ Effectiveness of a nutritional mobile application for management of hyperphosphatemia in patients on hemodialysis: a multicenter open-label randomized clinical trial Lee, Fang Teong Ban, Hock Khor Hi, Ming Ng Sahathevan, Sharmela Purba, Kristo Radion Narayanan, Sreelakshmi Sankara Abdul Gafor, Abdul Halim Bak, Leong Goh Boon, Cheak Bee Yahya, Rosnawati Bavanandan, Sunita Wahab, Zaimi Aqashiah Mazlan, Sadanah Chinna, Karuthan Morad, Zaki Mat Daud, Zulfitri Azuan Karupaiah, Tilakavati This study aims to determine the effectiveness of a phosphate mobile app (PMA), MyKidneyDiet-Phosphate Tracker ©2019, on hemodialysis (HD) patients with hyperphosphatemia. A multicenter, open-label, randomized controlled trial design allowed randomization of patients with hyperphosphatemia to either the usual care group (UG; receiving a single dietitian-led session with an education booklet) or the PMA group (PG). Thirty-three patients in each intervention group completed the 12-week study. Post-intervention, serum phosphorus levels were reduced in both groups (PG: −0.25 ± 0.42 mmol/L, p = 0.001; UG: −0.23 ± 0.33 mmol/L, p < 0.001) without any treatment difference (p > 0.05). Patients in both groups increased their phosphate knowledge (PG: 2.18 ± 3.40, p = 0.001; UG: 2.50 ± 4.50, p = 0.003), without any treatment difference (p > 0.05). Dietary phosphorus intake of both groups was reduced (PG: −188.1 ± 161.3 mg/d, p < 0.001; UG: −266.0 ± 193.3 mg/d, p < 0.001), without any treatment difference (p > 0.05). The serum calcium levels of patients in the UG group increased significantly (0.09 ± 0.20 mmol/L, p = 0.013) but not for the PG group (−0.03 ± 0.13 mmol/L, p = 0.386), and the treatment difference was significant (p = 0.007). As per phosphate binder adherence, both groups reported a significant increase in Morisky Medication Adherence Scale scores (PG: 1.1 ± 1.2, p < 0.001; UGa: 0.8 ± 1.5, p = 0.007), without any treatment difference (p > 0.05). HD patients with hyperphosphatemia using the PMA achieved reductions in serum phosphorus levels and dietary phosphorus intakes along with improved phosphate knowledge and phosphate binder adherence that were not significantly different from a one-off dietitian intervention. However, binder dose adjustment with meal phosphate content facilitated by the PMA allowed stability of corrected calcium levels, which was not attained by UC patients whose binder dose was fixed. MDPI 2022-06-12 Article PeerReviewed Lee, Fang Teong and Ban, Hock Khor and Hi, Ming Ng and Sahathevan, Sharmela and Purba, Kristo Radion and Narayanan, Sreelakshmi Sankara and Abdul Gafor, Abdul Halim and Bak, Leong Goh and Boon, Cheak Bee and Yahya, Rosnawati and Bavanandan, Sunita and Wahab, Zaimi and Aqashiah Mazlan, Sadanah and Chinna, Karuthan and Morad, Zaki and Mat Daud, Zulfitri Azuan and Karupaiah, Tilakavati (2022) Effectiveness of a nutritional mobile application for management of hyperphosphatemia in patients on hemodialysis: a multicenter open-label randomized clinical trial. Journal of Personalized Medicine, 12 (6). art. no. 961. pp. 1-16. ISSN 2075-4426 https://www.mdpi.com/2075-4426/12/6/961 10.3390/jpm12060961 |
spellingShingle | Lee, Fang Teong Ban, Hock Khor Hi, Ming Ng Sahathevan, Sharmela Purba, Kristo Radion Narayanan, Sreelakshmi Sankara Abdul Gafor, Abdul Halim Bak, Leong Goh Boon, Cheak Bee Yahya, Rosnawati Bavanandan, Sunita Wahab, Zaimi Aqashiah Mazlan, Sadanah Chinna, Karuthan Morad, Zaki Mat Daud, Zulfitri Azuan Karupaiah, Tilakavati Effectiveness of a nutritional mobile application for management of hyperphosphatemia in patients on hemodialysis: a multicenter open-label randomized clinical trial |
title | Effectiveness of a nutritional mobile application for management of hyperphosphatemia in patients on hemodialysis: a multicenter open-label randomized clinical trial |
title_full | Effectiveness of a nutritional mobile application for management of hyperphosphatemia in patients on hemodialysis: a multicenter open-label randomized clinical trial |
title_fullStr | Effectiveness of a nutritional mobile application for management of hyperphosphatemia in patients on hemodialysis: a multicenter open-label randomized clinical trial |
title_full_unstemmed | Effectiveness of a nutritional mobile application for management of hyperphosphatemia in patients on hemodialysis: a multicenter open-label randomized clinical trial |
title_short | Effectiveness of a nutritional mobile application for management of hyperphosphatemia in patients on hemodialysis: a multicenter open-label randomized clinical trial |
title_sort | effectiveness of a nutritional mobile application for management of hyperphosphatemia in patients on hemodialysis a multicenter open label randomized clinical trial |
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