ABSTRACT
OBJECTIVE: To evaluate the effectiveness of a protocol designed to optimize serum phosphate levels in patients undergoing regular hemodialysis (HD). DESIGN: Randomized, controlled trial. SETTING: Hemodialysis units at Barts and the London NHS Trust and satellite units. PATIENTS: Thirty-four clinically stable adults undergoing regular HD with a serum phosphate level >1.8 mmol/L on at least one occasion within 4 months of starting the study. INTERVENTION: Management of serum phosphate using a specially designed phosphate management protocol during a 4-month study period implemented by a renal dietitian and renal pharmacist compared with standard practice. MAIN OUTCOME MEASURE: Change in serum phosphate levels in both groups after 4 months. RESULTS: Patients managed using the phosphate management protocol had a significantly greater reduction in serum phosphate levels compared with patients receiving standard practice (-0.22 +/- 0.67 mmol/L vs. +0.19 +/- 0.32 mmol/L, P = 0.03). CONCLUSION: The phosphate management protocol was effective, and its implementation was associated with significantly better serum phosphate control in patients undergoing regular HD.
