Abstract: Objective: To explore the effects of collaborative intensive education on phosphorous control in hemodialysis (HD) patients with refractory hyperphosphatemia. Methods: Twenty-nine hemodialysis patients having refractory hyperphosphatemia from January to March 2016 were recruited in this study. A collaborative team including nurses, dietitian and physicians was set up to provide intensive education for these patients. After 3-month intervention, the patients' nutritional status, serum phosphorous level and mineral metabolism related knowledge were assessed and compared with those at baseline. Results: The patients' serum calcium, BMI, Kt/V and iPTH level were stable during the study period; while the serum phosphorous level decreased after the intervention. Both their dietary protein and phosphorous decreased, while their dietary phosphorous/protein ratio did not change. Meanwhile, their nutritional status and mineral metabolism related knowledge improved. Conclusion: The collaborative intensive education could improve the hyperphosphatemia control of HD patients through improving their awareness of mineral bone disorders and lowering dietary phosphorous intake without malnutrition.

Key words: hyperphosphatemia; hemodialysis; dietary intake; education; behavior change