The renal dietitian's role in managing hyperphosphatemia and secondary hyperparathyroidism in dialysis XXXX : a national survey.

@entity1 @entity18279 @entity79 @entity1391 @entity4959 @entity21453 @entity460 @entity3151 @entity461 @entity11649 @entity560
PURPOSE: To survey the medical nutrition therapy practices of renal dietitians for the treatment of bone mineral metabolism. OBJECTIVES: To obtain data on @entity3151 diet prescription levels. To determine allied team involvement for @entity1391 binder and @entity560 therapies. To assess the frequency and target levels for monitoring serum @entity460 , @entity3151 , - @entity3151 product, intact @entity461 and alkaline phosphatase. METHODS: Two renal dietitians from the National Kidney Foundation-Council on Renal Nutrition developed a 5-question survey. This was posted on both the RenalRD Listserv and the NKF-CRN website from January 1 through February 15, 2001. Dietitians were asked to respond using facsimile, e-mail or reply by mail. RESULTS: One hundred and thirty-one surveys were received representing all major dialysis providers in the United States, the British Virgin Islands, and Japan. Results included information for peritoneal and hemodialysis @entity1 . Five different methods for dosing @entity1391 binders were determined. Prescribed @entity1391 binders included @entity18279 , @entity11649 , and @entity4959 . 108 out of 131 dietitian respondents (82.5%) have a medical protocol in place for @entity560 therapy. Of the respondents, 47% were directly responsible for implementing the @entity560 protocol. @entity21453 was the most widely used form of IV @entity560 . Biochemistry results were as follows: @entity460 , 16 different ranges from 8.0 mg/dL to 11.5 mg/dL; @entity3151 , 13 different ranges from 2.5 mg/dL to 6.5 mg/dL; @entity460 - @entity3151 product, 13 different ranges from 55-75; iPTH, 20 different ranges from 50-300 pg/mL; alkaline phosphatase, 18 different ranges from no records being monitored to a level of 500 mg/dL. CONCLUSION: The survey revealed a large variability in the treatment of bone mineral metabolism. Improved clinical practice guidelines for the health care team are being developed with the National Kidney Foundation (NKF)-Kidney Disease Outcomes and Quality Initiative (KDOQI) @entity79 management workgroup.
