{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T13:36:38Z","timestamp":1769434598842,"version":"3.49.0"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,2,3]],"date-time":"2016-02-03T00:00:00Z","timestamp":1454457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hemodialysis International"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Introduction<\/jats:bold> Osteodystrophy management includes dietary phosphorus restriction, which may limit protein intake, exacerbate malnutrition\u2010inflammation syndrome and mortality among hemodialysis patients. <jats:bold>Methods<\/jats:bold> A multicenter randomized controlled trial was conducted in Lebanon, to test the hypothesis that intensive nutrition education focused on phosphorus\u2010to\u2010protein balance will improve patient outcomes. Six hemodialysis units were randomly assigned to the trained hospital dietitian (THD) protocol (210 patients). Six others (184 patients) were divided equally according to the patients\u2019 dialysis shifts and assigned to Dedicated Dietitian (DD) and Control protocols. Patients in the THD group received nutrition education from hospital dietitians who were trained by the study team on renal dietetics, but had limited time for hemodialysis patients. Patients in the DD group received individualized nutritional education on dietary phosphorus and protein management for 6 months (2\u2010hour\/patient\/month) from study renal dietitians. Patients in the control group continued receiving routine care from hospital dietitians who had limited time for these patients and were blinded to the study. Serum phosphorus (mmol\/L), malnutrition\u2010inflammation score (MIS), health\u2010related quality of life (HRQOL) index and length of hospital stay (LOS) were assessed at T0 (baseline), T1 (postintervention) and T2 (post6 month follow up). <jats:bold>Findings<\/jats:bold> Only the DD protocol significantly improved serum phosphorus (T0:1.78\u2009\u00b1\u20090.5, T1:1.63\u2009\u00b1\u20090.46, T2:1.69\u2009\u00b1\u20090.53), 3 domains of the HRQOL and maintained MIS at T1, but this protective effect resolved at T2. The LOS significantly dropped for all groups. <jats:bold>Discussion<\/jats:bold> The presence of competent renal dietitians fully dedicated to hemodialysis units was superior over the other protocols in temporarily improving patient outcomes.<\/jats:p>","DOI":"10.1111\/hdi.12405","type":"journal-article","created":{"date-parts":[[2016,2,4]],"date-time":"2016-02-04T02:39:15Z","timestamp":1454553555000},"page":"432-440","source":"Crossref","is-referenced-by-count":8,"title":["Nutritional education for management of osteodystrophy: Impact on serum phosphorus, quality of life, and malnutrition"],"prefix":"10.1111","volume":"20","author":[{"given":"Mirey","family":"Karavetian","sequence":"first","affiliation":[{"name":"Department of Health Promotion Maastricht University Maastricht The Netherlands 6200 MD Maastricht"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hafez","family":"Elzein","sequence":"additional","affiliation":[{"name":"Lebanese National Kidney Registry Beirut Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rana","family":"Rizk","sequence":"additional","affiliation":[{"name":"Department of Health Services Research Maastricht University Maastricht The Netherlands 6200 MD Maastricht"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rime","family":"Jibai","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics University of Saint Joseph Beirut Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanne","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Maastricht University Maastricht The Netherlands 6200 MD Maastricht"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,2,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2008.05.003"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2010.05.014"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2001.29222"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfh143"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2008.09.018"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfh254"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-011-9942-3"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jrn.2008.11.002"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03890609"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/17.1.86"},{"key":"e_1_2_6_12_1","first-page":"26","article-title":"The impact of education on nutrition on the quality of life in patients on hemodialysis: A comparative study from teaching hospitals","volume":"23","author":"Aghakhani N","year":"2012","journal-title":"Saudi J Kidney Dis Transpl."},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1054\/clnu.2000.0129"},{"key":"e_1_2_6_14_1","volume-title":"Pocket Guide to Nutrition Assessment of the Patient with Chronic Kidney Disease","author":"McCann L.","year":"2009"},{"key":"e_1_2_6_15_1","volume-title":"Is MNT provided by a Registered Dietitian for Chronic Kidney Disease (CKD) in Adults Effective? 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