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      Dietary advice in hemodialysis patients: Impact of a telehealth approach during the COVID-19 pandemic.

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          Abstract

          Objective

          The purpose of this study was to assess the effect of a telehealth-delivered nutritional intervention via telephone in maintenance hemodialysis (HD) patients during the coronavirus outbreak.

          Methods

          This was a multicenter, observational, prospective, and longitudinal study of 156 patients undergoing maintenance HD from 15 dialysis units conducted during the COVID-19 pandemic. We assigned patients to receive dietary counseling through a phone call, according to their biochemical and nutritional parameters. Dry weight, intradialytic weight gain percentage (%IDWG), body mass index, potassium, phosphorus, calcium, calcium/phosphorus product, normalized protein catabolic rate, albumin, and hemoglobin were recorded at baseline and one month after nutrition counseling.

          Results

          The prevalence of hyperkalemia and hyperphosphatemia decreased significantly after dietary advice. A statistically significant reduction in serum potassium and phosphorus levels was observed in patients receiving counseling for hyperkalemia and hyperphosphatemia. In addition, there was a statistically significant decrease in the prevalence of hypophosphatemia. We also observed a significant decrease in %IDWG, although no statistically significant differences were detected in patients with high %IDWG. The data demonstrated statistically significant differences in potassium and phosphorus values when the person making the phone contact was the patient or the caregiver. The main statistically significant differences in hypophosphatemia %IDWG were only observed when contact was made directly with the patient. No differences were observed when the contact was made through nursing homes.

          Conclusion

          Our results suggest that telehealth-delivered dietary interventions can improve the clinical and nutritional parameters of HD patients. Consequently, this strategy may be effective for promoting continuous nutritional monitoring in these patients, in particular when conducting a face-to-face option is not crucial.

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          Author and article information

          Journal
          J Ren Nutr
          J Ren Nutr
          Journal of Renal Nutrition
          Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc.
          1051-2276
          1532-8503
          5 May 2021
          5 May 2021
          Affiliations
          [1]Nutrition Department, Nephrocare, Portugal
          Author notes
          []Correspondence to: Ana Valente, Rua Prof. Salazar de Sousa, Lote 12, 1750-233 Lisboa, Portugal. Phone number: +351 93 660 10 18
          Article
          S1051-2276(21)00109-6
          10.1053/j.jrn.2021.04.002
          8098055
          34147308
          af77e1a4-e726-4928-81d8-e1e867dc24cb
          © 2021 Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc.

          Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

          History
          : 12 November 2020
          : 18 April 2021
          : 25 April 2021
          Categories
          Original Research

          end-stage renal disease,hemodialysis,telehealth,diet,covid-19 pandemic

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