Decreasing the complications of renal osteodystrophy secondary to high phosphorus levels by using an innovative...

We wanted continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD) patients to become more cognitive of the complications of high-serum phosphorus levels (> 6.0 mg/dL). The phosphorus self-monitoring program was designed to encourage patients to be more responsible for preventing the complications of renal osteodystrophy. Patients' phosphorus levels were graphed monthly on a poster in the exam room. Additional posters discussed their responsibilities to control phosphorus and the complications associated with hyperphosphatemia. All patients received an informative letter regarding the inception of the program in March 1994 and also were assured total anonymity of their laboratory results. At monthly clinic appointments, they received additional written information on phosphorus and discussed their phosphorus levels. Our teaching method proved effective in our CAPD/CCPD population. In March 1994, 31% of our patients had a phosphorus level greater than 6.0 mg/dL versus 10% in September 1994. The ability of patients to see their monthly progress and the comparison with other patients encouraged much interest and questions regarding phosphorus control.