AN OVERVIEW OF NURSES' MANAGEMENT OF SECONDARY HYPERPARATHYROIDISM: HOW IS EUROPE DOING?

BACKGROUND: Nurses have an important role to play in the management of secondary hyperparathyroidism (SHPT). An online survey conducted by the European Dialysis and Transplant Nurses Association/European Renal Care Association (EDTNA/ERCA) in conjunction with Amgen (Europe) GmbH surveyed nephrology nurses' knowledge of secondary hyperparathyroidism, treatment targets, current treatments, patient adherence and nephrology nurse training education needs. The survey's aim was to establish common practices being used by nurses in the management of secondary hyperparathyroidism and to identify nephrology nurses' training and educational needs in order to improve patient care. DESIGN: Descriptive study. MEASUREMENTS: An online survey of multiple choice and closed questions. PARTICIPANTS: A sample of nephrology nurses from Spain, Italy, France and the Netherlands. RESULTS: A total of 111 nurses completed the questionnaire (98% response rate, 82% of which were fully completed). Collected data revealed that there were specific aspects of SHPT patient management where nurses lacked confidence, despite the majority of respondents having 15 years nephrology nursing experience. These aspects included explaining the disorder and therapies to patients, managing side effects of drugs and appreciating the significance of controlling biochemical targets. Over 40% of the respondents felt they did not have sufficient training to support patients who were non-compliant. CONCLUSION: Nursing skills are integral to SHPT patient management as part of the multidisciplinary approach. The nurse's role is particularly important in patient assessment and monitoring, and in the provision of patient education and support, particularly with treatment adherence. Nephrology nurses who are better informed about SHPT and who receive training on practical patient care may improve the care of patients.

Management of hyperphosphataemia: practices and perspectives amongst the renal care community.

BACKGROUND: Protein-rich foods are a major source of dietary phosphorus; therefore, helping patients to increase their dietary protein intake, while simultaneously managing their hyperphosphataemia, poses a significant challenge for renal care professionals. OBJECTIVES: To examine the clinical recommendations and practice perceptions of renal care professionals providing nutrition and phosphate control advice to patients with chronic kidney disease (CKD). METHODS: Renal care professionals from four European countries completed an online survey on the clinical management of hyperphosphataemia. RESULTS: The majority of responders recommended a protein intake of less than 1.0 g/kg/day for pre-dialysis patients, 1.2 g/kg/day for patients undergoing peritoneal dialysis (PD) and 1.1-1.2 g/kg/day for patients undergoing haemodialysis (HD). The most common perception was that maintaining dietary protein intake and reducing dietary phosphorus intake are equally important for hyperphosphataemia management. For patients in the pre-dialysis stage, the majority of responders (59%) reported that their first-line management recommendation would be reduction of dietary phosphorus. For patients undergoing PD and HD, the majority of responders (53% and 59%, respectively) reported a first-line management recommendation of both reduction of dietary phosphorus and phosphate binder therapy. More renal nurses than dietitians perceived reducing dietary phosphorus to be more important than maintaining protein intake (for patients undergoing PD, 23% vs. 0%, respectively; for patients undergoing HD, 34% vs. 0%, respectively). CONCLUSION: This renal care community followed professionally accepted guidelines for patient nutrition and management of hyperphosphataemia. There was disparity in the perceptions and recommendations between nurses and dietitians, highlighting the need to standardise management practices amongst renal care professionals.