Does targeted dietary advice via telecommunications (video, phone and text) reduce blood phosphate levels in patients with kidney failure on dialysis?

We aim to recruit participants in Australia who are receiving maintenance dialysis. They will be randomly assigned to either a usual dietetic care group or dietary intervention group. The usual care group will continue to receive standard face to face/telemedicine care provided by the relevant hospital or dialysis unit dietitian. The intervention group will receive standard care plus intensive phosphate lowering education from the research dietitian via identification of high bioavailable dietary sources (from nutritional analysis with software program Foodworks), phosphate binder education and food preparation instruction. All instructions will be designed specifically for this trial. This will be done via telenutrition (video and/or phone determined by participant) at baseline (1 x 45 minute), another within one week of the baseline visit (1 x 45 minute) and then will be supported with weekly targeted messages and infographics via a specifically designed App over the next three month period. Messages will be unidirectional, (i.e., one-way with no response required from participants). Content of the messages will include advice, information, reminders, and motivation to support improved serum phosphate levels and quality of life. Messages will be personalised based on baseline dietary intake (from FFQ) and monthly serum phosphate blood tests (normal practice) to three months. Appropriate software will monitor delivery of messages to confirm delivery to participants. The duration of the study (usual care and intervention) is three months, with measurements of serum phosphate, dietary intake (FFQ) and pill burden undertaken at baseline and at the end of the study period. The interviews will be conducted by renal dietitians.