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Table 2 Questionnaires about dietary phosphorus for dialysis patients

From: The importance of nutritional intervention by dietitians for hyperphosphatemia in maintained hemodialysis patients

No. Questions
1 Do you pay attention to your intake of phosphorus?
2 Approximately how many times do you eat fish or meat in a week?
3 What kind of dairy products do you eat? (e.g., yogurt, cheese, milk, etc.?) How many times in a week?
4 Approximately how many times a week do you eat processed foods? (e.g., ham, sausages, chikuwa etc.)
5 Do you go to restaurants, eat bento boxes, or instant meals? If you answered yes, how many times? (everyday/once a every few days/once a week/once a month/twice a month)
6 Who cooks at home? (you/partner/your child/your parents/others)
7 Do you pay attention to what’s in your food? (e.g., Intake salt, use scale, restrict water, no attention, other)
8 Are you prescribed phosphate binders? If you answer yes, tell me their names.
9 If you take Fosrenol, tell me how do you take it? (crushed/ uncrushed)
10 Do you sometimes forget to take phosphate binders?
11 If you do forget to to take it, what do you then do? (e.g., nothing/take next meal time/when you remember/or other)
12 Do you take phosphate binders on an empty stomach?
13 Do you take laxatives? If you answer yes, how many, what kind? When do you take them? (the morning before HD/ Before sleeping/a non-dialysis morning) How many times do you defecate?
14 Do you know your blood level of phosphate?
15 Do you check your blood data? (Regularly/Sometimes/Never) If you do check, what do you see? (Phosphorus/potassium/neutral fat/bloodless data/blood sugar/others)
16 If you are told that your phosphorus levels are high, do you do something to combat it?(meals/take phosphate binders regularly/Do nothing/ Have never been told its high)
17 After paying attention to high phosphorus levels and trying to combat it, have your phosphorus levels declined?