Effectiveness of The Phosphate Mobile App on Serum Phosphorus in Adult Hemodialysis Patients With Hyperphosphatemia

Inclusion Criteria: * Patients aged 18 years old and above. * Patients were undergoing maintenance HD treatment for more than three months. * Patients were on hemodialysis treatment for 4 hours per session, three times a week. * Kt/V value (a numerical formula value to determine hemodialysis treatment adequacy. K is dialyser clearance of urea, t is dialysis time, and V is the volume of distribution of urea, approximately equal to the patient's total body water) is 1.2 and above each session. * Patients were able to read English or Malay or Mandarin. * Patients were on the single type of phosphate binder. * Patients were having serum phosphorus above 1.78mmol/l and above for more than three months. * Patients were not seen by a dietitian for the past one year for phosphate education. * Patients did not have ward admission for the past three months. * Patients did not have dementia or developmental delay. * Patients owned and able to use a smartphone. * Patients were able to use at least one comprehensive mobile application independently. * Patients had access to the internet/data plan. * Patients were willing to adhere to all study requirements and protocol. * Patients were willing to accept the publication of data without exposing their name. Exclusion Criteria: * Patients were on incremental or acute hemodialysis. * Patients had ward admission three months prior to the study and during the study period. * Patients were terminally ill. * Patients had cognitive impairment or physical disabilities (visual, hand dexterity, etc.) hindering interview and PMA utilisation. * Patients had visual impairment or blind hindering the interview or the use of PMA. * Patients were unable to self-care and dependent. * Patients stayed in an institutionalised setting. * Patients had undergone parathyroidectomy.