Interdialytic Weight Gain Research Articles

The Effect of Coaching Support Method on Interdialytic Weight Gain (IDWG) Changes Among Hemodialysis Patients

This research aimed determine impact of Coaching Support Method on IDWG values in CKD patients receiving hemodialysis. This quasi-experimental analysis, conducted in 2023, engaged 28 hemodialysis patients in Garut, Indonesia. Subjects were randomly assigned to the control (n = 14) and intervention (n = 14) groups, The intervention was performed in case group as 4 training sessions during 2 weeks based on coaching support. IDWG values were rechecked before and after intervention. Data analysis was performed using SPSS, applying dependent and independent t-tests, with statistical significance set at p < 0.05. The mean scores of IDWG values showed statistically difference before and after intervention in the intervention group (p-value < 0.05)). Additionally, the mean scores of IDWG values showed statistically difference in intervention group and control group (p-value < 0.05) following the two-week session. Coaching Support Method can be done as an effective method in hemodialysis patient for reducing IDWG values in CKD patients receiving hemodialysis.

C-Reactive Protein-to-Serum Chloride Ratio: A Novel Marker of All-Cause Mortality in Maintenance Haemodialysis Patients

Background and Objectives: hypochloremia is an emerging risk factor for mortality in patients with chronic kidney disease. The pathophysiological mechanisms of this finding are not very clear. Some studies suggest the influence of inflammation as a synergistic factor, so we set out to analyse the association of a novel C-reactive protein-to-serum chloride ratio (CRP/Cl−) with the prognosis of maintenance haemodialysis patients and to assess its relationship with fluid status and body composition measured by bioimpedance. Materials and Methods: the present work is a retrospective cohort study of maintenance haemodialysis patients from our chronic outpatient haemodialysis programme between 1 January 2022 and 31 December 2022. (n = 281). Survival time was collected for all patients and analysed using the Kaplan–Meier method. A Cox proportional hazards regression model was used to evaluate survival probabilities. Variables included in the model were selected using a stepwise selection procedure based on the corrected Akaike information criterion (AICc), which balances model fit and complexity. Results: during a median follow-up of 306 days, 34 patients died. Patients in the fourth quartile of the CRP/Cl− (>0.118 mg/mEq) had higher overall mortality (log-rank test, p = 0.0011). In the Cox multivariate analysis, the variables significantly associated with higher mortality were higher modified Charlson index (MCI), lower body surface area (BSA), lower interdialytic weight gain (IDWG), and higher CRP/Cl− ratio. The latter variable was independently associated with higher overall mortality (adjusted hazard ratio = 1.027; 95% confidence interval [CI], 1.000–1.055 p = 0.0469). Conclusions: Higher CRP/Cl− ratio values were associated with higher all-cause mortality in our maintenance haemodialysis patients.

Cultural and linguistic diversity is associated with increased inter-dialytic weight gain among patients on long-term haemodialysis.

Factors associated with suboptimal interdialytic weight gain have long been established. However, the influence of cultural and linguistic diversity on interdialytic weight gain among patients receiving haemodialysis is not well-understood. This study examined the relationship between interdialytic weight gain and cultural and linguistic diversity among patients receiving haemodialysis. Retrospective cross-sectional study. Demographic and clinical data were collected from electronic medical records of patients receiving haemodialysis at five dialysis units. Logistic regression analysis was performed to determine factors associated with suboptimal interdialytic weight gain. Two hundred and sixty-nine patients, 62% of whom were female, with mean ± age of 65.8 ± 14.8 years, were studied. Most were from culturally and linguistically diverse backgrounds (60%) and a significant number belonged to the most disadvantaged socioeconomic group. Patients from culturally and linguistically diverse backgrounds had significantly higher relative interdialytic weight gain (2.40% ± 1.45%) compared to those from nonculturally and linguistically diverse backgrounds (1.83 ± 1.09%) (mean difference: 0.57%, 95% CI: 0.25-0.90, p = 0.001). Being from culturally and linguistically diverse backgrounds was associated with increased odds of higher relative interdialytic weight gain (OR: 2.40; 95% CI: 1.38-4.17, p < 0.01). Among patients on maintenance haemodialysis, individuals from culturally and linguistically diverse backgrounds had higher interdialytic weight gain compared to those from nonculturally and linguistically diverse backgrounds. Future research focusing on co-developing culturally sensitive interventions to improve self-management capability of patients on maintenance haemodialysis from culturally and linguistically diverse backgrounds is needed.

Associations of Patient Activation with Outcomes Among Patients on Chronic Hemodialysis: A Retrospective, Longitudinal, Observational Study.

Patient activation, defined as an individual's readiness, willingness, and ability to manage their own health and health care, is associated with healthy behaviors and improved outcomes. Patients undergoing in-center hemodialysis (HD) have low activation, but the association of patient activation with clinical outcomes among dialysis patients is unclear. We investigated the association between patient activation and outcomes in HD patients. This cohort included 925 prevalent, in-center HD patients among 10 facilities in a mid-sized dialysis provider. All patients who completed the Patient Activation Measure 13-item (PAM-13) survey during a previous study were included, and their records were cross-referenced with data from the electronic heath system. Patients were followed for 180 days after completion of the survey for the primary outcomes of time to (1) death and (2) time to hospitalization. Markers of non-adherence during the month before and the month after completion of the PAM survey were examined as secondary outcomes, including (1) serum potassium >5.0 mEq/L; (2) serum phosphorus >5.5 mg/dL; (3) missed dialysis treatment due to absence (not hospitalization); and (4) interdialytic weight gain >4.0%. Univariate and adjusted regression models were fit to estimate associations of a 3-point increment in PAM-13 score with the outcomes of interest; adjustment factors comprised age, sex, dialysis vintage, serum albumin, diabetes, and hospitalization history. A 3-point increment in PAM score was associated with lower hazard of death (univariate HR=0.89, 95% CI: 0.84-0.94; adjusted HR=0.90, 95% CI: 0.85-0.96), but not with hospitalization (univariate HR=0.99, 95% CI: 0.96-1.02; adjusted HR=0.99, 95% CI: 0.96-1.02). Higher scores were associated with increased odds of having high phosphorus levels in the unadjusted analysis, but this was attenuated and not significant in adjusted models. There were no significant relationships between a 3-point increment in PAM score and any of the other secondary outcomes in univariate and adjusted analyses. In a cohort of prevalent, in-center HD patients, low activation was associated with mortality but not with hospitalization or measures of non-adherence.

Effect of Ice Popsicles on Thirst, Xerostomia and Interdialytic Weight Gain for Children Undergoing Hemodialysis

Effect of Ice Popsicles on Thirst, Xerostomia and Interdialytic Weight Gain for Children Undergoing Hemodialysis

The Usability and Feasibility of a Dietary Intake Self-Monitoring Application in a Population with Varying Literacy Levels.

Our aim was to study how hemodialysis patients with varying levels of literacy would use a diet and fluid intake monitoring mobile application (DIMA-P) and what would be its impact on their dietary behaviors. We developed a mobile application using user-centered methods and informed by the Integrated Theory of Health Behavior Change (ITHBC). Eight hemodialysis patients were recruited to use the application to record and monitor their diet and fluid intakes for a 6-week study. Overall, the participants had low literacy, numeracy, and technical skills. We collected the data on application usage and administered usability and context-of-use questionnaires to gain insights into the participants' interaction with the application. The participants' portion estimation skills and dietary self-regulation self-efficacy were assessed using various tests. In addition, interdialytic weight gain data were collected to assess the impact of app usage on the participants' health outcomes. The application usage patterns varied, with a general trend towards frequent use (n = 5) correlating with engagement in self-monitoring. The participants gave high comprehensibility, user-friendliness, satisfaction, and usefulness ratings, suggesting that the app was well designed and the target users could easily navigate and interact with the features. While the participants improved in estimating portion sizes, the impact on measuring skills was variable. There was also an improvement in the participants' dietary self-regulation self-efficacy post-study. The interdialytic weight gain trends indicated a slight improvement in fluid and diet management. People with different literacy skills can effectively use icon-based interfaces for portion size estimation and develop personalized usage patterns to self-regulate their fluid and dietary intakes. Moreover, they can experience an enhancement in their dietary self-efficacy skills by using a mobile application aimed at providing nutritional feedback. Furthermore, this research shows that the constructs of the ITHBC are effective in promoting dietary behavior change in a population with varying literacy skills. The target users can benefit from explicitly visualizing the relationship between their health outcomes and the factors influencing those outcomes. These user ambitions could be supported by developing machine learning models. Future research should also focus on enhancing the mechanisms by which technology can further enhance each component of the ITHBC framework.

Efficacy and safety of long-term treatment with elobixibat in hemodialysis patients with chronic constipation: an observational study

BackgroundConstipation is a common complication in hemodialysis patients and can impact their quality of life. Elobixibat selectively inhibits ileal bile acid transporter to suppress bile acid reabsorption, increase the amount of bile acid entering the colonic lumen, and promote water secretion and colonic motility in the large intestine. While the efficacy and safety of elobixibat in hemodialysis patients up to 12 weeks after administration have been reported, the long-term efficacy and safety of elobixibat in hemodialysis patients with chronic constipation are yet to be elucidated. This study evaluates the efficacy and safety of long-term treatment with elobixibat in hemodialysis patients with chronic constipation.MethodsThis was a single-center observational study. A total of 54 patients who had received elobixibat for at least 24 weeks were enrolled. Data on the frequency of spontaneous bowel movements (SBM), Bristol stool form scale (BSFS), patient satisfaction, constipation scoring system (CSS), interdialytic weight gain, laboratory values including blood electrolyte levels, controlling nutritional status (CONUT) score, and adverse events were collected and retrospectively compared between baseline and the last observation.ResultsLong-term elobixibat treatment in the 54 hemodialysis patients with chronic constipation significantly increased (p < 0.05) the frequency of SBM and mean stool form score assessed as per the BSFS at the last observation (duration of treatment, 24.4 to 240.0 weeks). Patient satisfaction and CSS also improved (p < 0.05). Mean serum phosphorus levels decreased (p < 0.05). The treatment was well tolerated.ConclusionsLong-term treatment with elobixibat maintained good bowel movement status and patient satisfaction in hemodialysis patients with chronic constipation. Improved dialysis-related laboratory levels were also demonstrated.Trial registration: UMIN Clinical Trials Registry, UMIN000049865, 22 December 2022, retrospectively registered.

Explaining International Trends in Mortality on Hemodialysis Through Changes in Hemodialysis Practices in the Dialysis Outcomes and Practice Patterns Study (DOPPS)

Rationale & ObjectiveCase-mix adjusted hemodialysis mortality has decreased since 1998. Many factors that influence mortality may have contributed to this trend and these associations may differ by continental region. We studied changes in hemodialysis facility practices over time and their potential role in mediating changes in patient survival. Study DesignObservational prospective cohort study. Setting & ParticipantsAdult hemodialysis patients treated in hemodialysis 500 facilities participating in the Dialysis Outcomes Practice Patterns Study (DOPPS) between 1999 and 2015 in the US, Japan, and 4 four European countries: Germany, Italy, Spain, and UK. PredictorsFour practice measures at each facility: the percentages of patients with Kt/V>1.2, interdialytic weight gain [IDWG]<5.7%, phosphorus<6 mg/dL, and using AV fistulae. OutcomesPatient survival. Analytical ApproachMediation analyses, adjusted for case mix, were conducted using 3-year study phase as the exposure and facility practice measures as potential mediators. ResultsIn Europe, we observed a 13% improvement in overall case-mix adjusted survival per decade. Trends in facility practice measures, especially Kt/V and phosphorus, explained 10% improvement in case-mix survival per decade, representing 77% (10% explained of 13% improvement) of the observed improvement. In Japan, 73% of the observed 12%/decade improvement in case-mix adjusted survival could be attributed to facility practices, especially Kt/V and IDWG. In the US, 56% of the observed 47%/decade improvement in case-mix adjusted survival could be attributed to facility practices, especially AV fistula use and phosphorus control. LimitationsUnmeasured changes in the characteristics of the patient population over this period may confound the observed associations. ConclusionThe improvements in adjusted hemodialysis patient survival in Europe, Japan, and the US from 1999 to 2015 can be largely explained by improvements in specific facility practices. Future changes in patient survival may be responsive to further evolution in the implementation of common clinical practices.

Exercise Improves Respiratory Function, Body Fluid and Nitric Oxide in Hemodialysis Patients.

Emerging evidence suggests that resistance training (RT) can mitigate respiratory muscle weakness in hemodialysis (HD) patients. However, the underlying mechanisms responsible for these beneficial effects remain unclear. The purpose of this study was to assess the impact of periodized RT on respiratory muscle strength and its relationship with handgrip strength (HGS), fat-free mass (FFM), nitric oxide (NO), and interdialytic weight gain (IWG) in HD patients. Thirty-three patients were randomly assigned to two groups: control (CTL; n=18) and RT (n=15). The RT group did not perform any additional exercise training specific to the respiratory tract. Maximal inspiratory (MIP) and expiratory (MEP) pressures, peak expiratory flow (PEF), HGS, FFM, NO, and IWG were measured before and after the intervention period. Participants in the RT group engaged in a 24-week RT program, three times per week. RT resulted in significant improvements in MIP, MEP, PEF, as well as enhancements in HGS, FFM, NO, and IWG (p<0.05). Notably, inverse correlations were observed between MIP (r=-0.37, p=0.03) and PEF (r=-0.4, p=0.02) with IWG. Thus, the amelioration of HGS and FFM coincided with a reduction in respiratory muscle weakness among HD patients. Decreased IWG and increased circulating NO are plausible mechanisms contributing to these improvements.

Effectiveness of Digital Self-Management Toward Fluid Restriction on Interdialytic Weight Gain Among Patients Undergoing Hemodialysis in Jakarta Islamic Hospital

Effectiveness of Digital Self-Management Toward Fluid Restriction on Interdialytic Weight Gain Among Patients Undergoing Hemodialysis in Jakarta Islamic Hospital

Effects of salt reduction education from a salt questionnaire on inter-dialysis weight gain in patients on hemodialysis.

Heart failure is the leading cause of death in patients undergoing hemodialysis (HD), with fluid overload being the most common cause. Therefore, it is important for patients undergoing HD to reduce salt intake. We recently developed a highly accurate and simple self-administered salt questionnaire. Using this salt questionnaire, we aimed to determine whether salt intake and inter-HD weight gain decrease when patients with HD are instructed to reduce their salt intake. Seventy-eight outpatients at a maintenance HD facility were assessed for dietary salt intake using a salt questionnaire. After one month of dietary guidance, salt intake was assessed again using the salt questionnaire. The mean age of the patients was 72.2 ± 11.9years; 47 (60.3%) were men, 23 had diabetic nephropathy as the primary disease, and the median HD vintage was 74months. Salt intake significantly decreased from 8.41 ± 2.43g/day before the salt questionnaire intervention to 7.67 ± 2.60g/day after the intervention (p = 0.010). Changes in salt intake before and after the intervention were significantly positively correlated with changes in weight gain before the start of HD sessions with an interval of 2days (r = 0.24, p = 0.037). Furthermore, changes in salt intake significantly and positively correlated with changes in weight gain after adjusting for age, sex, and dry weight. The salt questionnaire may be an effective tool for reducing salt intake and controlling weight gain during HD.

Safety and efficacy of very low calorie diet in patients receiving haemodialysis therapy.

Very low calorie diets (VLCDs) are an obesity treatment option in the general population, but their efficacy and safety in patients on haemodialysis (HD) is unknown. Prospective single arm study of VLCD in haemodialysis patients. All participants received 2.5-3.3MJ/day for 12weeks. Weekly assessment of VLCD, pre- and post-dialysis weight, inter-dialytic weight gain, and blood electrolytes occurred for the first 4 weeks, then fortnightly for another 8 weeks. Linear mixed models compared the change in weight over time as well as biochemical outcomes including potassium. Twenty-two participants [nine home HD (HHD) and 13 satellite HD (SHD)] enrolled with 19 completing the 12-week intervention. Mean post-dialysis weight declined from 121.1kg at baseline to 109.9 at week 12 resulting in average decline of 0.88kg per week (95% C.I. 0.71, 1.05, P<.001) with 12-week mean percentage weight loss9.3% (SD 3.5). Mean post-dialysis body mass index declined from 40.9kg/m2 at baseline to 37.1kg/m2 at week 12 (95% C.I. 0.25, 0.35, P<.001). Serum potassium rose from week 1 to 3, stabilized during weeks 4 to 6, and fell from week 8, returning near baseline by week 12. Six of the nine (66.6%) HHD participants and seven of the 13 (70%) SHD participants had at least one episode of hyperkalaemia (K>6mmol/l). There were no clinical changes in serum sodium, corrected calcium, or phosphate levels during the study. VLCD with dietitian supervision was effective in producing significant weight reduction, with an acceptable safety profile in patients treated with haemodialysis.

Hemodialysis patients have signs of a chronic thrombotic burden

BackgroundCardiovascular diseases are the dominant cause of morbidity in hemodialysis (HD) patients. Unless sufficient anticoagulation is used during HD, clotting may appear. The objective was to investigate if levels of fibrin degradation products (D-dimer) were increased before and during HD.MethodsThe combined observational study included 20 patients performing a total of 60 hemodialysis divided into three sessions of low-flux dialysis. None of the patients suffered from any clinically evident thromboembolic event before or during the study. Median bolus anticoagulation (mainly tinzaparin) doses were 84 Units/kg bow. Blood samples were drawn before HD (predialysis), and at 30min and 180min during HD with focus on analyzing D-dimer levels and its relation to interdialytic weight gain (IDWG) and speed of fluid elimination by HD (UF-rate).ResultsPredialysis, D-dimer levels (mean 0.767 ±0.821, min 0.136mg/L) were above the upper reference value in 95% of the sessions. D-dimer levels were lowered at 30min (p<0.001) and returned to predialysis levels at 180min. Predialysis D-dimer correlated with NT-pro-BNP, Troponin T, IDWG and UF-rate. Multiple regression analysis revealed that the D-dimer levels were significantly related to IDWG and the UF-rate.ConclusionsD-dimer levels were elevated in a high proportion predialysis and during HD and related to the IDWG and the UF-rate. Awareness of D-dimer levels and future studies will help clarify if optimization of those variables, besides anticoagulation and biocompatibility measures, will eradicate the repeated subclinical thromboembolic events related to each HD; one reason that may explain organ damage and shortened life span of these patients.

The Influence Of Education Based On Self-Efficacy Theory On Interdyalitic Weight Gain (IDWG) In The Hemodialysa Unit

Poor fluid management among hemodialysis patients can lead to detrimental outcomes such as high Interdialytic Weight Gain (IDWG), contributing to increased cardiovascular morbidity and mortality. While conventional education on fluid restriction exists in hospitals, non-compliance remains prevalent, highlighting the need for educational approaches grounded in self-efficacy theory to enhance patients' self-confidence in self-management. This study aimed to assess the impact of educational interventions based on self-efficacy theory on IDWG in hemodialysis patients at Malahayati Islamic Hospital. Using a quantitative quasi-experimental pretest-posttest control group design, the study included a total of 68 participants selected through purposive sampling. Statistical analysis revealed a significant difference (p &lt; 0.05) in IDWG scores between the intervention and control groups post-intervention, indicating the effectiveness of self-efficacy-based education in improving compliance with fluid intake restrictions among chronic kidney failure patients undergoing hemodialysis.

PENGARUH MENGUNYAH PERMEN KARET RENDAH GULA TERHADAP PENINGKATAN SEKRESI SALIVA PADA PASIEN YANG MENJALANI TERAPI HEMODIALISA

Abstract Background: Chronic kidney failure is a health problem that needs special attention. The number of end-stage renal failure sufferers undergoing hemodialysis therapy increases every year. Hemodialysis therapy is an appropriate action to replace kidney function with a method of supplying fluid intake which results in most patients complaining of dry mouth (xerostomia). Objective: Fluid restriction generally causes dry mouth in hemodialysis (HD) patients. The observed effects of chewing gum on the amount of saliva, interdialytic weight gain (IDWG), and thirst levels in HD patients are inconsistent. We are considering whether gum can modulate this third parameter in patients undergoing HD. Method: This study used purposive sampling with 37 patients on HD. Thirst levels were measured using a self-rated visual analogue scale (VAS) and the summed xerostomia inventory (SXI). Results: The level of thirst after blood washing was significantly lower in the gum chewing group compared to the control group with a p value (0.000) &lt;0.005. The amount of saliva was higher in the gum group than in the control group before dialysis, but the amount of saliva was comparable between the groups after dialysis. In addition, the amount of saliva was not associated with IDWG in patients undergoing HD before or after dialysis. Conclusion: Chewing gum can relieve thirst but does not affect the amount of saliva and IDWG in HD patients. Therefore, we suggest that chewing gum may be a useful approach to treat dry mouth and thirst in HD patients.

Stress level and interdialytic weight gain (IDWG) in hemodialysis patients

Stress has various impacts on hemodialysis patients. Stress in hemodialysis patients can cause physical symptoms (fatigue, muscle cramps, nausea, and vomiting), a decrease in quality of life, and non-compliance with self-management, one of which is compliance related to limiting fluid intake, thus adversely affecting on the patient's IDWG. IDWG is an important indicator for fluid monitoring in hemodialysis patients. Increasing IDWG that exceeds the tolerance limit can have a negative impact and can even cause mortality. This study aimed to determine the correlation between stress level and IDWG among hemodialysis patients. This study was conducted in the hemodialysis unit of RSD Mangusada, involving 95 respondents. This study was quantitative, with non-experimental research using a cross-sectional approach. Data collection was carried out with DASS questionnaires for stress and observation sheets for the IDWG. The data was analyzed using Pearson's Spearman Rank (α&lt;0.05). Respondents with IDWG within tolerance limits were the majority unstressed, and none experienced severe stress or very severe stress. There is a positive and weak correlation between stress and IDWG among patients undergoing hemodialysis. The findings from this study may provide useful information in reviewing existing nursing care and standards of care provided in hemodialysis units, including the need to consider psychological assistance services in the care of hemodialysis patients. Qualitative research is needed to explore the in-depth experience of stress in hemodialysis patients and the factors associated with it.

Interdialytic weight gain and low-salt diet in patients on chronic hemodialysis: A systematic review and meta-analysis

ObjectiveThe present systematic review and meta-analysis aims to determine the difference in the interdialytic weight gain (IDWG) between low salt intake diet and normal/high salt intake diet or between nutritional counseling aimed at reducing diet salt intake and no nutritional counseling in patients on chronic hemodialysis. MethodsMedline, PubMed, Web of Science, and the Cochrane Library were searched. Randomized, crossover or parallel studies and observational studies were considered for inclusion and: 1) included adult patients on chronic hemodialysis since at least 6 months; 2) compared normal salt intake diet with low salt intake diet on IDWG; 3) compared nutritional counseling aimed at reducing diet salt intake with no intervention on IDWG; 4) reported on IDWG. ResultsEight articles (783 patients) were fully assessed for eligibility and included in the investigation. Meta-analysis showed frequencies of patients that increased their weight after dialysis more than 2.5 Kg (events) over total enrolled subjects for each group (control and experimental). As no significant heterogeneity was observed (I2 =8%; p=0.36), the pooled analysis was performed using a fixed-effect model. Funnel plot was generated and no obvious asymmetry was observed. The Overall Odds Ratio to get an event in the experimental group, in respect to controls, is 0.57 (0.33-0.97) (p=0.04] with single studies OR ranging between 0.11 to 1.08. ConclusionThe present systematic review and meta-analysis suggest that the use of a low salt diet sodium or a nutritional counseling aimed at reducing diet salt intake is associated with a statistically significant reduction of the IDWG in patients on chronic hemodialysis.

Association of vascular endothelial growth factor-C, plasma angiotensinogen and left ventricular hypertrophy in patients with hemodialysis.

This study aims to examine the relationship between fluid overload, Vascular Endothelial Growth Factor C (VEGF-C), plasma Angiotensinogen (pAGT), and echocardiography findings in hemodialysis patients. This was a single-center, cross-sectional study. Patients were divided into two groups according to mid-week inter-dialytic weight gain (mIDWG): (1) mIDWG ≤3% and (2) mIDW >3%. A total of 55 patients were enrolled in this study. While the mean pAGT and left ventricular mass index were significantly higher in patients with mIDWG >3% compared to patients with mIDWG ≤3%, VEGF-C was similar between groups. pAGT ≥76.8 mcg/L, VEGF-C ≤175.5 pg/ML, and pAGT /VEGF-C ≥0.45 were significant cut-offs for the prediction of left ventricular hypertrophy(LVH). Univariate logistic regression analysis revealed that these cut-off values were significantly associated with LVH. Renin-angiotensin-aldosterone system activation may persist in hemodialysis patients with excessive IDWG. Additionally, pAGT and VEGF-C could be risk factors for the development of LVH.

Adherence to Fluid Restrictions among Haemodialysis Patients In Private Haemodialysis Centres in Kuala Lumpur Malaysia

End stage kidney disease (ESKD) is an irreversible progressive kidney function that requires kidney replacement therapy. Over two million people have currently received dialysis treatment worldwide. Haemodialysis treatment has been developed as a practical, safe and efficient method for the care of patients with ESRD. However, HD treatments generally have a more negative impact on patients' quality of life (QoL), high morbidity and mortality rate, as well as major adverse cardiovascular events. Compliance to dietary, fluid restrictions, medications and treatment regimens is one of the contributors to the quality of life observed in patients ESKD undergoing haemodialysis treatment. This study is aimed on the measurement of the fluid restriction adherence of 132 haemodialysis patient in MAIWP-PICOMS haemodialysis centres. An interdialytic weight gain (IDWG) was used as an indicator to describe the level of adherence level. Method: An observational study was conducted among consenting patients on HD for ≥3 months with criteria of age from 18 to 65 years old using end-stage renal disease-adherence questionnaire (ESRD-AQ). Result: Of 132 participated patients were observed, 53% were female and 47% were male with a mean age of 49.05 ±11.52 years and HD duration mean length of 1.33 ranging from 1-5 years. Statistically, a significant association between level of fluid adherence behaviour and treatment duration (p &lt; .01) was found in this study. Meanwhile, the level of adherence to fluid restrictions was range between 45.5% - 50%, which was considered good. Conclusion: Significantly, adhered to fluid restriction among haemodialysis patients may prevent patients from many adverse consequences and improve the quality of life. Therefore, nurses and healthcare providers has been suggested to play a pivotal role in delivering education on fluid restriction for haemodialysis patient.

Development of compliance theory based on self-regulation in chronic kidney failure patients on hemodialysis

Self-management in regulating diet, fluids, activities, and medication in chronic renal failure patients which getting hemodialysis is still worse. This research aimed to develop the theory of compliance based on self-regulation to increase patient obedience and awareness. A cross-sectional approach of 130 respondents was recruited using simple random sampling. Structural equation modeling partial least square (SEM-PLS) was the statistical analysis for this study. All indicators in the outer model showed outer loading value &amp;gt;0.7, it declared feasible to predict each of the latent variables. The R-square value of appraisal latent was 0.576, Coping was 0.897, and self-care compliance was 0.713. The model was relevant when applied in other research studies with a Q-Square value=0.832. The goodness of fit (GoF) was 0.832&amp;gt;0.36, which means that the model was applied well. The appraisal variable is the strongest variable that influences coping, based on the hypothesis test. The self-regulation-based compliance model for blood pressure, interdialytic weight gain (IDWG), sodium levels, and functional independence can be developed through analysis of the structural model.