Renal Failure Patients Research Articles

A Randomized Comparative Evaluation Of Effects Of Dexmedetomidine As An Adjuvant With Bupivacainein Supraclavicular Block In Crf Patients Undergoing Basilic Vein Transposition Surgery

Aim: To compare analysis of bupivacaine in supraclavicular block with dexmedetomidine bupivacaine in supraclavicular block in chronic renal failure patients undergoing basilica vein transposition surgery. Methodology: Double-blind randomised control trial. Department of Anaesthesia, Sindh Institute of Urology and Transplantation, Karachi, from September 1st, 2021, to February 28th, 2022 Seventy chronic renal failure patients undergoing elective basilic vein transposition surgery were enrolled. Patients were divided into two groups, in which 35 patients in group A received bupivacaine (0.25%) in 28mL plus dexmedetomidine (1ug/kg) diluted to 2 mL, and 35 patients in group B were injected with bupivacaine (0.25%) in 28 mL plus 2mL of normal saline. Results: The mean time of onset of sensory blockade was comparatively higher in group B as compared to group A. Similarly, the onset of motor block time was also higher in group B as compared to group A, and the duration of motor block did not show any significant results between groups, and the duration of motor block was not statistically significant between groups [p = 0.404]. Conclusion: The combination of bupivacaine and dexmedetomidine appeared to be useful for onset time and prolongs the duration of analgesia in supraclavicular brachial plexus block. Keywords: Chronic kidney disease, Dexmedetomidine, Supraclavicular brachial plexus block

Hypnotherapy Intervention on Pain Scale Level of Arteriovenous Fistula Cannulation in Haemodialysis Patients with Chronic Renal Failure

This study aims to determine the effectiveness of hypnotherapy intervention on the level of pain scale of arteriovenous fistula cannulation installation in haemodialysis patients with chronic renal failure. This research method is quasi experimental (one pre-post group desaign). The sample of this study was chronic renal failure patients in arteriovenous fistula cannulation access insertion totalling 45 respondents using total sampling technique. The results obtained before hypnotherapy were 11 respondents (24.4%) experienced a mild pain scale level response, 34 people (75.66%) experienced a moderate pain scale level response while after hypnotherapy intervention showed all 45 respondents (100%) with a mild pain scale with a P value of 0.000 (α <0.05). In conclusion, hypnotherapy intervention can significantly reduce or eliminate pain during arteriovenous fistula cannulation in haemodialysis

Ultrasonographic changes of the median nerve in patients with end-stage renal failure and comparing it with a control group

Carpal Tunnel Syndrome (CTS) is characterized by median nerve entrapment in the wrist. CTS is diagnosed by clinical symptoms, which are confirmed by electrodiagnostic studies. This study aimed to assess median nerve cross-sectional area and elastography in chronic hemodialysis patients. This case-control study was conducted on end-stage renal failure (ESRD) patients undergoing hemodialysis at Rasool Akram Hospital's Dialysis Unit. The healthy companions of the patients were included as control group. An experienced rheumatologist used a supersonic device with linear array probes and dynamic scanners (5-22 MHz) to perform the sonography. The current study was conducted on both hands. There was no statistically significant difference between 30 patients and 30 healthy individuals regarding age, weight, and body mass index. The cross sectional area of median nerve in both hands was increased in the dialysis group compared to the control group. However, it was significantly higher in the patient group's right hand than in the control group (P = 0.031). Considering the causes of ESRD and parathormone levels, the cross-sectional area and mean right and left median nerve elastography were not different between the two groups. The results showed that the patient group had a larger right and left median nerve cross-sectional area than the control group. However, the median nerve elastographic indices did not differ between dialysis patients and healthy individuals.

Creatinine Clearance as a Screening Tool for Dosage Adjustment among Renal Failure Patients

Creatinine Clearance as a Screening Tool for Dosage Adjustment among Renal Failure Patients

The nature of kidney damage causing the development of acute renal failure in patients with COVID-19 (according to morphological studies)

The literature review presents data on the study of the nature of kidney damage in patients with COVID-19 with acute renal insufficiency according to histo-morphological lifetime and postmortem studies of the kidneys during the peak of the epidemic of infection in 2020-2022. In the analysis, the role of direct viral damage to tissues and organ cells is questioned. The frequency of diagnosis of glomerular, tubular, interstitial and vascular lesions is specified, the significance of the presence of variants of the apolipoprotein-1 (APOL1) gene in patients with severe respiratory complications of acute viral infection is assessed.

Indoleamine 2,3-dioxygenase level and oxidative stress parameters in the serum of patients with chronic renal failure

Indoleamine 2,3-dioxygenase (IDO) is a tryptophan-degrading enzyme belonging to the kynurenine pathway. IDO activity has been suggested as a biomarker for diagnosis of chronic kidney disease. The aim of the study was to estimate the level of IDO, urea, creatinine, uric acid, phosphate, calcium, albumin, MDA, GSH, and activity of peroxidase, catalase, arylesterase in the serum of chronic renal failure (CRF) patients treated with dialysis compared to the healthy control group. The results showed a significant increment in IDO level in patients compared with the control. Linear regression analysis using the Pearson correlation coefficient showed that increased IDO level correlates positively with urea, creatinine, uric acid, phosphate, MDA level and peroxidase activity whereas negatively with albumin, calcium, glutathione level, catalase activity and glomerular filtration rate. We concluded that IDO level might be a possible marker of oxidative stress and inflammation in patients with CRF. Keywords: 3-dioxygenase, biochemical parameters, correlation analysis, indoleamine 2, renal failure, serum

Nail Whispers Revealing Dermatological and Systemic Secrets: An Analysis of Nail Disorders Associated With Diverse Dermatological and Systemic Conditions.

Background and objective Nail disorders encompass a wide spectrum of conditions, spanning congenital, developmental, infectious, neoplastic, degenerative, dermatological, and systemic diseases. A comprehensive exploration of their clinical manifestations, incidence, and associations is crucial for precise diagnosis and effective management. Methods This observational cross-sectionalstudyconducted atB.J. Medical College and Civil Hospital,Ahmedabad involved 300 consecutive patients with nail changesfrom July 2017 to June 2019 reporting diverse dermatological and systemic conditions. The inclusion criteria involved patients of both genders and all age groups displaying nail changes associated with dermatological and systemic diseases. Data collection entailed a comprehensive clinical history, systemic and dermatological examinations, nail assessment using Dermoscope (DermLite 3, 10x), and supplementary tests. Analyses were performed on Microsoft Excel 2007 software. The studywas approved by the Institute Ethics Committee. Results Among the300 cases, females had a higher prevalence of nail involvement (57%), with a female-to-male ratio of 1.3:1. The most affected age group was 21-40 years, with 6-10 nails typically affected. Notably, housewives showed a higher prevalence. The most frequent nail condition was onychomycosis (24.33%) followed by psoriatic nail changes (20%).Less frequent nail changes involved eczema (5.7%), paronychia (5%), drug-induced (4.3%), lichen planus (3.7%), trauma-induced (3%), twenty nail dystrophy (2.33%), Darier's disease (2%), pemphigus vulgaris (2%), alopecia areata (1.67%), median Heller dystrophy (1.33%), atopic dermatitis (1%), epidermolysis bullosa (1%), racquet nail (1%), leprosy (1%), pityriasis rubra pilaris (0.67%), vitiligo (0.67%), secondary syphilis (0.67%), pachyonychia congenita (0.67%), as well as a case each of total leukonychia, subungual warts, Koenentumor, and periungual fibroma(0.33%). Systemic autoimmune connective tissue disorders (CTD) accounted for 9%; the most common nail finding observed was nail fold erythema (48.1%) followed by nail fold telangiectasis (44.4%). In systemic sclerosis (SS), the most common finding was nail fold telangiectasia, and in systemic lupus erythematosus (SLE), the most common was nail fold erythema. Scleroderma capillary pattern on nail fold capillaroscopy was found in seven patients with SS, two patients with dermatomyositis, and only one patientwith SLE. Nail changes observed in systemic diseasesinclude onychomycosisin diabetes mellitus and chronic renal failure patients, splinter hemorrhagesin ischemic heart disease and hypertension, longitudinal melanonychia in HIV,and koilonychia and platynychia in iron deficiency anemia.Other systemic diseases, such asAddison's disease and renal failure, also exhibited various nail changes. Conclusions Beyond their cosmetic importance, nails hold a vital pathologic role. Proficiency in nail terminology and classification is key for skillful evaluation. Understanding normal and abnormal nail variants, along with their disease associations, benefits diagnosis and tailored management. Nails, often overlooked but accessible, serve as a window into patients' general health and should be an integral part of thorough examinations.This study highlights an intricate clinical panorama of nail disorders, highlighting their significant role in both dermatological and systemic contexts.

Oral Manifestations of Chronic Renal Failure Patients on Hemodialysis

Kidney disease is a worldwide health problem with increasing incidence and prevalence of disease, high cost, and poor prognosis. Chronic Kidney Disease involves an irreversible loss of renal function which leads to a change in the electrolyte balance of the human body. This can lead to a large plethora of oral manifestations. A wide range of lesions may be observed in chronic renal failure patients like gingival hyperplasia, enamel hypoplasia, petechiae, gingival bleeding, and various other lesions. As literature indicates that the incidence of these pathologies are increasing, identification and providing appropriate dental care to these patients can be imperative.
 Aims: To assess the oral manifestations of chronic renal failure patients on hemodialysis.
 Methods and Materials: The oral cavity of the patients was examined for features like uremic odour, coated tongue, ulcerations, pigmentation, petechiae, ecchymosis, uremic stomatitis, xerostomia and recorded accordingly.
 Statistical Analysis Used: All the findings were tabulated and were subjected to statistical analysis using Chi square test.
 Results: A wide range of oral signs, symptoms, and lesions that include uremic odor(36.6%), xerostomia(58.3%), uremic stomatitis(5%), altered taste sensation(46.6%), coated tongue(1%), burning sensation(40%), ulceration/pigmentation(6.6%), candidiasis(5%), pale mucosa(13.3%), gingival enlargement (6.6%) and petechiae/ecchymosis(5%) were observed. Xerostomia was found to be the most common finding in 35(58.3%) patients affecting 20 (57.1%) of males and 15(42.8%) of females followed by altered taste sensation in 28 (46.6%) patients that showed an equal gender predilection.
 Conclusions: Dental considerations of renal failure patients is of utmost importance as they present with a wide range of oral manifestations. It is the Oral Physicians responsibility to treat the oral manifestations along with rendering the appropriate dental therapy to the renal failure patients.

Ureum and Creatinine Levels of Kidney Failure Patients Pra and Post Hemodialysis in Jayapura General Hospital Papua

Kidney failure is a worldwide health problem seen from the increase in incidence, prevalence, and the level of morbidity. Indonesia is one country with high rates of kidney failure. The purpose of this research was to determine the description of the results of urea and creatinine levels in patients with kidney failure before and after hemodialysis. The population used in this study was all renal failure patients who would carry out hemodialysis at the Jayapura Regional General Hospital (RSUD). The number of samples in this research is 30. The method of examining urea and creatinine used is the photometry method. This research was conducted from 10 May to 10 June 2018. To determine the levels of urea and creatinine before and after hemodialysis, the average value of the results of the examination was calculated and the results of the average urea level before hemodialysis 53.37 mg/dl and the average yield were obtained. Average after hemodialysis 18.83 mg/dl. The results of the average creatinine level of patients before 12.25 mg/dl and the average results after hemodialysis were 43.63 mg/dl. The results of the examination showed that there were no significant differences and that the results remained high. This research concluded that there was no significant difference between the examination of urea and creatinine levels before hemodialysis and after hemodialysis.

Аcute renal failure in patients with implanted LVAD in the early postoperative period

AKI is one of the major complications in the cardiac surgery group of patients in the world. In patients with LVAD in the short postoperative period, the situation with such a complication as AKI is associated with the state of hemodynamics and fluctuations in the parameters of the hemostasis system.
 The purpose of this scientific work is to analyze the state of the blood coagulation system and its response to therapy and complications in the early postoperative period in fifty patients with implanted devices for mechanical support of the left ventricle, left ventricle assist device, LVAD, in the Silesian Heart Disease, Poland. Patients were divided into two groups, a control group receiving classical anticoagulation targeted therapy (ATT), which included the most controlled monotherapy with heparin, after reaching the target values of APTT, the addition and transition to monotherapy with warfarin until reaching the target INR and ASA, and the main, research group, who received an alternative ATT consisting of the previous one with the addition of P2Y12-receptor blockers and Xa-factors.
 The results showed that the control group of patients with classical anticoagulant targeted therapy had greater mortality associated with AKI than the patients of the study group, and it was also demonstrated that the initially longer duration of surgery and intraoperative polyuria gave a greater percentage of AKI in the postoperative period.
 The work was carried out within the framework of a bilateral agreement on scientific cooperation between the Department of Anesthesiology & Intensive Care at the National Medical Academy of Post-Graduate Education Named After P.L. Shupyk and the Silesian Center for Heart Diseases (Poland). This article is part of the analysis of the work on the analysis of the blood coagulation system in patients after implantation of the left ventricular mechanical circulatory support system with the analysis of such postoperative complication as acute kidney failure.

Effect of Direct Acting Anti-Viral Drugs on Myostatin Level among CRF Egyptian Patients with Chronic HCV Infection and Its Correlation with Sarcopenia

Background Chronic kidney disease (CKD) is a progressive condition that might negatively affect musculoskeletal health. Secondary sarcopenia due to chronic kidney disease may be accompanied with elevated fall risk and mobility limitations. The loss of muscle mass, in addition to the impact of poor body composition on muscle strength and mobility status are necessary for classification and staging of sarcopenia. Aim of the Work The main aim of this study was to assess the effect of direct anti-viral drugs on myostatin level and its correlation with sarcopenia in CRF patient with chronic HCV. Patients and Methods This was a case control study was conducted at gastroenterology outpatients’ clinics and internal medicine and nephrology department Ain Shams university hospital and om elmasryeen general hospital including 50 chronic renal failure patients with chronic HCV infection and normal persons; they were divided into: Group A: 20 chronic HCV patient received direct acting anti-viral drugs. Group B: 20 chronic HCV patients didn’t receive direct acting antiviral drugs. Group C: 10 normal persons without chronic renal failure or hepatitis C virus. The duration of the study ranged from 6-12 months. Results There was no statistically significant difference between the studied groups as regard demographic data, there was high statistically significant difference between the studied groups as regard weight, lean body mass and BMI, there was high statistically significant difference between the studied groups as regard Hb, there was high statistically significant difference between the studied groups as regard history of ALT and AST and significant difference between the two studied groups as regards Alpha fetoprotein, there was high statistically significant difference between the studied groups as regard history of BUN and significant difference between the two studied groups as regards Creatinine, there was statistically significant difference between the studied groups as regard Serum myostatin. Conclusion The serum myostatin level was significantly lower in chronic HCV patients didn’t receive direct acting anti-viral drugs than those who received direct acting anti-viral drugs and control groups.

Hubungan Penerimaan Diri dengan Kepatuhan Pembatasan Cairan pada Pasien Gagal Ginjal

This study aimed to identify the relationship between self acceptance and fluid adherence in ESRD patients undergoing HD. This study used cross sectional design with consecutive sampling of 121 respondents. Data collection used fluid adherence questionnaires, self acceptance scale and documentation studies. The analysis used chi square and logistic regression. The result showed that 79,3% of respondents had adherence to fluid restriction and 78,5% of them had self acceptance. The analysis result also showed there was a significant relationship between self acceptance and fluid adherence (p=0,024), but no significant relationship between self-acceptance and IDWG (p=0.154). There was significant relationship between confounding variable of the length of time undergoing HD and fluid adherence (p=0.033), adequacy HD and IDWG (p=0,011). However, other confounding variables were not significant relationship with fluid adherence, which were: age, gender, education, and comorbidities. Furthermore, the multivariat analysis found that self acceptance was the most dominant variable affecting fluid adherence (p=0.006) after controlling by variables of the sex and the length of time undergoing HD, which can predicted 21% to fluid adherence. In conclusion, from the results of this study, it was found that there was a significant relationship between self-acceptance and length of time undergoing hemodialysis with fluid adherence in terminal renal failure patients undergoing hemodialysis.
 
 Key words: Hemodialysis, End Stage Renal Disease, Fluid adherence, Self Acceptance

Efficacy and Safety of Different Modalities for Treatment of Erectile Dysfunction in Chronic Renal Failure Patients

Background Erectile dysfunction has been found to be significantly more common in men with chronic kidney disease (CKD) than in the general population. Objective of the Study Detection of the safest and most effective medical treatment of erectile dysfunction(ED) in chronic renal failure patients. Patients and Methods . This study was conducted at Ain Shams University Hospitals with a sample size of 60 patients: 15 patients per group. We assessed the improvement in the erectile function through assessment of IIEF (International Index of Erectile Function) score and EHS (Erection Hardness Scale) score pre- and post-administration of the drugs used in the study (oral sildenafil, oral vardenafil, oral tadalafil and intracavernosal injection of alprostadil). Results There is a statistically significant increase in IIEF score post-administration of the drugs used in this study with p value of < 0.001 and a mean difference of 6.92. The mean score of IIEF pre-administration of the drugs used was 8.13 and post-administration was 15.05. There is also a statistically significant difference in EHS score with p value of < 0.001 and mean difference of 1.4. The mean score of EHS pre-administration of the drugs was 1.22 and post-administration was 2.62. From the four drugs used in this study, Alprostadil showed the highest improvement in IIEF and EHS scores. The study also showed a negative correlation between age, duration of haemodialysis and serum creatinine with erectile function. In addition, there was a statistically significant decrease in pre- and- post-treatment IIEF and EHS scores in diabetic cases than in the non-diabetic cases. Conclusion There is high incidence of ED in CKD patients. The drugs used in the study showed improvement in the erectile function with mild side effects. Alprostadil had the best IIEF and EHS scores amongst the four drugs.

WTP2.2 Subjective Assessment of Frailty Compared to Validated Frailty Assessment in Adults with Chronic Renal Failure presenting for Dialysis-Access/Transplant workup has Poor Estimation of Agreement

Abstract Purpose Frailty assessment often rely on subjective frailty assessment, such as ‘the end-of-the-bed’ or ‘eyeball’ test. These assessments have traditionally been accurate in 40% of cases only. Frailty assessment is a part of our institutional clinical workup. We examined the association between subjective frailty and formal validated score aided frailty estimation in the adult renal failure population. Methods A cohort of all renal failure patients presenting for dialysis access/transplant assessment at a satellite unit over one year (December 2020-2021) was analyzed. Adult patients aged ≥18 years in the outpatient dialysis access/transplant assessment surgical clinic were rated with eyeball test in routine clinical assessment as either: frail, pre-frail, or non-frail, which was then compared to a formal frailty assessment using a modified version of the Frailty Phenotype. The association between clinician-estimated frailty and formal frailty assessment was examined. Results A total of 113 patients were approached, producing 109 paired frailty assessments. The median age of the patients was 62 years. The Composite Proportions of Agreement of clinician-estimated frailty to formal frailty was poor (0.57). The sensitivity of the Eyeball test was 0.30 & specificity was 0.43. The sensitivity of the Frailty Score was 0.70 & specificity was 0.57. The validated tool has more than twice the odds of estimating frailty OR 2.86 (1.49- 5.46). p=0.002 (2-tailed). Conclusion Subjective frailty assessment is not a reliable replacement for formal frailty assessment in adults with renal failure. The validated Frailty Tool provides a uniform frailty estimation.

A rare case of an aortic arch stent causing central vein stenosis

Purpose Central vein stenosis is commonly encountered in end stage renal disease patients on hemodialysis. Most are manageable with repeated procedures and venoplasty, however in some cases, venoplasty may not be successful. Method We discuss a rare case of persistent upper limb swelling due to severe central vein stenosis from compression of an aortic arch stent. Result Despite attempt at prolonged balloon inflation during venoplasty of the central vein, the stenosis still persisted. The arteriovenous fistula was then ligated and other forms of vascular access for hemodialysis were sought after. Conclusion Central venograms may be useful in end stage renal failure patients as part of pre-operative arteriovenous fistula creation so as to anticipate the possibility of central vein stenosis and its associated complications.

Epidemiological Study on Hepatitis B Virus Infections among Hemodialysis Patients in Taiz City, Yemen

Viral hepatitis has a special relationship to renal disease. Prevalence of Hepatitis B virus (HBV) infection is high among renal failure patients compared to prevalence in the general population. HBV is highly infectious and transmitted from person to person via blood transfusions, sexual, and vertical routes. Recently, this virus is a common nosocomial problem and the cause of morbidity and mortality among hemodialysis (HD) patients because of the complications in the management of patients in the dialysis units.
 Hemodialysis patients are at high risk of infection by hepatitis B (HBV), Chronic infections with HBV may lead to liver cirrhosis, hepatic failure, and hepatocellular carcinoma. This study aimed to investigate the prevalence of HBV infections among HD patients at dialysis center in Republic Hospital and Thawrah Hospital in Taiz City, Yemen.
 A total of 200 patients were the sample of the study. The following data was collected: name, age, gender, occupation, education, family history of HD and family members. Blood samples were collected and screened for hepatitis B surface antigen (HBsAg) by enzyme-linked immunosorbent assay (ELISA) techniques. The overall prevalence of HBV infection has been found to be 30%.
 Among 200 patients, 113 (56.5%) were males and 87(43.5%) were females, this study showed that male HD patients had slightly higher HBV prevalence than females (30.97%, 28.74%) respectively.
 The present work shows the highest HBV seroprevalence was among age group 16-20 years (50%). The results of study showed that single groups of hemodialysis patients have higher HBV seroprevalence, the results of study showed that secondary level of study groups of hemodialysis patients have higher HBV seroprevalence, the current study showed that family relationship groups, have a higher seroprevalence of HBV infection was among the aunts.
 This study has concluded that HBV infection among HD patients represents a serious nosocomial health problem in the dialysis units in standard centers. So, strict adherence to infection control is required to prevent the prevalence of hepatitis infections.

A Descriptive Study to Assess the Quality of Life in Chronic Renal Failure Patients Undergoing Haemodialysis in Selected Hospital, Udaipur

A Descriptive Study to Assess the Quality of Life in Chronic Renal Failure Patients Undergoing Haemodialysis in Selected Hospital, Udaipur

Urea and Creatinine in renal failure patients with Viral Hepatitis

Urea and Creatinine in renal failure patients with Viral Hepatitis

Étude du niveau de pression artérielle en consultation chez l'hypertendu algérien traité (PACT II)

BackgroundHypertension is responsible for 8.5 million deaths from stroke, ischemic heart disease and other vascular and kidney diseases. In Algeria, hypertension (HTN) is the most common chronic disease with an estimated prevalence of 23,6%. MethodsThe PACT II study is a national, observational, descriptive, cross-sectional, multicenter and non-interventional study of therapeutic strategy, conducted in Algeria on hypertensive patients treated for at least 3 months, followed by 100 specialists or general practitioners. The primary objective is to describe the hypertension management in Algeria through the distribution of patients treated for HTN through predefined levels of arterial pressure (AP) reached under treatment. Results2000 eligible patients were recruited in the study. 63.5% and 36.4% of patients were female and male respectively. The average age was 62.4 years ± 10.7. The most affected age group (65.2%) was between 55 to 75 years old. Most of the patients had an elevated blood pressure (BP) with 49.30 % at level III AP (130 – 139 mmHg of SBP or 80 – 89 mmHg of DBP), with 49.6% for diabetic patients and 48.8% for non-diabetic patients, then followed by 20.35% at the level IV AP (140 – 159 mmHg of SBP or 90 – 99 mmHg of DBP) with 21.4% for diabetic and 18.3% for non-diabetic patients. Also, 47.32% were at AP level III in patients with Renal failure. Regarding the achievement of the BP target, it was 17.4% for the overall population with 18,3% for diabetic's patients and only 12.64% for Renal failure patients. Additionally, the risk of cardiovascular disease (CVD) was at very high level for most patients, corresponding to 38,4 % of the overall study population. At last, PACT II study data were collected on analysis of blood pressure levels in the overall population and in cardiovascular risk (CVR) population groups such as diabetes (65%), sedentary lifestyle (53%), dyslipidemia (50%), obesity (44%), and renal failure (11.3%). ConclusionPACT II has made it possible to update national data relating to hypertension in Algeria. It confirmed the low level of achievement of the BP target, even if the average arterial pressure level obtained was acceptable in 76% patients with a BP level which was lower than 140 mmHg for SBP and less than 90 mmHg for DBP. Many efforts must be made, according to WHO recommendations, to improve the management of hypertensive patients and BP control in Algeria.

The Effect of Counseling With Dietary Journal on Knowledge, Attitude, And Compliance of Renal Failure Patients on Haemodialysis Therapy

Chronic kidney disease (CKD) is a form of renal failure for 3 consecutive months that can be treated with hemodialysis. CKD patients need to undergo diet according to their kidney condition to prevent complications. On Riskesdas 2018, the prevalence of CKD reached 3.8 percent for population aged ≥15 years. The study aimed to determine the effect of nutritional counseling with dietary journal on the knowledge, attitudes, and dietary compliance of CKD patients who were undergoing hemodialysis at PGI Cikini Hospital. The study used a one-group pre and post-test design with 39 samples. Nutrition counseling was carried out using dietary journal twice. Knowledge and attitudes of samples were collected by asking samples to fill out questionnaire before and 1 week after nutrition counselings. Dietary compliances were collected from energy intake, macro and micronutrients, and IDWG values. The results showed that there were increases in the number of samples with adequate and good knowledge levels, positive attitudes, and in the compliant group to 84.6 percent; 94.9 percent; and 69.3 percent, respectively. Bivariate analysis showed that there were significant differences in the level of knowledge and compliance of CKD patients underwent hemodialysis at RSI PGI Cikini after nutrition counseling with a dietary journal. However, nutrition counseling has no effect on patients’ attitudes towards hemodialysis diet. It was concluded that nutritional counseling with a dietary journal affected the knowledge and dietary compliance of CKD patients underwent hemodialysis at PGI Cikini Hospital. Dietary journal can be used as a tool to monitor patient’s dietary compliance.
 Keywords: nutrition counseling, dietary journal, CKD