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Interdialytic weight gain

Dhea Natashia, Miaofen Yen, Hsing-Mei Chen, Susan J Fetzer
PURPOSE: The purpose of this study was to understand the influence of demographic and psychological factors on self-management behaviors and interdialytic weight gain (IDWG) as a fluid adherence marker among patients undergoing hemodialysis in Indonesia. DESIGN: A quantitative correlational study. METHOD: A convenience sample of 145 patients undergoing hemodialysis was recruited from the dialysis units in two hospitals in Jakarta from September to December 2015...
February 18, 2019: Journal of Nursing Scholarship
Nurten Ozen, Fatma Ilknur Cinar, Dilek Askin, Dilek Mut, Turker Turker
BACKGROUND: Nonadherence to dietary and fluid restrictions, hemodialysis (HD), and medication treatment has been shown to increase the risks of hospitalization and mortality significantly. Sociodemographic and biochemical parameters as well as psychosocial conditions such as depression and anxiety are known to affect nonadherence in HD patients. However, evidence related to the relative importance and actual impact of these factors varies among studies. PURPOSE: The aim of this study was to identify the factors that affect nonadherence to dietary and fluid restrictions, HD, and medication treatment...
January 31, 2019: Journal of Nursing Research: JNR
Rame John L Mina, Maria-Angelica B Lerma, Prince Lyncon B Litan, Alyssa Andrea L Milano, April Dawn R Mojica, Charito P Malong-Consolacion, Eleanore B Lerma, John Rey B Macindo, Gian Carlo S Torres
AIM: To determine the effects of a fluid distribution timetable on adherence to fluid restriction of patients with end-stage renal disease undergoing hemodialysis. BACKGROUND: Fluid restriction is necessary among patients with chronic kidney disease. However, treatment adherence remains a challenge. DESIGN: Single-blind, randomized-controlled pilot study. METHODS: From September - December 2016, 24 consecutively-selected patients with end-stage renal disease from a single dialysis clinic were randomly-assigned using computer-generated sequences of randomly permuted blocks stratified according to sex to receive the fluid distribution timetable or standard care...
January 31, 2019: Journal of Advanced Nursing
Ok Lae Park, Sung Reul Kim
AIM: To evaluate the effects of an integrated self-management program using a mobile application, a short message service using a smartphone, and face-to-face counseling and education among hemodialysis patients. METHODS: A quasi-experimental study design was used. The participants of this study were 84 hemodialysis patients (42 in the experimental group and 42 in the control group). The experimental group received the integrated self-management program for 8 weeks...
January 22, 2019: Japan Journal of Nursing Science: JJNS
Joanna L Dunlop, Alain C Vandal, Mark R Marshall
BACKGROUND: Cardiovascular (CV) disease is the leading cause of death in dialysis patients, and strongly associated with fluid overload and hypertension. It is plausible that low dialysate [Na+] may decrease total body sodium content, thereby reducing fluid overload and hypertension, and ultimately reducing CV morbidity and mortality. OBJECTIVES: This review evaluated harms and benefits of using a low (< 138 mM) dialysate [Na+] for maintenance haemodialysis (HD) patients...
January 16, 2019: Cochrane Database of Systematic Reviews
Lenina Ludimila Sampaio de Almeida, Luís Henrique Bezerra Cavalanti Sette, Fernando Luiz Affonso Fonseca, Leila Silveira Vieira da Silva Bezerra, Francisco Hélio Oliveira Júnior, Ronaldo Roberto Bérgamo
INTRODUCTION: It is unclear whether residual renal function (RRF) in dialysis patients can attenuate the metabolic impact of the long 68-hour interdialytic interval, in which water, acid, and electrolyte accumulation occurs. OBJECTIVE: to evaluate serum electrolyte levels, water balance, and acid-base status in dialytic patients with and without RRF over the long interdialytic interval (LII). METHODOLOGY: this was a single-center, cross-sectional, and analytical study that compared patients with and without RRF, defined by diuresis above 200 mL in 24 hours...
January 7, 2019: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Fatemah Saleh Bin Saleh, Marriam Nasser Naji, Abdalla A Eltayeb, Fayez Faleh Hejaili, Abdulla Ahmed Al Sayyari
Thyroid function abnormalities are common in hemodialysis (HD) patients. Here, we investigated their frequency and impact on intradialytic hemodynamics and erythropoietin resistance index (ERI). Demographic and laboratory data including thyroid-stimulating hormone (TSH), interdialytic weight gain, and intradialytic blood pressure (BP) changes were measured, and ERI was calculated. The prevalence and causes of abnormities in TSH and free thyroxine (FT4) and their effects on ERI and intradialytic hemodynamics were then assessed...
November 2018: Saudi Journal of Kidney Diseases and Transplantation
Glenda B Daniels, Janie R Robinson, Charles A Walker
End stage renal disease (ESRD) affects African Americans more than any other ethnic group. Adherence is a challenge. Patients with ESRD must adhere to medication, diet, fluid restrictions, and dialysis treatment schedules if they do not receive a kidney transplant. The purpose of this exploratory, descriptive study was to assess adherence in 120 African Americans with ESRD undergoing hemodialysis (HD). Participants completed a demographic questionnaire and the ESRD Adherence Questionnaire (ESRD-AQ). Biomarkers were collected from medical records...
November 2018: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
Scott Sibbel, Adam G Walker, Carey Colson, Francesca Tentori, Steven M Brunelli, Jennifer Flythe
BACKGROUND AND OBJECTIVES: Loop diuretics are commonly used to manage nondialysis-dependent CKD. Despite benefits of augmented urine output, loop diuretics are often discontinued after dialysis initiation. Here, we assessed the association of the early decision to continue loop diuretics at hemodialysis start with clinical outcomes during the first year of dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We considered all patients on in-center hemodialysis at a large dialysis organization (2006-2013) with Medicare Part A and D benefits who had an active supply of a loop diuretic at dialysis initiation ( n =11,297)...
January 7, 2019: Clinical Journal of the American Society of Nephrology: CJASN
Jessica Saunders, Shahram Ahmadzadeh, Margaret Bush, Robin Wright, Bradi Granger
BACKGROUND: The commonly employed medication reconciliation process leaves room for mismanagement of medications in the complex end-stage renal disease patient population. PURPOSE: The purpose of this quality improvement project was to implement and evaluate a multidisciplinary education and feedback intervention designed to improve self-management for adults with end-stage renal disease. METHODS: A pre-post, same subject repeated measures design was used to evaluate the intervention...
December 12, 2018: Journal of Nursing Care Quality
Berfu Korucu, Ozant Helvaci, Burak Ozbas, Hasan Yeter, Deniz Yuce, Sehri Elbeg, Ulver Derici
BACKGROUND: Intradialytic hypotension (IDH) is related with high morbidity and mortality. There is evidence that arginine-vasopressin (AVP) responses could play a role. Copeptin is the reliable biomarker of AVP. In this study, copeptin, aldosterone, epinephrine, and norepinephrine levels in patients with IDH were evaluated throughout a hemodialysis (HD) session and compared with control group. METHODS: Study is composed of 15 patients that are normotensive during HD and 15 patients IDH with a minimum HD vintage of 1 year...
December 14, 2018: Therapeutic Apheresis and Dialysis
Graziella Allana Serra Alves de Oliveira Oller, Marília Pilotto de Oliveira, Cláudia Bernardi Cesarino, Carla Regina de Souza Teixeira, José Abrão Cardeal da Costa, Luciana Kusumota
OBJECTIVE: to analyze the impact of an educational and motivational intervention for patients with a chronic kidney disease, undergoing hemodialysis treatment, on the control of fluid intake during interdialytic periods. METHOD: a quasi-experimental, non-randomized clinical trial with patients from a Nephrological Unit of the State of São Paulo. Participants were included in two groups: Control Group with 106 patients and Intervention Group with 86 patients, totaling 192 participants...
November 29, 2018: Revista Latino-americana de Enfermagem
Sook H Park, Ida T Fonkoue, Yunxiao Li, Dana R DaCosta, Holly R Middlekauff, Jeanie Park
Introduction: End-stage renal disease (ESRD) patients with a paradoxical increase in blood pressure (BP) during hemodialysis (HD), termed intradialytic hypertension (ID-HTN), are at significantly increased risk for mortality and adverse cardiovascular events. ID-HTN affects up to 15% of all HD patients, and the pathophysiologic mechanisms remain unknown. We hypothesized that ESRD patients prone to ID-HTN have heightened volume-sensitive cardiopulmonary baroreflex sensitivity (BRS) that leads to exaggerated increases in sympathetic nervous system (SNS) activation during HD...
November 2018: KI Reports
Jeroen P Kooman, Len A Usvyat, Marijke J E Dekker, Dugan W Maddux, Jochen G Raimann, Frank M van der Sande, Xiaoling Ye, Yuedong Wang, Peter Kotanko
Patients with end-stage renal disease (ESRD) experience unique patterns in their lifetime, such as the start of dialysis and renal transplantation. In addition, there is also an intricate link between ESRD and biological time patterns. In terms of cyclic patterns, the circadian blood pressure (BP) rhythm can be flattened, contributing to allostatic load, whereas the circadian temperature rhythm is related to the decline in BP during hemodialysis (HD). Seasonal variations in BP and interdialytic-weight gain have been observed in ESRD patients in addition to a profound relative increase in mortality during the winter period...
November 16, 2018: Blood Purification
Ziye Chen, Fang Sun, Yang Shen, Lijie Ma, Jing Liu, Yilun Zhou
Blood pressure variability is an independent risk factor for mortality and cardiovascular events in hemodialysis patients. Dialysate sodium concentration may not only have effects on blood pressure but also on blood pressure variability. We investigated whether dialysate sodium concentration lowering could decrease home blood pressure variability in hemodialysis patients. Forty-three hemodialysis patients at their dry weight assessed by bioimpedance methods with pre-dialysis serum sodium >136 mmol/L were recruited...
November 1, 2018: Therapeutic Apheresis and Dialysis
Norio Hanafusa, Ken Tsuchiya, Kosaku Nitta
The concentration of sodium in dialysis fluid, a major determinant of extracellular fluid volume and blood pressure, plays a major role in the sodium balance in end-stage renal disease patients. A low dialysate sodium concentration (DNa) reduces interdialytic weight gain (IDWG) and blood pressure and might help ameliorate endothelial dysfunction and inflammation. However, low DNa can also increase the incidence of hypotensive episodes and muscle cramps. Sodium profiling, as typically prescribed in which the DNa is ramped up from above 140 mEq/L to nonphysiological levels, might reduce hypotension in patients with hemodynamic instability but at the cost of the consequences of hypernatremia...
October 21, 2018: Seminars in Dialysis
Tomonari Harada, Masaru Obokata, Koji Kurosawa, Hidemi Sorimachi, Kuniko Yoshida, Hideki Ishida, Kyoko Ito, Tetsuya Ogawa, Yoshitaka Ando, Masahiko Kurabayashi, Kazuaki Negishi
Hemodialysis patients have conditions that increase cardiac output (CO), including arteriovenous fistula, fluid retention, vasodilator use, and anemia. We sought to determine the relationships between these factors and CO and to evaluate the effects of the high-output states on ventricular morphology, function, and myocardial energetics in hemodialysis patients, using noninvasive load-insensitive indices. Cardiovascular function was assessed in hemodialysis patients with high output [ejection fraction ≥ 50%, cardiac index (CI) > 3...
October 16, 2018: International Journal of Cardiovascular Imaging
Lu-Xi Zou, Ling Sun
BACKGROUND: Intradialytic hypertension (IDH) is emerging as an important issue in maintenance hemodialysis (MHD) patients. This study aimed to discuss potential factors related to IDH and build forecasting models for post-dialysis blood pressure (BP) in MHD patients with IDH. METHODS: A total of 266 MHD patients were enrolled, included 133 (50%) patients with IDH and 133 patients without IDH. The BP and pulse were determined and recorded over six consecutive dialysis treatments...
October 16, 2018: Clinical and Experimental Hypertension: CHE
Cristina Caetano, Ana Valente, Telma Oliveira, Cristina Garagarza
BACKGROUND AND AIMS: Coffee is one of the most widely consumed beverages worldwide. However, fluid intake restriction is an important and difficult challenge for hemodialysis (HD) patients. The aim of this study was to analyze the effect of coffee intake on hydration and nutritional parameters of HD patients. METHODS: This was an observational, cross-sectional, multicenter study where 373 HD patients from 8 dialysis centers in Portugal were enrolled. A face-to-face questionnaire was applied and patient's clinical and body composition parameters were analyzed...
October 8, 2018: European Journal of Clinical Nutrition
Priscila Preciado, Hanjie Zhang, Stephan Thijssen, Jeroen P Kooman, Frank M van der Sande, Peter Kotanko
Background: Relative blood volume (RBV) monitoring is widely used in hemodialysis (HD) patients, yet the association between intradialytic RBV and mortality is unknown. Methods: Intradialytic RBV was recorded once/min during a 6-month baseline period; all-cause mortality was noted during follow-up. RBV at 1, 2 and 3 h into HD served as a predictor of all-cause mortality during follow-up. We employed Kaplan-Meier analysis, univariate and adjusted Cox proportional hazards models for survival analysis...
September 18, 2018: Nephrology, Dialysis, Transplantation
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