Comparison of short-term effects of stepwise sodium profile method and individual adjustment of sodium dialysate on interdialytic weight gain.

Comparison of short-term effects of stepwise sodium profile method and individual adjustment of sodium dialysate on interdialytic weight gain.


Authors:

Maryam Sadat Hashemi1, Nahid Shahgholiyan2, Shahrzad Shahidi3 1PhD Candidate in Nursing, Isfahan University of Medical Sciences, Isfahan, Iran, 2 Department of Critical Care, Isfahan Kidney Disease Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran. 3Department of Nephrology, Isfahan Kidney Disease Research Center, School of Medicine, Isfahan, Iran.

Correspondence:

mshf201252@yahoo.com

Backgrounds: Interdialytic weight gain control and reaching dry weight is a critical issue for patients undergoing hemodialysis. Not reaching the desired dry weight of the patient leads to consequences, such as hypertension, acute pulmonary edema, congestive heart failure, left ventricular hypertrophy, and increased complications during dialysis, resulting in increased mortality of the patients. Sodium and extracellular fluid balance, and the amount of sodium in dialysate have important roles in controlling interdialytic weight gain of patients undergoing hemodialysis. There is a lack of common agreement on using or not using sodium profiles and individual adjustment of dialysate sodium. Therefore, this study aimed to compare the two methods and propose the preferred method of sodium adjustment of dialysate for appropriate interdialytic weight gain.

Methods:This was a quasi-experimental study. 40 eligible patients entered the study via convenient sampling. Then, based on table of random numbers the patients underwent hemodialysis for 9 sessions with either stepwise sodium profile method or individual adjustment of dialysate sodium. A questionnaire was usedto collectdata. Data analysis was performed using paired t-test, Student’s independent t-test, descriptive statistics, and SPSS software version 20.

Findings: Patients in the two groups regarding quantitative variables (age, duration of hemodialysis and hemodialysis adequacy) and qualitative variables (gender, type of vascular access, and using erythropoietin and antihypertensive drugs) did not have a statistically significant difference in the two methods and were similar (P > 0.05). Interdialytic weight gain significantly decreased in the second session and at the end of the intervention in the ninth session (P = 0.045). In the stepwise sodium profile method, there was no significant change in interdialytic weight gain (P > 0.05). Mean interdialytic weight gain in the two groups did not have a statistically significant difference (P = 0. 372).

Conclusion:Interdialytic weight gain did not have any differences in the individual adjustment of dialysate sodium and stepwise sodium profile method in short time.

Abstract

Backgrounds: Interdialytic weight gain control and reaching dry weight is a critical issue for patients undergoing hemodialysis. Not reaching the desired dry weight of the patient leads to consequences, such as hypertension, acute pulmonary edema, congestive heart failure, left ventricular hypertrophy, and increased complications during dialysis, resulting in increased mortality of the patients. Sodium and extracellular fluid balance, and the amount of sodium in dialysate have important roles in controlling interdialytic weight gain of patients undergoing hemodialysis. There is a lack of common agreement on using or not using sodium profiles and individual adjustment of dialysate sodium. Therefore, this study aimed to compare the two methods and propose the preferred method of sodium adjustment of dialysate for appropriate interdialytic weight gain.

Methods:This was a quasi-experimental study. 40 eligible patients entered the study via convenient sampling. Then, based on table of random numbers the patients underwent hemodialysis for 9 sessions with either stepwise sodium profile method or individual adjustment of dialysate sodium. A questionnaire was usedto collectdata. Data analysis was performed using paired t-test, Student’s independent t-test, descriptive statistics, and SPSS software version 20.

Findings: Patients in the two groups regarding quantitative variables (age, duration of hemodialysis and hemodialysis adequacy) and qualitative variables (gender, type of vascular access, and using erythropoietin and antihypertensive drugs) did not have a statistically significant difference in the two methods and were similar (P > 0.05). Interdialytic weight gain significantly decreased in the second session and at the end of the intervention in the ninth session (P = 0.045). In the stepwise sodium profile method, there was no significant change in interdialytic weight gain (P > 0.05). Mean interdialytic weight gain in the two groups did not have a statistically significant difference (P = 0. 372).

Conclusion:Interdialytic weight gain did not have any differences in the individual adjustment of dialysate sodium and stepwise sodium profile method in short time.Abstract Backgrounds: Interdialytic weight gain control and reaching dry weight is a critical issue for patients undergoing hemodialysis. Not reaching the desired dry weight of the patient leads to consequences, such as hypertension, acute pulmonary edema, congestive heart failure, left ventricular hypertrophy, and increased complications during dialysis, resulting in increased mortality of the patients. Sodium and extracellular fluid balance, and the amount of sodium in dialysate have important roles in controlling interdialytic weight gain of patients undergoing hemodialysis. There is a lack of common agreement on using or not using sodium profiles and individual adjustment of dialysate sodium. Therefore, this study aimed to compare the two methods and propose the preferred method of sodium adjustment of dialysate for appropriate interdialytic weight gain. Methods: This was a quasi-experimental study. 40 eligible patients entered the study via convenient sampling. Then, based on table of random numbers the patients underwent hemodialysis for 9 sessions with either stepwise sodium profile method or individual adjustment of dialysate sodium. A questionnaire was used to collect data. Data analysis was performed using paired t-test, Student’s independent t-test, descriptive statistics, and SPSS software version 20. Findings: Patients in the two groups regarding quantitative variables (age, duration of hemodialysis and hemodialysis adequacy) and qualitative variables (gender, type of vascular access, and using erythropoietin and antihypertensive drugs) did not have a statistically significant difference in the two methods and were similar (P > 0.05). Interdialytic weight gain significantly decreased in the second session and at the end of the intervention in the ninth session (P = 0.045). In the stepwise sodium profile method, there was no significant change in interdialytic weight gain (P > 0.05). Mean interdialytic weight gain in the two groups did not have a statistically significant difference (P = 0. 372). Conclusion: Interdialytic weight gain did not have any differences in the individual adjustment of dialysate sodium and stepwise sodium profile method in short time.

Keywords:Sodium Profile, Dialysis Solutions, Interdialytic Weight Gain, Hemodialysis.