Evaluation of dietary and fluid restriction non-adherence in patients on hemodialysis
Serkan Günalay1, Emin Taşkıran2, Haluk Mergen1
1Tepecik Eğitim ve Araştırma Hastanesi, Aile Hekimliği Kliniği, İzmir, Türkiye
2Tepecik Eğitim ve Araştırma Hastanesi, İç Hastalıkları Kliniği, İzmir, Türkiye
Keywords: Hemodialysis; non-adherence; the dialysis diet and fluid non-adherence questionnaire.
Abstract
Objectives: This study aims to evaluate the dietary and fluid restriction non-adherence in patients on hemodialysis by using the dialysis diet and fluid non-adherence questionnaire (DDFQ) and biochemical parameters, and to assess the correlation between these two methods.
Patients and methods: Between May 2016 and July 2016, a total of 50 hemodialysis patients, (23 males, 27 females, mean age 50.0±18.9 years; range from 18 to 87 years) were included in the study. The patients filled the sociodemographic form, we applied DDFQ and recorded the mean values of the last three months of biochemical parameters.
Results: The mean phosphorus level was 5.1±1.5 mg/dL, potassium level was 4.9±0.5 mmol/L, sodium level was 135.6±2.7 mmol/L and albumin level was 3.6±0.3 g/dL. The mean interdialytic weight gain (IDWG) was determined to be 2330±1217 gr. The rate of patients above 3% IDWG was 62%. We detected increased serum phosphorus level in 56% of the patients, while 34% were detected to have increased serum potassium level. Non-adherence to dietary restriction was found in 70% of the patients and non-adherence to fluid restriction was detected in 74%. The mean frequency of non- adherence to fluid restriction was determined to be 6±5.6 days and the mean frequency of non-adherence to dietary restriction was determined to be 7.4±6.1 days. Although non-adherence to dietary restriction frequency and level was not found to have a significant correlation with the serum potassium level of the patients, we found positive correlation with the serum phosphorus level of the patients. (r=0.338 p=0.016; r=0.414 p=0.003, respectively). There was no significant correlation between the frequency and level of non-adherence to fluid restriction and IDWG.
Conclusion: While non-adherence to dietary and fluid restriction affects mortality and morbidity of the patients negatively, there is a need for new studies to create new objective and conventional tools that can exclude the patient and patient related factors as far as possible in the evaluation of non-adherence.