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Effect of Diet Education in the Management of Higher Interdialytic Weight Gain and Predialysis Blood Pressure among Hemodialysis Patients: Network Review Using Recent Data
Elsa Mukti Atmaja, Bianda Aulia
2020 ; 2020(1):
    Diet Education | Interdialytic Weight Gain | Blood Pressure | Hemodialysis Patient
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춘계학술대회 초록집
Interdialytic weight gain should be maintained between dialysis treatment to minimize unnecessary accumulation of harmful toxins, electrolytes and fluid. Higher IDWG may cause higher pre-dialytic BP, greater intradialytic reductions in BP (hypotension risk) as a result of higher ultrafiltrate on rates and increasing mortality risk. However, IDWG and BP can be managed by dietary and fluid restriction between dialysis treatment. The aim of this review was to discuss the effectivity of diet education on interdialytic weight gain and blood pressure change among hemodialysis (HD) patients based on recent studies. The preparation of review was obtained from the analysis and synthesis of various journals. Three recent studies were found on PubMed Medline and Google Scholar with the main search terms are “interdialytic weight gain”, “blood pressure”, “diet education”. Diet educational intervention on hemodialysis patients concern on salt and fluid restriction. Those intervention conducted by registered dietitian and/or nephrology nurse at the bedside patient during hemodialysis session. Result of three reviewed-studies showed the decreasing of IDWG or IDWG ratio after diet education after 2-month periods and 48-month periods of intervention. Diet education that focused on salt and fluid restriction also leads on decreasing of pre-dialytic blood pressure but not all of the studies showed significantly difference after intervention. It contributed on decreasing of dosage of antihypertensive drugs among patients that experienced improvement of IDWG ratio. Based on nutritional parameter, there was significantly difference between creatinine amount after 2-month intervention (p≤ 0.01). Meanwhile, estimated salt and water intake showed significantly decreasing from 13.3±2.7 to 11.8±2.4 g/day and 2528±455 to 2332±410 ml/day, respectively (p< 0.05) after 48-month nutritional counseling. Diet educational intervention may contribute on decreasing of IDWG, IDWG ratio, predialysis blood pressure among hemodialysis patients. Diet education session during hemodialysis treatment also improve nutritional status and nutrition intake especially salt and water intake.    
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