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The Effect of Psychological Intervention on Thirst and Interdialytic Weight Gain in Patients on Chronic Hemodialysis: A Randomized Controlled Trial.
J Ren Nutr. 2015 Sep; 25(5):426-32.JR

Abstract

OBJECTIVE

Patients on hemodialysis (HD) are unable to eliminate excess fluid and must adhere to a regimen of dietary fluid restriction to prevent volume overload. Thirst represents a major obstacle to the achievement of such a goal. The aim of our study was (1) to assess the association of thirst and xerostomia, measured by validated questionnaires, Dialysis Thirst Inventory and Xerostomia Inventory with interdialytic weight gain (IDWG) and (2) to evaluate in a randomized controlled trial (RCT), the effect of psychological intervention on IDWG and thirst.

STUDY DESIGN

Cross-sectional evaluation of association of thirst and IDWG and single-blind RCT of psychological intervention on IDWG management.

SETTING

Outpatient dialysis unit.

SUBJECTS

The cross-sectional evaluation included 117 patients on HD (age, 71 ± 13 years); among these, 54 were selected for the RCT.

INTERVENTION

The questionnaires were administered to all the participating patients; IDWG (4-week average), Kt/V, predialysis blood pressure, dialyzate sodium, hematocrit, serum electrolytes, parathyroid hormone, and patients' medications were recorded. Fifty-four patients were randomized on a 1:1 basis to usual treatment (including dietary advice) or psychological intervention, consisting of group sessions, held once a week for 5 weeks; IDWG and all the other parameters were rechecked after 6 weeks and 6 months.

MAIN OUTCOME MEASURE

IDWG change from baseline.

RESULTS

Dialysis Thirst Inventory score was correlated with IDWG (ρ = 0.575; P < .001), body mass index (ρ = 0.257; P = .005), and inversely with age (ρ = -0.344; P < .001). A small but significant decrease of IDWG compared to baseline was observed in the intervention group (baseline 1332 ± 338 g/day; at 6 weeks, 1183 ± 258 g/day; at 6 months, 1203 ± 284 g/day; P < .001). No IDWG changes with respect to baseline occurred in controls (baseline 1310 ± 333 g/day; at 6 weeks, 1336 ± 340 g/day; at 6 months, 1323 ± 328 g/day; P = .57). The secondary outcomes were not affected by the intervention.

CONCLUSIONS

The findings of our study show that a psychological support may help managing IDWG in HD patients.

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Authors+Show Affiliations

Bellomo G
Nephrology and Dialysis Unit, Media Valle del Tevere Hospital, Department of Specialistic Medicine, Todi, Perugia, Italy. Electronic address: gianni.bellomo@uslumbria1.it.
Coccetta P
Nephrology and Dialysis Unit, Media Valle del Tevere Hospital, Department of Specialistic Medicine, Todi, Perugia, Italy.
Pasticci F
Nephrology and Dialysis Unit, Media Valle del Tevere Hospital, Department of Specialistic Medicine, Todi, Perugia, Italy.
Rossi D
Nephrology and Dialysis Unit, Media Valle del Tevere Hospital, Department of Specialistic Medicine, Todi, Perugia, Italy.
Selvi A
Nephrology and Dialysis Unit, Media Valle del Tevere Hospital, Department of Specialistic Medicine, Todi, Perugia, Italy.

MeSH

AgedAged, 80 and overBlood PressureCross-Sectional StudiesDialysis SolutionsElectrolytesHematocritHumansKidney Failure, ChronicMiddle AgedParathyroid HormoneRenal DialysisSingle-Blind MethodSurveys and QuestionnairesThirstWeight GainXerostomia

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26003264

Citation

Bellomo, Gianni, et al. "The Effect of Psychological Intervention On Thirst and Interdialytic Weight Gain in Patients On Chronic Hemodialysis: a Randomized Controlled Trial." Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 25, no. 5, 2015, pp. 426-32.
Bellomo G, Coccetta P, Pasticci F, et al. The Effect of Psychological Intervention on Thirst and Interdialytic Weight Gain in Patients on Chronic Hemodialysis: A Randomized Controlled Trial. J Ren Nutr. 2015;25(5):426-32.
Bellomo, G., Coccetta, P., Pasticci, F., Rossi, D., & Selvi, A. (2015). The Effect of Psychological Intervention on Thirst and Interdialytic Weight Gain in Patients on Chronic Hemodialysis: A Randomized Controlled Trial. Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 25(5), 426-32. https://doi.org/10.1053/j.jrn.2015.04.005
Bellomo G, et al. The Effect of Psychological Intervention On Thirst and Interdialytic Weight Gain in Patients On Chronic Hemodialysis: a Randomized Controlled Trial. J Ren Nutr. 2015;25(5):426-32. PubMed PMID: 26003264.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Effect of Psychological Intervention on Thirst and Interdialytic Weight Gain in Patients on Chronic Hemodialysis: A Randomized Controlled Trial. AU - Bellomo,Gianni, AU - Coccetta,Pamela, AU - Pasticci,Franca, AU - Rossi,Davide, AU - Selvi,Antonio, Y1 - 2015/05/21/ PY - 2014/12/30/received PY - 2015/03/08/revised PY - 2015/04/13/accepted PY - 2015/5/25/entrez PY - 2015/5/25/pubmed PY - 2016/5/31/medline SP - 426 EP - 32 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 25 IS - 5 N2 - OBJECTIVE: Patients on hemodialysis (HD) are unable to eliminate excess fluid and must adhere to a regimen of dietary fluid restriction to prevent volume overload. Thirst represents a major obstacle to the achievement of such a goal. The aim of our study was (1) to assess the association of thirst and xerostomia, measured by validated questionnaires, Dialysis Thirst Inventory and Xerostomia Inventory with interdialytic weight gain (IDWG) and (2) to evaluate in a randomized controlled trial (RCT), the effect of psychological intervention on IDWG and thirst. STUDY DESIGN: Cross-sectional evaluation of association of thirst and IDWG and single-blind RCT of psychological intervention on IDWG management. SETTING: Outpatient dialysis unit. SUBJECTS: The cross-sectional evaluation included 117 patients on HD (age, 71 ± 13 years); among these, 54 were selected for the RCT. INTERVENTION: The questionnaires were administered to all the participating patients; IDWG (4-week average), Kt/V, predialysis blood pressure, dialyzate sodium, hematocrit, serum electrolytes, parathyroid hormone, and patients' medications were recorded. Fifty-four patients were randomized on a 1:1 basis to usual treatment (including dietary advice) or psychological intervention, consisting of group sessions, held once a week for 5 weeks; IDWG and all the other parameters were rechecked after 6 weeks and 6 months. MAIN OUTCOME MEASURE: IDWG change from baseline. RESULTS: Dialysis Thirst Inventory score was correlated with IDWG (ρ = 0.575; P < .001), body mass index (ρ = 0.257; P = .005), and inversely with age (ρ = -0.344; P < .001). A small but significant decrease of IDWG compared to baseline was observed in the intervention group (baseline 1332 ± 338 g/day; at 6 weeks, 1183 ± 258 g/day; at 6 months, 1203 ± 284 g/day; P < .001). No IDWG changes with respect to baseline occurred in controls (baseline 1310 ± 333 g/day; at 6 weeks, 1336 ± 340 g/day; at 6 months, 1323 ± 328 g/day; P = .57). The secondary outcomes were not affected by the intervention. CONCLUSIONS: The findings of our study show that a psychological support may help managing IDWG in HD patients. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/26003264/The_Effect_of_Psychological_Intervention_on_Thirst_and_Interdialytic_Weight_Gain_in_Patients_on_Chronic_Hemodialysis:_A_Randomized_Controlled_Trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-2276(15)00088-6 DB - PRIME DP - Unbound Medicine ER -