Interdialytic Weight Gain and Educational/cognitive, Counseling/behavioral and Psychological/affective Interventions in Patients on Chronic Hemodialysis: a Systematic Review and Meta-analysis

Overview

Journal J Nephrol

Publisher Springer

Specialty Nephrology

Date 2022 Sep 16

PMID 36112313

Authors

Maurizio Bossola

Gilda Pepe

Manuela Antocicco

Altea Severino

Enrico Di Stasio

Affiliations

Soon will be listed here.

Abstract

Background: This work aimed to shed light on the notorious debate over the role of an educational/cognitive/behavioral or psychological approach in the reduction of interdialytic weight gain (IDWG) in patients on chronic hemodialysis.

Methods: Searches were run from 1975 to January 2022 on Medline, PubMed, Web of Science, and the Cochrane Library. The search terms included "hemodialysis/haemodialysis" AND "adherence" AND ("fluid intake" OR "water intake") AND ("weight gain" OR "interdialytic weight gain" OR "IDWG") AND "patient-level interventions. Randomized controlled studies were eligible if they were in English, published in a peer-reviewed journal and regarded adults patients with on chronic hemodialysis for at least 6 months; compared educational/cognitive and/or counseling/behavioral or psychological interventions to no intervention on interdialytic weight gain. Outcome of interest was interdialytic weight gain. The review was registered on the International Prospective Register of Systematic Reviews in Health and Social Care (PROSPERO, ID number CRD42022332401).

Results: Eighteen studies (1759 patients) were included in the analysis. Compared to the untreated group, educational/cognitive and/or counseling/behavioral interventions significantly reduced interdialytic weight gain with a pooled mean difference of - 0.15 kg (95% CI - 0.26, 30-0.05; P = 0.004). On the other hand, psychological/affective interventions reduced interdialytic weight gain with a pooled mean difference of - 0.26 kg (95% CI - 0.48, - 0.04; P = 0.020).

Conclusions: Educational/cognitive, counseling/behavioral or psychological/affective interventions significantly reduced the interdialytic weight gain in patients on chronic hemodialysis, although such reduction did not appear to be clinically relevant on hard outcomes.

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References

Higgins J, Thompson S . Quantifying heterogeneity in a meta-analysis. Stat Med. 2002; 21(11):1539-58. DOI: 10.1002/sim.1186. View

Ifudu O, Uribarri J, Rajwani I, Vlacich V, Reydel K, Delosreyes G . Relation between interdialytic weight gain, body weight and nutrition in hemodialysis patients. Am J Nephrol. 2002; 22(4):363-8. DOI: 10.1159/000065228. View

Griva K, Nandakumar M, Ng J, Lam K, McBain H, Newman S . Hemodialysis Self-management Intervention Randomized Trial (HED-SMART): A Practical Low-Intensity Intervention to Improve Adherence and Clinical Markers in Patients Receiving Hemodialysis. Am J Kidney Dis. 2017; 71(3):371-381. DOI: 10.1053/j.ajkd.2017.09.014. View

Kauric-Klein Z . Improving blood pressure control in end stage renal disease through a supportive educative nursing intervention. Nephrol Nurs J. 2012; 39(3):217-28. View

Saran R, Bragg-Gresham J, Rayner H, Goodkin D, Keen M, van Dijk P . Nonadherence in hemodialysis: associations with mortality, hospitalization, and practice patterns in the DOPPS. Kidney Int. 2003; 64(1):254-62. DOI: 10.1046/j.1523-1755.2003.00064.x. View

Bossola M, Mariani I, Sacco M, Antocicco M, Pepe G, Di Stasio E . Interdialytic weight gain and low dialysate sodium concentration in patients on chronic hemodialysis: a systematic review and meta-analysis. Int Urol Nephrol. 2024; 56(7):2313-2323. PMC: 11189964. DOI: 10.1007/s11255-024-03972-3. View

Walsh E, Lehane E . An exploration of the relationship between adherence with dietary sodium restrictions and health beliefs regarding these restrictions in Irish patients receiving haemodialysis for end-stage renal disease. J Clin Nurs. 2011; 20(3-4):331-40. DOI: 10.1111/j.1365-2702.2010.03348.x. View

Ahrari S, Moshki M, Bahrami M . The Relationship Between Social Support and Adherence of Dietary and Fluids Restrictions among Hemodialysis Patients in Iran. J Caring Sci. 2014; 3(1):11-9. PMC: 4134167. DOI: 10.5681/jcs.2014.002. View

Baser E, Mollaoglu M . The effect of a hemodialysis patient education program on fluid control and dietary compliance. Hemodial Int. 2019; 23(3):392-401. DOI: 10.1111/hdi.12744. View

10.

Pasyar N, Rambod M, Sharif F, Rafii F, Pourali-Mohammadi N . Improving adherence and biomedical markers in hemodialysis patients: the effects of relaxation therapy. Complement Ther Med. 2015; 23(1):38-45. DOI: 10.1016/j.ctim.2014.10.011. View

11.

Cukor D, Ver Halen N, Asher D, Coplan J, Weedon J, Wyka K . Psychosocial intervention improves depression, quality of life, and fluid adherence in hemodialysis. J Am Soc Nephrol. 2013; 25(1):196-206. PMC: 3871769. DOI: 10.1681/ASN.2012111134. View

12.

Kurita N, Hayashino Y, Yamazaki S, Akizawa T, Akiba T, Saito A . Revisiting Interdialytic Weight Gain and Mortality Association With Serum Albumin Interactions: The Japanese Dialysis Outcomes and Practice Pattern Study. J Ren Nutr. 2017; 27(6):421-429. DOI: 10.1053/j.jrn.2017.05.003. View

13.

Christensen A, Moran P, Lawton W, Stallman D, Voigts A . Monitoring attentional style and medical regimen adherence in hemodialysis patients. Health Psychol. 1997; 16(3):256-62. DOI: 10.1037//0278-6133.16.3.256. View

14.

Mantel N, Haenszel W . Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959; 22(4):719-48. View

15.

Friend R, Hatchett L, Schneider M, Wadhwa N . A comparison of attributions, health beliefs, and negative emotions as predictors of fluid adherence in renal dialysis patients: a prospective analysis. Ann Behav Med. 1998; 19(4):344-7. DOI: 10.1007/BF02895152. View

16.

Lau J, Ioannidis J, Schmid C . Quantitative synthesis in systematic reviews. Ann Intern Med. 1998; 127(9):820-6. DOI: 10.7326/0003-4819-127-9-199711010-00008. View

17.

Sharp J, Wild M, Gumley A, Deighan C . A cognitive behavioral group approach to enhance adherence to hemodialysis fluid restrictions: a randomized controlled trial. Am J Kidney Dis. 2005; 45(6):1046-57. DOI: 10.1053/j.ajkd.2005.02.032. View

18.

Smith K, Coston M, Glock K, Elasy T, Wallston K, Ikizler T . Patient perspectives on fluid management in chronic hemodialysis. J Ren Nutr. 2009; 20(5):334-41. PMC: 2888683. DOI: 10.1053/j.jrn.2009.09.001. View

19.

Gibson E, Held I, Khawnekar D, Rutherford P . Differences in Knowledge, Stress, Sensation Seeking, and Locus of Control Linked to Dietary Adherence in Hemodialysis Patients. Front Psychol. 2016; 7:1864. PMC: 5126042. DOI: 10.3389/fpsyg.2016.01864. View

20.

Geng X, Song Y, Hou B, Ma Y, Wang Y . The efficacy and safety of low dialysate sodium levels for patients with maintenance haemodialysis: A systematic review and meta-analysis. Int J Surg. 2020; 79:332-339. DOI: 10.1016/j.ijsu.2020.05.027. View