The Effect of Psychological Intervention on Thirst and Interdialytic Weight Gain in Patients on Chronic Hemodialysis: A Randomized Controlled Trial
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 an...
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| Veröffentlicht in: | Journal of renal nutrition 2015-09, Vol.25 (5), p.426-432 |
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| creator | Bellomo, Gianni, MD Coccetta, Pamela, PhD Pasticci, Franca, MS, RD Rossi, Davide, MD Selvi, Antonio, MD |
| description | 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 |
| doi_str_mv | 10.1053/j.jrn.2015.04.005 |
| format | Article |
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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.</description><identifier>ISSN: 1051-2276</identifier><identifier>EISSN: 1532-8503</identifier><identifier>DOI: 10.1053/j.jrn.2015.04.005</identifier><identifier>PMID: 26003264</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Blood Pressure ; Cross-Sectional Studies ; Dialysis Solutions - metabolism ; Electrolytes - blood ; Hematocrit ; Humans ; Kidney Failure, Chronic - psychology ; Kidney Failure, Chronic - therapy ; Middle Aged ; Nephrology ; Parathyroid Hormone - blood ; Renal Dialysis - adverse effects ; Renal Dialysis - psychology ; Single-Blind Method ; Surveys and Questionnaires ; Thirst ; Weight Gain ; Xerostomia - diagnosis ; Xerostomia - etiology ; Xerostomia - psychology</subject><ispartof>Journal of renal nutrition, 2015-09, Vol.25 (5), p.426-432</ispartof><rights>National Kidney Foundation, Inc.</rights><rights>2015 National Kidney Foundation, Inc.</rights><rights>Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-cad92c0bb09326ddb2c242eb298d4756d49807dfc692afcce46122050557fc973</citedby><cites>FETCH-LOGICAL-c441t-cad92c0bb09326ddb2c242eb298d4756d49807dfc692afcce46122050557fc973</cites><orcidid>0000-0002-6089-4742</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.jrn.2015.04.005$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26003264$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bellomo, Gianni, MD</creatorcontrib><creatorcontrib>Coccetta, Pamela, PhD</creatorcontrib><creatorcontrib>Pasticci, Franca, MS, RD</creatorcontrib><creatorcontrib>Rossi, Davide, MD</creatorcontrib><creatorcontrib>Selvi, Antonio, MD</creatorcontrib><title>The Effect of Psychological Intervention on Thirst and Interdialytic Weight Gain in Patients on Chronic Hemodialysis: A Randomized Controlled Trial</title><title>Journal of renal nutrition</title><addtitle>J Ren Nutr</addtitle><description>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.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Blood Pressure</subject><subject>Cross-Sectional Studies</subject><subject>Dialysis Solutions - metabolism</subject><subject>Electrolytes - blood</subject><subject>Hematocrit</subject><subject>Humans</subject><subject>Kidney Failure, Chronic - psychology</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Middle Aged</subject><subject>Nephrology</subject><subject>Parathyroid Hormone - blood</subject><subject>Renal Dialysis - adverse effects</subject><subject>Renal Dialysis - psychology</subject><subject>Single-Blind Method</subject><subject>Surveys and Questionnaires</subject><subject>Thirst</subject><subject>Weight Gain</subject><subject>Xerostomia - diagnosis</subject><subject>Xerostomia - etiology</subject><subject>Xerostomia - psychology</subject><issn>1051-2276</issn><issn>1532-8503</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kt9qFTEQxhdRbK0-gDeSS292nWQ3-0dBKIfaFgoWPeJlyCaz3ay7SU1yCsfX6As366leeCEMZCC_74OZb7LsNYWCAi_fTcXkbcGA8gKqAoA_yY4pL1neciifph44zRlr6qPsRQgTAKW8Zc-zI1YDlKyujrP77YjkbBhQReIGch32anSzuzFKzuTSRvR3aKNxlqTajsaHSKTVhy9t5LyPRpHvaG7GSM6lsSTVtYwmqcKq2Yze2YRc4OJ-88GE9-SUfEkubjG_UJONs9G7eU7t1ifkZfZskHPAV4_vSfbt09l2c5FffT6_3Jxe5aqqaMyV1B1T0PfQpVm07pliFcOeda2uGl7rqmuh0YOqOyYHpbCqKWPAgfNmUF1TnmRvD7633v3cYYhiMUHhPEuLbhcEbaBm0LVdl1B6QJV3IXgcxK03i_R7QUGsWYhJpCzEmoWASqQskubNo_2uX1D_VfxZfgI-HABMQ94Z9CKotDeF2viUh9DO_Nf-4z9qNRu75vYD9xgmt_M2bU9QEZgA8XU9hvUWKAeAtq3LB8D3sGU</recordid><startdate>20150901</startdate><enddate>20150901</enddate><creator>Bellomo, Gianni, MD</creator><creator>Coccetta, Pamela, PhD</creator><creator>Pasticci, Franca, MS, RD</creator><creator>Rossi, Davide, MD</creator><creator>Selvi, Antonio, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6089-4742</orcidid></search><sort><creationdate>20150901</creationdate><title>The Effect of Psychological Intervention on Thirst and Interdialytic Weight Gain in Patients on Chronic Hemodialysis: A Randomized Controlled Trial</title><author>Bellomo, Gianni, MD ; Coccetta, Pamela, PhD ; Pasticci, Franca, MS, RD ; Rossi, Davide, MD ; Selvi, Antonio, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-cad92c0bb09326ddb2c242eb298d4756d49807dfc692afcce46122050557fc973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Blood Pressure</topic><topic>Cross-Sectional Studies</topic><topic>Dialysis Solutions - metabolism</topic><topic>Electrolytes - blood</topic><topic>Hematocrit</topic><topic>Humans</topic><topic>Kidney Failure, Chronic - psychology</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Middle Aged</topic><topic>Nephrology</topic><topic>Parathyroid Hormone - blood</topic><topic>Renal Dialysis - adverse effects</topic><topic>Renal Dialysis - psychology</topic><topic>Single-Blind Method</topic><topic>Surveys and Questionnaires</topic><topic>Thirst</topic><topic>Weight Gain</topic><topic>Xerostomia - diagnosis</topic><topic>Xerostomia - etiology</topic><topic>Xerostomia - psychology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bellomo, Gianni, MD</creatorcontrib><creatorcontrib>Coccetta, Pamela, PhD</creatorcontrib><creatorcontrib>Pasticci, Franca, MS, RD</creatorcontrib><creatorcontrib>Rossi, Davide, MD</creatorcontrib><creatorcontrib>Selvi, Antonio, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of renal nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bellomo, Gianni, MD</au><au>Coccetta, Pamela, PhD</au><au>Pasticci, Franca, MS, RD</au><au>Rossi, Davide, MD</au><au>Selvi, Antonio, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effect of Psychological Intervention on Thirst and Interdialytic Weight Gain in Patients on Chronic Hemodialysis: A Randomized Controlled Trial</atitle><jtitle>Journal of renal nutrition</jtitle><addtitle>J Ren Nutr</addtitle><date>2015-09-01</date><risdate>2015</risdate><volume>25</volume><issue>5</issue><spage>426</spage><epage>432</epage><pages>426-432</pages><issn>1051-2276</issn><eissn>1532-8503</eissn><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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26003264</pmid><doi>10.1053/j.jrn.2015.04.005</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-6089-4742</orcidid></addata></record> |
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| ispartof | Journal of renal nutrition, 2015-09, Vol.25 (5), p.426-432 |
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| subjects | Aged Aged, 80 and over Blood Pressure Cross-Sectional Studies Dialysis Solutions - metabolism Electrolytes - blood Hematocrit Humans Kidney Failure, Chronic - psychology Kidney Failure, Chronic - therapy Middle Aged Nephrology Parathyroid Hormone - blood Renal Dialysis - adverse effects Renal Dialysis - psychology Single-Blind Method Surveys and Questionnaires Thirst Weight Gain Xerostomia - diagnosis Xerostomia - etiology Xerostomia - psychology |
| title | The Effect of Psychological Intervention on Thirst and Interdialytic Weight Gain in Patients on Chronic Hemodialysis: A Randomized Controlled Trial |
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