Depending upon how it is measured (i.e., self-report, interdialytic
weight gain), up to 70% of patients are nonadherent with fluid intake recommendations (Kugler, Vlaminck, Haverich, & Maes, 2005), largely due to psychosocial barriers, such as depression.
The ABP was then monitored during the 44-hour interdialytic
interval and returned at the next dialysis.
Reducing target weight for blood pressure control in these patients will simply increase their interdialytic
fluid gain (IDFG) and make their post-dialysis blood pressure even higher due to activation of the renin angiotensin system.
Fluid retention as a proxy for adherence was operationally defined as the patient's interdialytic
weight gain (IDWG) of 2.5 kilograms (kg) or less during the week and 3.5 kg or less over a 2-day weekend or holiday period, as suggested by the study dialysis clinics.
There are some novel chapters discussing very specific areas of nutrition such as "Interdialytic
parenteral nutrition, intraperitoneal nutrition and nutritional haemodialysis"; "The nutritional management of patients receiving continuous renal replacement therapy"; "Herbal supplements in patients with renal disease" and "Bariatric surgery and renal disease".
In a study from 2001, 25% of hemodialysis patients reported two or more interdialytic
cramps weekly (Khajehdhi, Mojerlou, Behzadi, & Rais-Jalali, 2001).
Because the mean interdialytic
weight gain of the patients was 2.72 kg, it was not critical enough to trigger IDH occurrence.
These factors include an excessive reduction in blood volume due to rapid fluid removal; the need for a high ultrafiltration rate (UFR) due to excessive interdialytic
weight gain (IDWG); target weight set too low; intake of food during treatments; ingestion of antihypertensive medications prior to treatment; and poor contractility due to age and/or cardiac disease (Henrich, 2012; Holley, 2012; Sherman, Daugirdas, & Ing, 2007).
(b) 25% of dialysis patients report two or more interdialytic
cramps per week
As a team of registered dietitian-nutritionists (RDNs) at our hospital-based dialysis network, we set out to identify interventions for improving interdialytic
weight (IDW) gains in at-risk patients on hemodialysis (HD).
(2009) Pictures and perspectives: a unique reflection on interdialytic
The National Kidney Foundation Dialysis Outcome and Quality Initiative (KDOQI) considers non-adherence to include missed or shortened dialysis treatments, interdialytic
weight gain, treatment adequacy (Kt/V), serum albumin, and serum phosphorus (National Kidney Foundation, 2006).