Dataset Information

Patient-stated preferences regarding volume-related risk mitigation strategies for hemodialysis.

ABSTRACT:

Background and objectives

Larger weight gain and higher ultrafiltration rates have been associated with poorer outcomes among patients on dialysis. Dietary restrictions reduce fluid-related risk; however, adherence is challenging. Alternative fluid mitigation strategies include treatment time extension, more frequent dialysis, adjunct peritoneal dialysis, and wearable ultrafiltration devices. No data regarding patient preferences for fluid management exist. A survey was designed, tested, and administered to assess patient-stated preferences regarding fluid mitigation.

Design, setting, participants, & measurements

A written survey concerning fluid-related symptoms, patient and treatment characteristics, and fluid management preferences was developed. The cross-sectional survey was completed by 600 patients on hemodialysis at 18 geographically diverse ambulatory facilities. Comparisons of patient willingness to engage in volume mitigation strategies across fluid symptom burden, dietary restriction experience, and patient characteristics were performed.

Results

Final analyses included 588 surveys. Overall, if allowed to liberalize fluid intake, 44.6% of patients were willing to extend treatment time by 15 minutes. Willingness to extend treatment time was incrementally less for longer treatment extensions; 12.2% of patients were willing to add a fourth weekly treatment session, and 13.5% of patients were willing to participate in nocturnal dialysis three nights per week. Patients more bothered by their fluid restrictions (versus less bothered) were more willing to engage in fluid mitigation strategies. Demographic characteristics and symptoms, such as cramping and dyspnea, were not consistently associated with willingness to engage in the proposed strategies. More than 25% of patients were unsure of their dry weights and typical interdialytic weight gains.

Conclusions

Patients were generally averse to treatment time extension>15 minutes. Patients more bothered (versus less bothered) by their prescribed fluid restrictions were more willing to engage in volume mitigation strategies. Additional study of patient-stated preferences in hemodialysis treatment practices is needed to guide patient care and identify deficiencies in patient treatment and disease-related knowledge.

SUBMITTER: Flythe JE

PROVIDER: S-EPMC4123390 | biostudies-literature | 2014 Aug

REPOSITORIES: biostudies-literature

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Publications

Patient-stated preferences regarding volume-related risk mitigation strategies for hemodialysis.

Flythe Jennifer E JE Mangione Thomas W TW Brunelli Steven M SM Curhan Gary C GC

Clinical journal of the American Society of Nephrology : CJASN 20140605 8

<h4>Background and objectives</h4>Larger weight gain and higher ultrafiltration rates have been associated with poorer outcomes among patients on dialysis. Dietary restrictions reduce fluid-related risk; however, adherence is challenging. Alternative fluid mitigation strategies include treatment time extension, more frequent dialysis, adjunct peritoneal dialysis, and wearable ultrafiltration devices. No data regarding patient preferences for fluid management exist. A survey was designed, tested, ...[more]

PMID: 24903386

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Dataset Information

Patient-stated preferences regarding volume-related risk mitigation strategies for hemodialysis.

Background and objectives

Design, setting, participants, & measurements

Results

Conclusions

Publications

Patient-stated preferences regarding volume-related risk mitigation strategies for hemodialysis.

Similar Datasets

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