Home-delivered meals as an adjuvant to improve volume overload and clinical outcomes in hemodialysis

Abstract

Patients on chronic hemodialysis are counseled to reduce dietary sodium intake to limit their thirst and consequent interdialytic weight gain (IDWG), chronic volume overload, and hypertension. Low-sodium dietary trials in hemodialysis are sparse and mostly indicate that dietary education and behavioral counseling are ineffective in reducing sodium intake and IDWG. Additional nutritional restrictions and numerous barriers further complicate dietary adherence. A low-sodium diet may also reduce tissue sodium, which is positively associated with hypertension and left ventricular hypertrophy. A potential alternative or complementary approach to dietary counseling is home delivery of low-sodium meals. Low-sodium meal delivery has demonstrated benefits in patients with hypertension and congestive heart failure but has not been explored or implemented in patients undergoing hemodialysis. The objective of this review is to summarize current strategies to improve volume overload and provide rationale for low-sodium meal delivery as a novel method to reduce volume-dependent hypertension and tissue sodium accumulation, while improving quality of life and other clinical outcomes in patients undergoing hemodialysis.

Self-regulatory-based compliance module improve chronic kidney failure patients condition

“…Water that enters the body is made in balance with water that comes out either through urine, insensible water loss. This can help to prevent such occurrences through excessive monitoring of IDWG to improve clinical outcomes in HD patients [30]. Based on the foregoing, efforts are needed to monitor and suppress the increase in IDWG values in hemodialysis patients.…”

Development of compliance theory based on self-regulation in chronic kidney failure patients on hemodialysis

“…Patients find it difficult to follow treatment recommendations [2] and physical activity management [3]. Meanwhile, self-regulation is needed by HD patients to maintain compliance and limit fluid intake [4], treatment of medication [5], diet [6], and physical activity management [7]. Low self-regulation including maintaining fluid needs, medication, diet, and physical activity is the highest risk factor for hemodialysis failure.…”