Rambod Masoume, Peyravi Hamid, Shokrpour Nasrin, Sareban Mohammad Taghi
Shiraz University of Medical Sciences, Shiraz, Iran.
Health Care Manag (Frederick). 2010 Oct-Dec;29(4):359-64. doi: 10.1097/HCM.0b013e3181fa0691.
Adherence to fluid restrictions and dietary and medication guidelines is important for adequate management of hemodialysis (HD) patients. This study aimed at assessing the factors suggestive of adherence in uremic patients on HD. Two hundred HD patients were recruited by census method. Data on blood urea nitrogen (BUN), serum potassium and phosphate levels, and interdialytic weight gain (IWG) were collected from medical records and analyzed. Most of the patients (56%) did not adhere to fluid restrictions. Nonadherence to phosphate, potassium, and BUN levels was 25.5%, 5.5%, and 4.5%, respectively. In addition, there was a relationship between BUN, serum potassium and phosphate levels, and IWG with educational status (p ≤ .05). However, there was no correlation between BUN, serum potassium and phosphate levels, and IWG with sex, age, financial status, marital status, and duration of dialysis (p > .05). Based on the results, most of the patients adhered to dietary and medication regimens. Educational level of the patients was associated with adherence to fluid restriction. It was concluded that dietary compliance may be improved by using dietary counseling techniques and that education motivates patients to change and comply with dietary recommendations.
坚持液体限制以及饮食和药物治疗指南对于充分管理血液透析（HD）患者至关重要。本研究旨在评估提示尿毒症HD患者依从性的因素。通过普查方法招募了200名HD患者。从病历中收集并分析了血尿素氮（BUN）、血清钾和磷水平以及透析间期体重增加（IWG）的数据。大多数患者（56%）未坚持液体限制。不遵守磷、钾和BUN水平的比例分别为25.5%、5.5%和4.5%。此外，BUN、血清钾和磷水平以及IWG与教育程度之间存在关联（p≤0.05）。然而，BUN、血清钾和磷水平以及IWG与性别、年龄、经济状况、婚姻状况和透析时间之间无相关性（p>0.05）。基于这些结果，大多数患者遵守饮食和药物治疗方案。患者的教育水平与液体限制的依从性相关。得出的结论是，通过使用饮食咨询技术可以提高饮食依从性，并且教育能促使患者改变并遵守饮食建议。
