Akkabut Wilaiporn, Trakulsuntornchai Wasan, Junhoaton Sutasiny, Kitpermkiat Rungthiwa, Shantavasinkul Prapimporn Chattranukulchai, Kantachuvesiri Surasak
Nursing Division, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Division of Nephrology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Kidney Int Rep. 2025 Jun 19;10(9):3081-3093. doi: 10.1016/j.ekir.2025.06.027. eCollection 2025 Sep.
Patients on hemodialysis experience a progressive inability to regulate sodium and water balance as kidney function declines. This study investigated the potential of self-monitoring of sodium intake using a salt meter and intensive dietary education in patients on hemodialysis.
This feasibility, quasi-experimental study recruited patients on hemodialysis from 2 hemodialysis units; the units as a whole were assigned to receive intensive dietary education in combination with a dietary diary and salt meter for 8 weeks (intervention group) or standard dietary education alone (control group). Blood pressure (BP) and sodium-related outcomes were measured at baseline, and at 8 and 16 weeks.
We analyzed 21 patients in the intervention group and 25 in the control group. Mean interdialytic weight gain (IDWG) remained stable in the intervention group but increased in the control group from baseline by 0.9 and 1.2 kg (at week 8 and 16, respectively). The mean systolic BP decreased by 9.7 mm Hg from baseline to week 16 in the intervention group and increased by 10.7 and 13.7 mm Hg (at week 8 and 16, respectively) in the control group ( < 0.05). Serum sodium levels in the intervention group decreased significantly from baseline by 1.8 mmol/l at 8 weeks ( < 0.05).
Intensive dietary education combined with salt meter-based self-monitoring of sodium intake was more effective than standard education alone in controlling serum sodium and BP with improved adherence to the low-salt diet. Salt meters may be useful to support sodium restriction in patients on hemodialysis.
随着肾功能下降，接受血液透析的患者调节钠和水平衡的能力逐渐丧失。本研究调查了使用盐度计自我监测钠摄入量以及对接受血液透析的患者进行强化饮食教育的潜力。
这项可行性准实验研究从2个血液透析单元招募了接受血液透析的患者；将整个单元分配为接受强化饮食教育并结合饮食日记和盐度计8周（干预组）或仅接受标准饮食教育（对照组）。在基线、第8周和第16周测量血压（BP）和与钠相关的结果。
我们分析了干预组的21名患者和对照组的25名患者。干预组的平均透析间期体重增加（IDWG）保持稳定，而对照组从基线开始增加，在第8周和第16周分别增加0.9 kg和1.2 kg。干预组的平均收缩压从基线到第16周下降了9.7 mmHg，而对照组在第8周和第16周分别增加了10.7 mmHg和13.7 mmHg（<0.05）。干预组的血清钠水平在8周时从基线显著下降了1.8 mmol/l（<0.05）。
强化饮食教育结合基于盐度计的钠摄入量自我监测在控制血清钠和血压方面比单独的标准教育更有效，同时提高了对低盐饮食的依从性。盐度计可能有助于支持血液透析患者限制钠摄入。
