Safdar N, Baakza H, Kumar H, Naqvi S A
Kidney Centre, Karachi.
J Pak Med Assoc. 1995 Nov;45(11):293-5.
Compliance with fluid and dietary instructions is a critically significant factor in the health and well-being of haemodialysis patients. Serial measurement of serum potassium (K) and interdialytic weight gain (IWG) were carried out in 50 haemodialysis patients at the Kidney Centre over a period of one month. Sixty-two percent were males. Ages ranged from 19-69 years (mean 49 years). Duration on dialysis varied from 6 months to 9 years. Patients with an IWG > 1.5 Kg and/or serum K+ > 5.5 m Eq/L were defined as non-compliant. Thirty-two patients (64%) were non-compliant in either diet or fluid. In 13 of these cases, both serum K and IWG were elevated. In the remaining 19, only one value was high. Predictors of non-compliance to diet and fluid regimens were older age (81%), males (68%), less education (75%), single (90%) depression (59%) and not feeling responsible for one's own well-being (85%). Attempts to improve compliance should be aimed by exposing the non-compliant group to nutritional and psychosocial therapy.
遵守液体和饮食指示是血液透析患者健康和福祉的一个极其重要的因素。在肾脏中心,对50名血液透析患者进行了为期一个月的血清钾(K)和透析间期体重增加(IWG)的连续测量。62%为男性。年龄范围为19至69岁(平均49岁)。透析时间从6个月到9年不等。IWG>1.5千克和/或血清钾离子>5.5毫当量/升的患者被定义为不依从。32名患者(64%)在饮食或液体方面不依从。在其中13例中,血清钾和IWG均升高。在其余19例中,只有一个值较高。饮食和液体方案不依从的预测因素为年龄较大(81%)、男性(68%)、教育程度较低(75%)、单身(90%)、抑郁(59%)以及对自身健康不负责(85%)。改善依从性的尝试应以让不依从组接受营养和心理社会治疗为目标。