International Journal of Urology and Nephrology ISSN: 2091-1252 Vol. 2 (4), pp. 063-068, December, 2014. © International Scholars Journals

Full Length Research Paper

Repeated education improves diet compliance in maintenance Hemodialysis Patients

HyangJin Ryu1, Hyun Ju Jeon1, Hui-Kyoung Sun2, Kum Hyun Han2, Chun Gyung Whang3, and Sang Youb Han2

1Artificial Kidney Unit, Inje University, Ilsan-Paik Hospital, GoYang, Korea.

2Division of Nephrology,Department of Medicine, Inje University, Ilsan-Paik Hospital, GoYang, Korea.

3Division of Nutrition, Inje University, Ilsan-Paik Hospital, GoYang, Korea.

*Corresponding author. E-mail:

Accepted 25 November, 2014


Dietary education is important for improving the status of hemodialysis (HD) patients; however, general dietary instructions are not sufficient to reach dietary goals. To determine the effectiveness of repeated education in maintenance HD patients, we prospectively compared pre- and post-education data on the level of diet-related knowledge, role behavior, and laboratory results. Thirty HD patients were matched with a specific nurse and offered repeated individualized dietary information on sodium, potassium, phosphorus, protein, and water consumption every week for 3 months. Educational compliance was evaluated by questionnaires. The diet knowledge score increased from 4.26±0.84 to 4.72±1.43 out of 10 (p<0.001). The actual practice score, which showed the patients’ knowledge application, also improved from 17.1±4.18 to 19.1±3.49 out of 25 (p<0.001). The number of sessions with greater than 5% interdialytic weight gain (IDWG) fell significantly from 22.5±0.17% to 7.46±0.09% after intensive education (P<0.001). The rate of hyperkalemia (>5.5 mEq/L) significantly decreased from 26.7±0.31% to 13.9±0.20% on a similar dosage of potassium-lowering medicine (p=0.035). There were no significant changes in the rates of hyperphosphatemia (>5.5 mg/dL) and Ca*P product (>55 mg2/dL2) although requirement for phosphate binders decreased. Repeated education is effective in terms of improving hemodialysis patients’ dietary compliance and their physiological results.

Key words: Renal dialysis, education, nutrition, weight gain, hyperkalemia.