End Stage Kidney Disease Clinical Trial
Official title:
Daily Sodium Intake in Anuric Hemodialysis Patients and Interdialytic Weight Gain
This study will evaluate the efficiency of dietary intervention on intradialytic weight gain. Uniric hemodialysis patients without serious dietary complications, who accumulate above 2.5 kg (or above 4%) of their dry weight, will undergo a series of dietary consultations for sodium restriction. One month after the intervention, their intradialytic weight accumulation will be measured.
Inter Dialytic Weight Gain (IDWG) ascribed to fluid retention is one of the major clinical
problem that patients in hemodialysis need to cope with between 2 subsequent hemodialysis
especially in patients with no residual renal function. Fluid retention is associated with
morbid conditions such as lower-extremity edema, ascites, pulmonary vascular congestion or
edema, hypertension, and worsening heart failure. Gain weight above 2 kg between 2
subsequent hemodialysis found to be in higher risk of all-cause mortality and cardiovascular
death .Lowering daily sodium intake found to mitigate fluid retention ,however there are
only a few researches that check it. 2IDWG also associated with poorer quality of life.
Dietary sodium restriction recommendation since the beginning of hemodialysis are based on
association of this restriction with balance of hypertension and fluid retention. Sodium
intake recommended for patients in hemodialysis is limited to 2 grams a day. Nevertheless,
there are only a few studies that examine the efficiency of this restriction because of the
complexity of measurement of sodium intake. One recently published study which used a 24-h
recall to measure sodium intake, found a direct correlation between IDGW and mortality form
any reason. In spite of this complexity, IDWG has been found to be in a direct relation with
patients' nutrition status.
One of sodium-related issues is malnutrition. Malnutrition in dialysis is a risk factor for
patients' morbidity and mortality. Higher sodium intake is associated with higher calorie
and protein intake, while adherence to restriction of sodium intake is poor in hemodialysis.
This is a reason for high importance to study effects of sodium restriction in people with
more than 2.5 kg (or 4% of dry body weight) IDWG while following up their nutritional status
;
Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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