Before and after a nutritional educational intervention. Knowledge and compliance with dietary guidelines for hemodialysis patients

Abstract

Introduction: renal replacement treatment must be accompanied by adequate nutritional therapy. Compliance with it improves the quality of life and survival of patients and food education positively influences their adherence.

Objective: to describe the knowledge and compliance with dietary guidelines in patients with chronic kidney disease undergoing hemodialysis treatment in an acute general hospital, before and after a nutritional educational intervention.

Materials and method: pre-experimental, longitudinal, prospective study during May to August 2022 in an acute care hospital in the city of La Plata, Buenos Aires. Food and nutritional education workshops were held where topics related to the consumption of sodium, potassium, phosphorus and liquids were addressed. At the beginning and at the end of the workshop cycle, a survey was carried out to obtain data on the nutritional therapy carried out and knowledge about the recommended nutritional treatment. Biochemical data and body weight pre and post dialysis were collected. The data obtained were transferred to a spreadsheet for subsequent processing and analysis, using the IBM SPSS Statistics 22 software.

Results: a total of 27 patients were studied. The degree of knowledge prior to carrying out the educational intervention
presented a median of 64.4 points (IQR 50-78.5), corresponding to a medium degree of knowledge. After carrying out the
educational intervention, the degree of knowledge presented a median of 85.7 points (IQR 50-92.8), corresponding to an
optimal degree of knowledge; observing a statistically significant increase after carrying out the workshops (p=0.007).
Regarding the degree of compliance prior to the intervention, a median of 71.4 points (IQR 64.3-78.5) was obtained, an optimal degree of compliance. After the educational intervention, the degree of compliance remained with a median of 71.4 points (IQR 57.1-85.7), not being a statistically significant change (p=0.726). Regarding the serum parameters surveyed, a significant reduction in serum potassium parameters was observed after the workshops (p=0.033), but not in the case of phosphorus (p=0.454). In relation to interdialysis weight gain prior to the intervention, it presented a median of 3.7% (IQR 2.9-4.6). After the intervention, it presented a median of 3.8% (IQR 2.6-4.9), not being a statistically significant change (p=0.179).

Conclusion: the educational intervention used significantly improved the level of knowledge of nutritional therapy and the biochemical potassium parameters of the patients. No significant changes were observed in the rest of the measured parameters; nor in interdialytic weight gain.