Non-compliance to diet and increased fluid intake can lead to unpleasant side effects and premature mortality in hemodialysis patients. Intervention strategies in educational and cognitive-behavioral domains can be used to improve diet compliance and restrict fluid intake in hemodialysis patients. The present study aimed to implement a participatory care model on diet compliance in patients undergoing hemodialysis referred to the Urmia Hemodialysis Center of Urmia in 1397. The present study is an experimental-randomized study that was performed on 60 patients undergoing diet without hemodialysis referring to Urmia Hemodialysis Center of Urmia. From 175 patients undergoing hemodialysis based on laboratory parameters of non-compliance patients and 60 patients were selected based on simple randomization and were randomly divided into intervention and control groups. After intervention steps of participatory care, diet compliance of the two groups was compared using the results of the comparable laboratory parameters. Analysis of the results of the present study showed that the collaborative care model significantly improved the results of laboratory parameters related to diet compliance in the intervention group compared to the results of the laboratory parameters before the intervention and the control group (p <0.05). Based on the results of the present study, it seems that participatory care intervention can be useful in improving diet compliance and fluid restriction in hemodialysis patients. The aim is to improve the quality of life of hemodialysis patients.
Introduction: One of the basic pillars of hemodialysis is its adequacy, which is achieved by stabilizing hemodynamic parameters. This is especially important in the hemodialysis adequacy of diabetic patients. The current study aims to determine the effect of lowering the dialysate temperature on hemodynamic indices and dialysis adequacy of diabetic patients. Materials and methods: This is a clinical trial that was performed on 32 diabetic patients admitted to the Dialysis Ward of Ali ibn Abi Talib Hospital affiliated with Zahedan University of Medical Sciences in 2017. The research subjects were selected using the convenience sampling method from eligible patients. Each patient underwent hemodialysis twice; i.e. routine dialysate temperature (37° C) and cold dialysate temperature (36 °C). Except for lowering the dialysate temperature to (36 °C), all other conditions were the same during the study. Blood pressure (BP) and pulse rate of patients were monitored before and after dialysis and during the first, second, and third hours after dialysis; however, the body temperature and weight of patients were monitored before and after each dialysis session. Patients' blood samples were collected at each stage before and after dialysis to evaluate urea and calculate dialysis adequacy. Data analysis was carried out using descriptive statistics, paired t-test, and one-way repeated measures ANOVA in SPSS Ver. 21. P-value <0.05 was considered as the significant level. Results: Systolic, diastolic, and mean arterial blood pressure among patients who underwent hemodialysis with normal dialysate temperature were significantly lower than those who underwent hemodialysis with cold dialysate temperature (p<0.05). There were no significant differences between cold and routine dialysis in terms of changes in body temperature before and after dialysis. The dialysis adequacy at 36 °C showed a significant increase as compared to 37° C. Conclusion: The results of the present study showed that hemodialysis with cold solution (36 °C) stabilized hemodynamic variables and improved dialysis adequacy among diabetic patients, therefore, this treatment is recommended in hemodialysis wards.
