Hemodialysis international. International Symposium on Home Hemodialysis最新文献

{"title":"Clinical Practice Guidelines on the Integration of Residual Kidney Function in Hemodialysis Prescription: A Global Scoping Review.","authors":"Sheikh I Hiba, Jobira Woldemichael, Alaa S Awad, Emaad Abdel-Rahman, Olivia R Warfel, Samir C Gautam, Mariana Murea","doi":"10.1111/hdi.70123","DOIUrl":"https://doi.org/10.1111/hdi.70123","url":null,"abstract":"<p><strong>Background: </strong>Residual kidney function (RKF) is strongly associated with improved outcomes in patients receiving hemodialysis, and incremental hemodialysis-where dialysis dose and frequency are tailored to RKF-has gained increasing attention. However, the extent to which hemodialysis clinical practice guidelines (CPGs) provide actionable guidance for RKF-based prescribing remains unclear.</p><p><strong>Methods: </strong>We conducted a scoping review using Joanna Briggs Institute methodology and PRISMA ScR reporting. National and international adult hemodialysis CPGs were identified through database and organizational website searches (inception-December 2025). Guidelines were classified by depth of RKF integration into three tiers: Tier 3 (no RKF guidance), Tier 2 (conceptual acknowledgment without operational protocols), and Tier 1 (explicit, operational RKF-based prescribing frameworks).</p><p><strong>Results: </strong>Twelve guideline documents were included. Five were classified as Tier 3, providing no RKF guidance for chronic hemodialysis prescribing. Three were Tier 2 guidelines which acknowledged RKF and provided the concept of incremental hemodialysis but did not have standardized thresholds or implementation pathways. Four guidelines met Tier 1 criteria; among these, one provided a fully specified, mathematically integrated framework linking RKF measurement to adequacy targets, monitoring frequency, and eligibility for reduced-frequency dialysis. Other Tier 1 guidelines endorsed incremental hemodialysis or RKF quantification but offered limited detail on measurement protocols, thresholds, or dose adjustment, resulting in substantial heterogeneity across approaches.</p><p><strong>Conclusions: </strong>Despite growing interest in RKF-informed hemodialysis, most CPGs offer limited operational guidance. Fully actionable frameworks are rare, underscoring the need for future guidelines to standardize RKF measurement, integration into adequacy targets, and monitoring strategies to support consistent clinical implementation.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extended Double Plasma Molecular Adsorption Sessions and Bilirubin Clearance: A Case Report.","authors":"Hui Ye, Yi Long Hao, Hai Nan Yang, Wei Fang Yuan, Kai Liang Xu, Xiao Xiao Li, Ming Lei, Yu Xia Sun","doi":"10.1111/hdi.70108","DOIUrl":"10.1111/hdi.70108","url":null,"abstract":"<p><strong>Background: </strong>The double plasma molecular adsorption system is an artificial-liver treatment model combining the use of ion exchange resins and neutral microporous resins to remove toxins such as inflammatory cytokines without consuming large amounts of plasma and albumin. Given the relatively expensive consumables needed for Bilirubin adsorption, extending treatment duration and maximizing adsorption column efficiency help save medical expenses and resources.</p><p><strong>Case presentation: </strong>We report on a 51-year-old male hyperbilirubinemia patient of Chinese Han ethnicity, which was treated with prolonged double plasma molecular adsorption system sessions. The patient underwent two treatment sessions, each lasting over 6 h with a plasma adsorption volume greater than 10 L. total bilirubin clearance was 44.6% in the first session and 34.6% in the second. Dynamic monitoring of serum total bilirubin showed that clearance was maximized when plasma adsorption volume equaled the patient's plasma volume. When plasma adsorption volume reached 2 × plasma volume, total bilirubin decreased by less than 20%, indicating near-saturation of the column's bilirubin adsorption capacity. After plasma adsorption volume doubled in the first session, total bilirubin clearance dropped to nearly 20%, suggesting that the column still had some adsorption capacity. While the efficiency of bilirubin removal per unit of plasma volume decreased, continuing the treatment still allowed for the elimination of additional bilirubin.</p><p><strong>Conclusion: </strong>Total plasma adsorption volume in a single double plasma molecular adsorption system treatment session can serve as a reference for determining the therapeutic dose in future treatments. Furthermore, extending the treatment duration with a bilirubin adsorption column enhances bilirubin clearance.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":"817-822"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral Breast Edema as a Rare Manifestation of Brachiocephalic Vein Occlusion in a Hemodialysis Patient.","authors":"Ömer Burak Çelik, Abdülmelik Birgün, Mehmet Murat Şahin, Abdullah Sarıhan, Macit Kalçık, Mucahit Yetim, Muhammet Cihat Çelik, Yusuf Karavelioğlu","doi":"10.1111/hdi.70096","DOIUrl":"10.1111/hdi.70096","url":null,"abstract":"<p><strong>Background: </strong>Central venous stenosis and occlusion are recognized complications in hemodialysis patients and commonly present with ipsilateral arm, neck, or facial swelling. Unilateral breast edema is an uncommon manifestation that may mimic primary breast disorders and delay diagnosis.</p><p><strong>Case presentation: </strong>A 58-year-old woman with end-stage kidney disease receiving maintenance hemodialysis through a left-arm arteriovenous fistula presented with progressive unilateral left breast swelling accompanied by ipsilateral arm edema and facial congestion. Clinical evaluation excluded infection, malignancy, and lymphedema. Duplex ultrasonography suggested a central venous abnormality, and venography demonstrated complete occlusion of the left brachiocephalic vein with extensive collateral venous circulation. Endovascular treatment was performed with balloon angioplasty followed by self-expanding stent implantation because of significant elastic recoil. Post-procedural venography confirmed restoration of venous flow. The patient experienced rapid improvement in breast, arm, and facial swelling, with near-complete resolution at 1-month follow-up while maintaining functional dialysis access.</p><p><strong>Conclusion: </strong>Central venous obstruction should be considered in the differential diagnosis of unilateral breast swelling in hemodialysis patients. Prompt recognition and endovascular intervention can provide effective symptom relief, prevent unnecessary diagnostic procedures, and preserve vascular access.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":"813-816"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148165811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Patients Ineligible for Arteriovenous Vascular Access: A Retrospective Cohort Analysis.","authors":"Rafael Figueiredo, Hugo Diniz, Joana Ferreira, Jorge Costa Lima, Armando Mansilha, Luís Coentrão","doi":"10.1111/hdi.70122","DOIUrl":"https://doi.org/10.1111/hdi.70122","url":null,"abstract":"<p><strong>Background: </strong>A subset of patients with advanced chronic kidney disease (CKD) or kidney replacement therapy becomes ineligible for arteriovenous vascular access creation due to vascular exhaustion or comorbidity-driven contraindications. Outcomes following a negative surgical vascular access recommendation remain poorly characterized and may differ according to kidney replacement therapy status at assessment.</p><p><strong>Methods: </strong>We retrospectively studied all patients evaluated by a multidisciplinary vascular access team (January 2022-December 2024) who received a negative surgical recommendation for autologous or prosthetic vascular access construction. Patients were primarily stratified as pre-dialysis CKD G4-5 or already receiving kidney replacement therapy. Reason for ineligibility was analyzed descriptively.</p><p><strong>Results: </strong>Among 647 patients evaluated, 40 (6.2%) patients received a negative surgical vascular access recommendation; 20 were pre-dialysis CKD G4-5 and 20 were already receiving kidney replacement therapy. Vascular exhaustion accounted for 23 cases and comorbidity-driven contraindication for 17. Among pre-dialysis patients, 11/20 (55%) initiated kidney replacement therapy after index evaluation: 10 initiated hemodialysis and 1 initiated peritoneal dialysis. Non-planned hemodialysis initiation occurred in 9/10 (90%) patients who started hemodialysis as their first kidney replacement therapy modality, mainly due to acute cardiorenal or coronary syndromes. Among patients already receiving kidney replacement therapy, surgical ineligibility identified persistent absence of durable arteriovenous options: 18/20 (90%) received hemodialysis after index evaluation, with prolonged catheter exposure. Overall, 17/40 (43%) patients died, including 7/20 (35%) pre-dialysis patients and 10/20 (50%) already-kidney replacement therapy patients.</p><p><strong>Conclusions: </strong>Surgical vascular access ineligibility defines a high-risk clinical state whose implications differ by kidney replacement therapy status. Earlier identification, structured modality assessment, and timely palliative integration may better align care with prognosis, physiology, and patient goals.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of a Risk Prediction Model for Depression in Elderly Chinese Patients on Maintenance Hemodialysis: A Multicenter Study.","authors":"Yiqian Fang, Lin Li, Xueqin Gan, Xiufang Li, Yanhua Hu, Rong Zeng, Shuxia Deng, Qian Yang","doi":"10.1111/hdi.70121","DOIUrl":"https://doi.org/10.1111/hdi.70121","url":null,"abstract":"<p><strong>Background: </strong>Depression is the most prevalent psychological condition among elderly patients on maintenance hemodialysis, significantly impairing quality of life and increasing readmission and mortality risks.</p><p><strong>Methods: </strong>This study recruited 871 elderly patients undergoing hemodialysis from nine tertiary hospitals in China between November 2023 and February 2024. Depression symptoms were assessed using the Geriatric Depression Scale (GDS-15), with a score of ≥ 8 indicating clinically significant depressive symptoms. Participants were divided into depressed (n = 333) and nondepressed (n = 538) groups. Multivariable logistic regression analysis was used to identify independent risk factors and develop a risk prediction model presented as a nomogram, with internal validation performed. External validation was conducted in an independent cohort of 219 elderly patients undergoing maintenance hemodialysis recruited from three additional hospitals in Chengdu between March and April 2024.</p><p><strong>Results: </strong>The prevalence of depressive symptoms among elderly maintenance hemodialysis patients was 38.2%. Logistic regression identified education level, vision impairment, frailty, cognitive impairment, malnutrition, low activities of daily living, and poor social support as independent risk factors (p < 0.05). Both internal and external validation of the model demonstrated a receiver operating characteristic (ROC) curve area under the curve (AUC) greater than 0.80, indicating good model discrimination, with calibration and clinical decision analyses confirming its clinical utility.</p><p><strong>Conclusions: </strong>The high prevalence of depressive symptoms in this population is linked to specific risk factors. The nomogram provides valuable support for identification of high-risk patients in clinical practice.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Intradialytic Exercise on the Symptom of CKD Associated Pruritus.","authors":"Namrata Joshi, Katherine L Hull, Angus C Jennings, James O Burton","doi":"10.1111/hdi.70120","DOIUrl":"https://doi.org/10.1111/hdi.70120","url":null,"abstract":"","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Montelukast Versus Gabapentin for Uremic Pruritus in Twice-Weekly Hemodialysis Patients: A 52-Week Prospective Non-Randomized Open-Label Comparative Study.","authors":"Bilal Mohsin, Muhammad Ahmad, Irfan Rasool, Nouf Alotaibi, Wahaj Mirajullah, Imran Khan, Sara Faisal, Khalid Abdulrazek, Aziz Mengal, Saima Faisal","doi":"10.1111/hdi.70119","DOIUrl":"https://doi.org/10.1111/hdi.70119","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Uremic pruritus (UP) remains a common and distressing complication in patients with end-stage renal disease (ESRD) receiving maintenance hemodialysis. The burden is particularly pronounced in low- and middle-income countries where twice-weekly hemodialysis is frequently practiced because of resource limitations. Gabapentin is widely used for the treatment of uremic pruritus; however, its use is often limited by central nervous system adverse effects and poor tolerability in older dialysis populations. Montelukast, a leukotriene receptor antagonist with anti-inflammatory properties, has been proposed as a potential alternative therapy. This study aimed to evaluate the comparative efficacy and safety of montelukast versus gabapentin for the treatment of uremic pruritus in patients receiving twice-weekly hemodialysis, with extended follow-up over 52 weeks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective, open-label, non-randomized comparative study enrolled 195 adult patients with refractory uremic pruritus receiving twice-weekly hemodialysis. Participants were allocated to receive either montelukast or gabapentin based on predefined clinical and demographic criteria, including physician discretion and patient-specific factors. Clinical follow-up was conducted at 2, 4, 8, 12, 24, and 52 weeks. Pruritus severity was assessed using the Visual Analogue Scale (VAS). The primary outcome was change in Visual Analogue Scale score from baseline. Secondary outcomes included adverse events, treatment tolerability, need for dose escalation, and treatment discontinuation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 176 patients completed the 52-week follow-up (montelukast, n = 91; gabapentin, n = 85). Baseline pruritus severity was comparable between the montelukast and gabapentin groups (mean VAS score 7.26 ± 1.56 vs. 7.41 ± 1.67, p = 0.54). Both treatments produced significant reductions in Visual Analogue Scale scores from baseline throughout the 52-week follow-up (p &lt; 0.001 for both groups). Dose escalation was required in 38 patients (44.7%) receiving gabapentin within the first 6 weeks of therapy. Adverse events occurred significantly more frequently in the gabapentin group than in the montelukast group; 6 histories of falls and 11 treatment discontinuations due to adverse effects. Frequent adverse events reported in the montelukast group were abdominal pain and headache (17 and 14 episodes, respectively); whereas in the gabapentin group the common side effects were somnolence (39 incidence), fatigue (n = 21), dizziness (n = 17), and cognitive slowing (n = 16). Although gabapentin achieved modestly greater reductions in Visual Analogue Scale scores at selected follow-up time points, the absolute between-group differences remained below the predefined minimum clinically important difference of 1.0 VAS point.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Montelukast provided sustained clinically meaningful improvement in uremic pruritu","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Changes in Acid-Base Parameters From Dialysis Initiation to Death in Maintenance Hemodialysis Patients.","authors":"Christoph Schwarz, Gregor Lindner, Markus Pirklbauer","doi":"10.1111/hdi.70118","DOIUrl":"https://doi.org/10.1111/hdi.70118","url":null,"abstract":"<p><strong>Introduction: </strong>Blood gas analysis is routinely performed in hemodialysis patients to monitor acid-base status and serum potassium. Despite frequent testing, longitudinal analyses of acid-base parameters over patients' lifetime are lacking.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 45 chronic hemodialysis patients at a secondary dialysis center in Austria, including 7946 blood gas analyses. Acid-base disturbances and respiratory compensation to metabolic acidosis were evaluated. Longitudinal changes were assessed at three time points: START (4 weeks after dialysis initiation), MID (mid-survival), and EOL (last 4 weeks of dialysis). Four measurements per patient were included at each time point. Venous blood gas values were adjusted to arterial equivalents to improve comparability. Linear mixed-effects models were used for analysis.</p><p><strong>Findings: </strong>Venous blood gas analysis systematically misclassified respiratory status; standard formulas for compensation (e.g., Winter's formula) were not applicable. Over the course of dialysis treatment, acid-base and electrolyte homeostasis changed significantly. Temporal patterns were largely comparable between expected and unexpected death, with the exception of lactate, which increased significantly in patients with unexpected death.</p><p><strong>Discussion: </strong>This study provides a comprehensive longitudinal evaluation of acid-base parameters from dialysis initiation to death. Observed temporal patterns, particularly in patients with unexpected death, suggest distinct terminal metabolic trajectories. These findings warrant further investigation in larger cohorts, potentially supported by artificial intelligence-based analyses.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gentamicin Lock Therapy and Duration-Dependent Catheter-Related Bloodstream Infection Risk in Hemodialysis.","authors":"I-Chieh Tsai, Min-Juei Tsai, Yin-Cheng Chen","doi":"10.1111/hdi.70117","DOIUrl":"https://doi.org/10.1111/hdi.70117","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical guidelines recommend antimicrobial lock solutions when infection rates exceed specific thresholds, yet their ability to modify duration-dependent risk accumulation remains unexplored. This study compared catheter-related bloodstream infection (CRBSI) outcomes and duration-modifying effects between gentamicin-heparin and heparin-only lock protocols.</p><p><strong>Methods: </strong>This retrospective dual-center cohort study (January 2020-December 2024) included 266 maintenance hemodialysis patients with tunneled catheters (gentamicin-heparin: n = 198, 52,193 catheter-days; heparin-only: n = 68, 15,443 catheter-days). Primary outcome was CRBSI incidence density. Firth logistic regression with interaction analysis explored duration-modifying effects. Safety was evaluated through antimicrobial resistance patterns and a cross-sectional hearing assessment (15 gentamicin-exposed patients vs. 15 matched controls) using the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S).</p><p><strong>Findings: </strong>Gentamicin-heparin lock was associated with a 67% reduction in CRBSI (0.17 vs. 0.52 per 1000 catheter-days; incidence rate ratio 0.33, 95% CI 0.13-0.86, p = 0.024). Stratified analysis revealed divergent duration-risk relationships: each 30-day increment significantly increased CRBSI risk with heparin-only (OR 1.11, p = 0.006) but not with gentamicin-heparin (OR 1.02, p = 0.547). The duration-protocol interaction approached significance (coefficient -0.089, p = 0.061), suggesting gentamicin lock may attenuate time-dependent risk accumulation. Among CRBSI isolates in the gentamicin cohort, 87.5% (7/8) demonstrated gentamicin resistance. HHIE-S scores did not differ significantly between the gentamicin and control groups (p = 0.507).</p><p><strong>Discussion: </strong>Gentamicin-heparin lock effectively reduced CRBSI incidence. Stratified analysis suggested attenuation of duration-dependent risk, though the interaction did not reach significance (p = 0.061). Sustained clinical efficacy despite high resistance, alongside a favorable preliminary hearing safety profile, suggests its clinical utility while warranting careful stewardship and prospective study.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of a Traffic Light Diary in Volume Management for Patients Undergoing Maintenance Hemodialysis: A Randomized Controlled Study.","authors":"Amin Li, Di Zhang, Liheng Zhou, Wenwen Lu","doi":"10.1111/hdi.70114","DOIUrl":"10.1111/hdi.70114","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy of a traffic light diary in volume management for patients undergoing maintenance hemodialysis.</p><p><strong>Methods: </strong>A total of 80 patients undergoing maintenance hemodialysis were enrolled and randomly assigned using a random number table to either an intervention group (n = 40) or a control group (n = 40) for a 12-week intervention period. The control group received routine hemodialysis treatment and health education on volume management in the hemodialysis unit. The intervention group additionally implemented volume management based on a traffic light diary. Comparisons were made between the two groups regarding before and after the intervention scores on the knowledge, attitude, and practice scales for volume management. The volume management compliance rate, interdialytic weight gain, ultrafiltration rate, and blood pressure levels were statistically analyzed. Acute dialysis complications during the intervention period were recorded and statistically evaluated for both groups.</p><p><strong>Results: </strong>Before the intervention, there were no statistically significant differences between the two groups in terms of fluid management knowledge, attitude, and practice scores; fluid management compliance rate; or blood pressure levels (all p > 0.05). After the intervention, the intervention group scored significantly higher than the control group in knowledge (median [IQR]: 9 [8-10] vs. 7 [6-8]), attitudes (9.2 [8.5-10.0] vs. 7.0 [6.1-8.2]), and practice (22.9 ± 1.62 vs. 18.7 ± 1.01) (all p < 0.05). The fluid management compliance rate was 95% in the intervention group, which was significantly higher than the 75% in the control group (p < 0.05). Interdialytic weight gain and ultrafiltration rate decreased significantly in the intervention group compared with the control group (p < 0.05). Blood pressure control was also superior in the intervention group compared to the control group (p < 0.05). The incidence of acute intradialytic complications, namely hypotension and muscle cramps, was significantly lower in the intervention group than in the control group (p < 0.05).</p><p><strong>Conclusion: </strong>The implementation of fluid management based on a traffic light diary, which combines self-monitoring feedback with professional health education, is of significant importance for improving patients' knowledge, attitude, and practice regarding fluid management, enhancing fluid management efficacy, stabilizing blood pressure levels, and reducing the incidence of acute intradialytic complications.</p>","PeriodicalId":94027,"journal":{"name":"Hemodialysis international. International Symposium on Home Hemodialysis","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}