Coping with fluid restriction and the quality of life in hemodialysis patients with very low or no daily urine output.


Journal Article

Fluid restriction is crucial to prevent circulatory overload in maintenance hemodialysis (MHD) patients with very low urine volume, but fluid restriction may result in psychological distress. We studied MHD patients with urine volume ≤ 200 ml/day to investigate if their acceptance of fluid restriction was associated with their health-related quality of life (HRQOL).Cross-sectional study of 271 Brazilian adult MHD patients enrolled in the Prospective Study of the Prognosis of Chronic Hemodialysis Patients (PROHEMO). To assess the acceptance of fluid restriction, patients were asked about the extent of feeling bothered by living on this restriction. The KDQOL was used to determine HRQOL scores. Higher scores indicate better HRQOL with differences of >3.0 points considered clinically significant.52.4% reported being "moderately to extremely" bothered by fluid restriction and had lower scores for all HRQOL scales than patients less bothered by fluid restriction. The largest covariate-adjusted differences in HRQOL were 19.5 for emotional role (p<0.001), 15.1 for emotional well-being (p<0.001), and 14.1 for vitality (p<0.001). Adjusted differences were larger for mental component (7.53 points, p<0.001) than for physical component (2.07, p = 0.075) summaries.These results indicate that MHD patients with a lower level of acceptance of fluid restriction have poorer HRQOL, particularly in mental domains of HRQOL. The high prevalence of poor acceptance of fluid restriction in the present study underscores the need for interventions to improve acceptance of fluid restriction and determine if such interventions improve HRQOL of MHD patients with very low urine volume.

Full Text

Duke Authors

Cited Authors

  • Silva, LF; Lopes, GB; Cunha, TO; Protásio, BM; Pisoni, RL; James, SA; Lopes, AA

Published Date

  • June 2014

Published In

Volume / Issue

  • 37 / 6

Start / End Page

  • 427 - 435

PubMed ID

  • 24970556

Pubmed Central ID

  • 24970556

Electronic International Standard Serial Number (EISSN)

  • 1724-6040

International Standard Serial Number (ISSN)

  • 0391-3988

Digital Object Identifier (DOI)

  • 10.5301/ijao.5000329


  • eng