Predictors of excess fluid volume in hemodialysis patients: an observational study.
Maria Isabel da Conceição Dias Fernandes, Jéssica Dantas de Sá Tinôco, Renata Marinho Fernandes and 5 others
PMID 38716904WHAT IT FOUND
Excessive fluid intake, inadequate fluid removal during dialysis, insufficient knowledge and excessive sodium intake were each linked with about twice the chance of excess fluid volume in hemodialysis patients.
Older age and more education were linked with lower chance.
Key findings
01In the bivariate analysis, inadequate fluid removal during hemodialysis, excessive fluid intake and excessive sodium intake were each associated with about a two-fold increased risk of excess fluid volume, while age >= 60 years was protective.
02In the final logistic model, insufficient knowledge, excessive fluid intake and inadequate fluid removal during hemodialysis were each associated with roughly a two-fold increased chance of excess fluid volume.
03In the final model, each year of age or education was associated with about a 5% lower risk of excess fluid volume.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It is a retrospective case-control study, so it identifies associations but cannot prove that any factor caused excess fluid volume. The case and control groups were not paired, which the authors say may have affected identification of risk factors. Excess fluid volume was defined by weight gain and edema, not by objective measurement of fluid status. Risk factors were collected through interviews and records, including self-reported fluid and sodium intake and knowledge, so recall or reporting error is possible. The paper describes a population of 600 hemodialysis patients but analysed 392; the supplied text does not explain what happened to the others.
The easy way to misread this
Do not conclude that changing one factor, such as sodium intake, fluid intake, knowledge or dialysis fluid removal, will reduce excess fluid volume. This study found associations in a retrospective case-control sample, and the contribution of any single factor cannot be separated from the others.