DOI: https://doi.org/10.14710/nmjn.v11i3.38838

The Fluid Management Experience in Patients with Chronic Kidney Disease Undergoing Hemodialysis in Indonesia: A Qualitative Study

*Fitri Mailani  -  Faculty of Nursing, Universitas Andalas, Indonesia
Rahmi Muthia  -  Faculty of Nursing, Universitas Andalas, Indonesia
Yelly Herien  -  Faculty of Nursing, Universitas Andalas, Indonesia
Emil Huriani  -  Faculty of Nursing, Universitas Andalas, Indonesia
Chong Mei Chan  -  Department of Nursing Science, Faculty of Medicine, University of Malaya, Malaysia
Khatijah Lim Abdullah  -  Department of Nursing, School of Medical and Life Sciences, Sunway University, Malaysia
Open Access Copyright (c) 2021 Nurse Media Journal of Nursing
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Abstract

Background: Fluid management can reduce mortality, severe comorbidities, and debilitating symptoms in patients on hemodialysis. Therefore, a restricted fluid intake plan is crucial for patients with chronic kidney disease (CKD). Little evidence has been found to date on exploring the experience in fluid management of CKD patients in Indonesia.

Purpose: This study aimed to explore the fluid management experience of adults with chronic kidney disease participating in hemodialysis treatment in Indonesia.

Methods: A qualitative study with a phenomenological approach was conducted. Purposive sampling was used to recruit 14 adults patients with chronic kidney disease undergoing hemodialysis in a tertiary hospital in Padang between July and September 2020. Manual content analysis using the Colaizzi approach was used to identify themes.

Results: Data analysis revealed four themes with 12 sub-themes. The four major themes include the challenge of thirst control, fluid/diet restriction management, inadequate information, and the support system.

Conclusions: The result showed the severe suffering and sadness experienced by CKD patients who conform to fluid restrictions. It is important to provide clear information on the fluid prescription or the exact consumable amount per day. Structured education with a personal approach is recommended to ensure detailed information regarding "fluid prescribing". The support obtained from family, friends, and dialysis staff is a significant factor in promoting acceptance and adherence.
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Keywords: Chronic kidney disease; fluid restriction; hemodialysis; nursing care; qualitative study

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  1. Beerendrakumar, N., Ramamoorthy, L., & Haridasan, S. (2018). Dietary and fluid regime adherence in chronic kidney disease patients. Journal of Caring Sciences, 7(1), 17–20. https://doi.org/10.15171/jcs.2018.003
  2. Biruete, A., Jeong, J. H., Barnes, J. L., & Wilund, K. R. (2017). Modified nutritional recommendations to improve dietary patterns and outcomes in hemodialysis patients. Journal of Renal Nutrition, 27(1), 62–70. https://doi.org/10.1053/j.jrn.2016.06.001
  3. Bossola, M., Calvani, R., Marzetti, E., Picca, A., & Antocicco, E. (2020). Thirst in patients on chronic hemodialysis: What do we know so far?. International Urology and Nephrology, 52(4), 697–711. https://doi.org/10.1007/s11255-020-02401-5
  4. Bs, M. W., Bs, P. G., Phillips, S., & Rd, M. S. (2017). Tips for dialysis patients with fluid restrictions. Journal of Renal Nutrition, 27(5), e35–e38. https://doi.org/10.1053/j.jrn.2017.06.001
  5. Canaud, B., Chazot, C., Koomans, J., & Collins, A. (2019). Fluid and hemodynamic management in hemodialysis patients: challenges and opportunities. Jornal Brasileiro de Nefrologia : ’orgao Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia, 41(4), 550–559. https://doi.org/10.1590/2175-8239-JBN-2019-0135
  6. Carman, K., Griffin, B., Jamieson, W., Wong, I., Shaw, J. J., Carman, K. L., Dardess, P., Maurer, M., Sofaer, S., Bechtel, C., & Sweeney, J. (2013). Patient and family engagement : A framework for understanding the elements and developing interventions and policies. Health Affairs, 32, 223–231. https://doi.org/10.1377/hlthaff.2012.1133
  7. Chiaranai, C. (2016). The lived experience of patients receiving hemodialysis treatment for end-stage renal disease: a qualitative study. Journal of nursing research, 24(2), 101-108. doi: 10.1097/jnr.0000000000000100
  8. Chironda, G., & Bhengu, B. (2016). Engagement with fluid and dietary restriction among chronic kidney disease (CKD) patients in selected public hospitals of KwaZulu-Natal (KZN) Province, South Africa. Health Science Journal, 10(5), 1-9. https://doi.org/10.4172/1791-809X.1000100504
  9. Cho, M. K., & Shin, G. (2016). Gender-based experiences on the survival of chronic renal failure patients under hemodialysis for more than 20 years. Applied Nursing Research, 32, 262–268. https://doi.org/10.1016/j.apnr.2016.08.008
  10. Clark-Cutaia, M. N., Ren, D., Hoffman, L. A., Burke, L. E., & Sevick, M. A. (2014). Adherence to hemodialysis dietary sodium recommendations: Influence of patient characteristics, self-efficacy, and perceived barriers. Journal of Renal Nutrition, 24(2), 92–99. https://doi.org/10.1053/j.jrn.2013.11.007
  11. Cox, K. J., Parshall, M. B., Hernandez, S. H. A., Parvez, S. Z., & Unruh, M. L. (2017). Symptoms among patients receiving in-center hemodialysis : A qualitative study. Hemodialysis International, 21 (4). 524–533. https://doi.org/10.1111/hdi.12521
  12. Creswell, J. W., & Poth, C. N. (2016). Qualitative inquiry and research design: Choosing among five approaches. Sage publications
  13. Dasgupta, I., Farrington, K., Davies, S. J., Davenport, A., & Mitra, S. (2016). UK national survey of practice patterns of fluid volume management in haemodialysis patients: A need for evidence. Blood Purification, 41(4), 324–331. https://doi.org/10.1159/000444246
  14. Daugirdas, J. T., Depner, T. A., Inrig, J., Mehrotra, R., Rocco, M. V., Suri, R. S., Weiner, D. E., Green, N., Ishani, A., MacDonald, R., Olson, C., Rutks, I., Slinin, Y., Wilt, T. J., Kramer. H., Choi, M. J., Samaniego, M., Scheel, P. J., Willis, K., ... Brereton, L. (2015). KDOQI clinical practice guideline for hemodialysis adequacy: 2015 update. American Journal of Kidney Diseases, 66(5), 884-930. https://doi.org/10.1053/j.ajkd.2015.07.015
  15. Estruch, R., Ros, E., Salvadó, J. S., Covas, M., Corella, D., Arós, F., Gracia, E. G., Gutiérrez, V. R., Fiol, M., Lapetra, J., Raventos, R. M. L., Majem, L. S., Pintó, X., Basora, J., Muñoz, M. A., Sorlí, J. V, Martínez, J. A., & Fitó, M. (2018). Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts. New England Journal Of Medicine, 378(25), e34. https://doi.org/10.1056/NEJMoa1800389
  16. Ford-anderson, C. A. (2011). Lived experiences : Hemodialysis and adherence. Journal of nephrology, 35, 33–39
  17. Freire, S. de M., Melo, G. A., Lima, M. M. de, Silva, R. A., Caetano, J. Á., & Santiago, J. C. (2020). Contexts of experience of being (un) comfortable in patients with chronic kidney disease. Escola Anna Nery, 24(4), e20190326. https://doi.org/10.1590/2177-9465-EAN-2019-0326
  18. Garcia, A. K. A., Fonseca, L. F., Aroni, P., & Galvão, C. M. (2016). Strategies for thirst relief: integrative literature review. Revista Brasileira de Enfermagem, 69(6), 1215–1222. https://doi.org/10.1590/0034-7167-2016-0317
  19. Hall, R., Rutledge, J., Colón-Emeric, C., & Fish, L. J. (2020). Unmet needs of older adults receiving in-center hemodialysis: A qualitative needs assessment. Kidney Medicine, 2(5), 543-551.e1. https://doi.org/10.1016/j.xkme.2020.04.011
  20. Hill, N. R., Fatoba, S. T., Oke, J. L., Hirst, J. A., O’Callaghan, C. A., Lasserson, D. S., & Hobbs, F. R. (2016). Global prevalence of chronic kidney disease–a systematic review and meta-analysis. PLoS ONE, 11(7), e0158765-83. https://doi.org/10.1371/journal.pone.0158765
  21. Hong, L. I., Wang, W., Chan, E. Y., Mohamed, F., & Chen, H. C. (2017). Dietary and fluid restriction perceptions of patients undergoing haemodialysis: An exploratory study. Journal of Clinical Nursing, 26(21–22), 3664–3676. https://doi.org/10.1111/jocn.13739
  22. Husain, F., Kusuma, H., & Johan, A. (2020). Effects of peer support program on self-management in patients with end-stage renal disease undergoing hemodialysis. Nurse Media Journal of Nursing, 10(2), 171–181. https://doi.org/10.14710/nmjn.v10i2.26502
  23. Imtiaz S, Salman B, Dhrolia MF, Nasir K, Abbas HN, A. A. (2016). Clinical and biochemical parameters of hemodialysis patients before and during islamic month of ramadan. Iranian Journal of Kidney Disease, 10(2), 75–78
  24. Indonesia National Intitute of Health Research and Development. (2014). Indonesia diet total survey report: Individual food consumption survey in West Sumatra Province. Indonesian Ministry of Health. https://labmandat.litbang.kemkes.go.id/23-labmandat/398-bahan-paparan-survei-konsumsi-makanan-individu-studi-diet-total-2014
  25. Indonesian Renal Registry. (2018). 11th report of Indonesian renal registry 2018. https://www.indonesianrenalregistry.org/data/IRR 2018.pdf
  26. Kalantar-zadeh, K., Brown, A., Chen, J. L. T., Kamgar, M., Lau, W., Moradi, H., Rhee, C. M., Streja, E., & Kovesdy, C. P. (2016). Dietary restrictions in dialysis patients : is there anything left. Seminar in dialysis, 28(2), 159–168. https://doi.org/10.1111/sdi.12348.Dietary
  27. Kelly, J. T., Campbell, K. L., Hoffmann, T., & Reidlinger, D. P. (2017). Patient experiences of dietary management in chronic kidney disease : A focus group study. Journal of Renal Nutrition, 28(6), 393-402. https://doi.org/10.1053/j.jrn.2017.07.008
  28. Lee, E. J., Chang, A. K., & Chung, Y. C. (2020). Socioecological factors affecting fluid restriction adherence among korean patients receiving hemodialysis: A qualitative study. Journal of Transcultural Nursing, 32(3), 239–247. https://doi.org/10.1177/1043659620919162
  29. Lindberg, M. (2010). Excessive fluid overload among haemodialysis patients: prevalence, individual characteristics and self-regulation of fluid intake [Doctoral dissertation, Uppsala Universitet]. Acta Universitatis Upsaliensis. https://www.diva-portal.org/smash/get/diva2:308451/FULLTEXT01.pdf
  30. Lipoeto NI, Agus Z, Oenzil F, Wahlqvist ML, W. N. (2004). Dietary intake and the risk of coronary heart disease among the coconut-consuming Minangkabau in West Sumatra, Indonesia. Asia Pacific Journal of Clinical Nutrition, 13(4), 377–384
  31. Lucena, A. de F., Magro, C. Z., Proença, M. C. da C., Pires, A. U. B., Moraes, V. M., & Aliti, G. B. (2018). Validation of the nursing interventions and activities for patients on hemodialytic therapy. Revista Gaucha de Enfermagem, 38(3), e66789. https://doi.org/10.1590/1983-1447.2017.03.66789
  32. Maimani, Y. Al, Elias, F., Salmi, I. Al, Aboshakra, A., Alla, M. A., & Hannawi, S. (2021). Interdialytic weight gain in hemodialysis patients : worse hospital admissions and intradialytic hypotension. Open Journal of Nephrology, 11, 156–170. https://doi.org/10.4236/ojneph.2021.112013
  33. Mason, M. (2010). Sample size and saturation in PhD studies using qualitative interviews. Forum: Qualitative Social Research, 11(3), 1-19. https://doi.org/10.17169/fqs-11.3.1428
  34. Mays, N., & Pope, C. (2020). Quality in qualitative research: an overview. Journal of Continuing Nursing Education, 21(1), 76–80. https://doi.org/10.1002/9781119410867.ch15
  35. Nazly, E. Al, Ahmad, M., Musil, C., & Nabolsi, M. (2013). Hemodialysis stressors and coping strategies among Jordanian patients on hemodialysis: A qualitative study. Nephrology Nursing Journal, 40(4), 321–327
  36. Nerbass, F. B., Correa, D., Santos, R. G. D., Kruger, T. S., Sczip, A. C., Vieira, M. A., & Morais, J. G. (2017). Perceptions of hemodialysis patients about dietary and fluid restrictions. Jornal Brasileiro de Nefrologia : ’orgao Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia, 39(2), 154–161. https://doi.org/10.5935/0101-2800.20170031
  37. Okoyo Opiyo, R., Nyawade, S. A., McCaul, M., Nyasulu, P. S., Lango, D. B., Were, A. J. O., Nabakwe, E. C., Bukania, Z. N., & Olenja, J. M. (2020). Perceptions on adherence to dietary prescriptions for adults with chronic kidney disease on hemodialysis: A qualitative study. Diseases, 8(3), 29. https://doi.org/10.3390/diseases8030029
  38. Palmer, S. C., Hanson, C. S., Hons, B., Craig, J. C., Strippoli, G. F. M., Ruospo, M., Campbell, K., Johnson, D. W., & Tong, A. (2015). Dietary and fluid restrictions in ckd: A thematic synthesis of patient views from qualitative studies. American Journal of Kidney Diseases, 65(4), 559–573. https://doi.org/10.1053/j.ajkd.2014.09.012
  39. Polit, D. F., & Beck, C. T. (2008). Nursing research: Generating and assessing evidence for nursing practice. Lippincott Williams & Wilkins
  40. Rhee, C. M., Chou, J. A., & Kalantar-Zadeh, K. (2018). Dialysis Prescription and Sudden Death. Seminars in Nephrology, 38(6), 570–581. https://doi.org/10.1016/j.semnephrol.2018.08.003
  41. Sarkar, S. R., Kotanko, P., & Levin, N. W. (2006). Interdialytic weight gain: Implications in hemodialysis patients. Seminars in Dialysis, 19(5), 429–433. https://doi.org/10.1111/j.1525-139X.2006.00199_1.x
  42. Seng, J. J. B., Tan, J. Y., Yeam, C. T., Htay, H., & Foo, W. Y. M. (2020). Factors affecting medication adherence among pre-dialysis chronic kidney disease patients: a systematic review and meta-analysis of literature. International Urology and Nephrology, 52(5), 903–916. https://doi.org/10.1007/s11255-020-02452-8
  43. Shahgholian, N., & Yousefi, H. (2018). The lived experiences of patients undergoing hemodialysis with the concept of care: a phenomenological study. BMC nephrology, 19(1), 1-7. https://doi.org/10.1186/s12882-018-1138-4
  44. Smith, K., Coston, M., Glock, K., Elasy, T. A., Wallston, K. A., Ikizler, T. A., & Cavanaugh, K. L. (2010). Patient perspectives on fluid management in chronic hemodialysis. Journal of Renal Nutrition, 20(5), 334-341. https://doi.org/10.1053/j.jrn.2009.09.001
  45. Stevenson, J., Tong, A., Gutman, T., Campbell, K. L., Craig, J. C., Brown, M. A., & Vincent, W. (2018). Experiences and perspectives of dietary management among patients on hemodialysis : An interview study. Journal of Renal Nutrition, 28(6), 411-421. https://doi.org/10.1053/j.jrn.2018.02.005
  46. Subramanian, L., Quinn, M., Zhao, J., Lachance, L., Zee, J., & Tentori, F. (2017). Coping with kidney disease – qualitative findings from the Empowering Patients on Choices for Renal Replacement Therapy (EPOCH-RRT) study. BMC (Nephrology), 18 (1), 1–10. https://doi.org/10.1186/s12882-017-0542-5
  47. Theofilou, P. (2013). The effect of sociodemographic features and beliefs about medicines on adherence to chronic kidney disease treatment. International Journal of Caring Sciences, 6(2), 188-194
  48. Thomas, N. (Ed.). (2019). Renal nursing: Care and management of people with kidney disease. John Wiley & Sons
  49. Walker, R., James, H., & Burns, A. (2012). Adhering to behaviour change in older pre‐dialysis populations—what do patients think? A qualitative study. Journal of Renal Care, 38(1), 34–42. https://doi.org/10.1111/j.1755-6686.2012.00262.x
  50. World Medical Association. (2013). World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. Jama, 310(20), 2191-2194. doi: 10.1001/jama.2013.281053
  51. Yang, L., Chin, C., & Kao, T. (2010). Effect of acupressure on thirst in hemodialysis patients. Kidney and blood pressure reserch, 33(4), 260–265. https://doi.org/10.1159/000317933

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