Andi Putra Wijayaa, Rina Septiani, Dewi Kartika Sari, Ahmad Fauzi Rizky, Nurul Hidayah, Zulkarnain Arifin

Fluid restriction in hemodialysis patients with chronic kidney disease in RSUP Dr. Mohammad Hoesin Palembang

Introduction

Fluid restriction in hemodialysis patients with chronic kidney disease in rsup dr. Mohammad hoesin palembang. Study fluid restriction adherence in CKD hemodialysis patients. Identifies knowledge, psychological & social factors, proposing education & coping strategies to boost compliance and patient outcomes.

Abstract

Background: Chronic kidney disease (CKD) patients undergoing hemodialysis must adhere to fluid restrictions to prevent complications such as hypertension, heart failure, and pulmonary edema. However, maintaining adherence is challenging due to physiological, psychological, and social factors. Purpose: This study aims to evaluate compliance with fluid restrictions among hemodialysis patients, identify factors influencing adherence, and propose strategies to improve compliance at RSUP Dr. Mohammad Hoesin Palembang. Methods: A mixed-methods approach was employed, involving a cross-sectional survey of 100 hemodialysis patients and in-depth interviews with 16 participants. Quantitative data were analyzed using descriptive and inferential statistics, while qualitative data were thematically analyzed. Measures to minimize biases, such as ensuring confidentiality and cross-checking data, were implemented. Results: Quantitative findings revealed that participants had a moderate knowledge score (mean: 7.8/10) and an adherence rate of 75.3%, with a mean interdialytic weight gain of 2.5 kg. Significant correlations were found between knowledge and adherence (r = 0.58, p < 0.001) and adherence and weight gain (r = -0.65, p < 0.001). Qualitative analysis identified themes such as psychological challenges, social influences, coping strategies, and the importance of education. Participants highlighted thirst, cultural expectations, and limited understanding as barriers to adherence, while family support and education emerged as facilitators. Conclusion: Enhancing patient education, addressing psychological and social challenges, and promoting innovative coping strategies are essential to improving adherence to fluid restrictions. Tailored interventions and multidisciplinary approaches can optimize fluid management and patient outcomes in hemodialysis care

Review

This study, "Fluid restriction in hemodialysis patients with chronic kidney disease in RSUP Dr. Mohammad Hoesin Palembang," addresses a critically important and challenging aspect of chronic kidney disease management: adherence to fluid restrictions. The chosen topic is highly relevant to improving patient outcomes and preventing severe complications such as hypertension, heart failure, and pulmonary edema in hemodialysis patients. The authors adopted a robust mixed-methods approach, combining quantitative surveys with qualitative interviews, which is commendable for providing a comprehensive understanding of a complex issue. The study's focus on a specific local context, RSUP Dr. Mohammad Hoesin Palembang, adds valuable regional data to the broader literature on fluid management in CKD. A significant strength of this research lies in its dual methodological approach, allowing for both statistical generalization and in-depth exploration of patient experiences. The quantitative data provides clear metrics, revealing a moderate knowledge score (7.8/10) and an adherence rate of 75.3%, alongside an average interdialytic weight gain of 2.5 kg. The identified strong correlations between knowledge and adherence (r = 0.58, p < 0.001) and adherence and weight gain (r = -0.65, p < 0.001) are particularly insightful, empirically supporting the importance of patient understanding. Complementing these, the qualitative findings illuminate the nuanced physiological, psychological, and social dimensions impacting adherence, detailing specific barriers like thirst, cultural expectations, and limited understanding, and facilitators such as family support and education. This integrated approach effectively captures the multifaceted nature of fluid restriction challenges. While the study presents compelling findings and actionable conclusions, future discussions could explore the specifics of current educational interventions and how these might be enhanced, perhaps through comparative analysis with other centers or by evaluating the long-term impact of proposed strategies. Considering the relatively high adherence rate reported, further investigation into the characteristics of the non-adherent group might provide more targeted intervention strategies. Nevertheless, the study's conclusion, emphasizing enhanced education, psychological support, and innovative coping strategies, provides a strong foundation for developing tailored, multidisciplinary interventions. The findings are highly valuable for clinicians, educators, and policymakers in Palembang and potentially in similar cultural contexts, offering clear pathways to optimize fluid management, improve patient quality of life, and ultimately reduce the burden of complications associated with poor fluid adherence in hemodialysis patients.

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