Abstract
INTRODUCTION: Patients on hemodialysis experience a progressive inability to regulate sodium and water balance as kidney function declines. This study investigated the potential of self-monitoring of sodium intake using a salt meter and intensive dietary education in patients on hemodialysis. METHODS: This feasibility, quasi-experimental study recruited patients on hemodialysis from 2 hemodialysis units; the units as a whole were assigned to receive intensive dietary education in combination with a dietary diary and salt meter for 8 weeks (intervention group) or standard dietary education alone (control group). Blood pressure (BP) and sodium-related outcomes were measured at baseline, and at 8 and 16 weeks. RESULTS: We analyzed 21 patients in the intervention group and 25 in the control group. Mean interdialytic weight gain (IDWG) remained stable in the intervention group but increased in the control group from baseline by 0.9 and 1.2 kg (at week 8 and 16, respectively). The mean systolic BP decreased by 9.7 mm Hg from baseline to week 16 in the intervention group and increased by 10.7 and 13.7 mm Hg (at week 8 and 16, respectively) in the control group (P < 0.05). Serum sodium levels in the intervention group decreased significantly from baseline by 1.8 mmol/l at 8 weeks (P < 0.05). CONCLUSION: Intensive dietary education combined with salt meter-based self-monitoring of sodium intake was more effective than standard education alone in controlling serum sodium and BP with improved adherence to the low-salt diet. Salt meters may be useful to support sodium restriction in patients on hemodialysis.