Suetonia C Palmer1, Camilla S Hanson2, Jonathan C Craig3, Giovanni F M Strippoli4, Marinella Ruospo5, Katrina Campbell6, David W Johnson6, Allison Tong3. 1. Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand. Electronic address: suetonia.palmer@otago.ac.nz. 2. Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia. 3. Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia; Sydney School of Public Health, University of Sydney, Sydney, Australia. 4. Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia; Sydney School of Public Health, University of Sydney, Sydney, Australia; Department of Clinical Pharmacology and Epidemiology, Fondazione Mario Negri Sud, S. Maria Imbaro, Italy; Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy; Department of Translational Medicine, Division of Nephrology and Transplantation, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Diaverum Medical Scientific Office, Lund, Sweden. 5. Diaverum Medical Scientific Office, Lund, Sweden. 6. Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia.
Abstract
BACKGROUND: Managing the complex fluid and diet requirements of chronic kidney disease (CKD) is challenging for patients. We aimed to summarize patients' perspectives of dietary and fluid management in CKD to inform clinical practice and research. STUDY DESIGN: Systematic review of qualitative studies. SETTING & POPULATION: Adults with CKD who express opinions about dietary and fluid management. SEARCH STRATEGY & SOURCES: MEDLINE, EMBASE, PsycINFO, CINAHL, Google Scholar, reference lists, and PhD dissertations were searched to May 2013. ANALYTICAL APPROACH: Thematic synthesis. RESULTS: We included 46 studies involving 816 patients living in middle- to high-income countries. Studies involved patients treated with facility-based and home hemodialysis (33 studies; 462 patients), peritoneal dialysis (10 studies; 112 patients), either hemodialysis or peritoneal dialysis (3 studies; 73 patients), kidney transplant recipients (9 studies; 89 patients), and patients with non-dialysis-dependent CKD stages 1 to 5 (5 studies; 80 patients). Five major themes were identified: preserving relationships (interference with roles, social limitations, and being a burden), navigating change (feeling deprived, disrupting held truths, breaking habits and norms, being overwhelmed by information, questioning efficacy, and negotiating priorities), fighting temptation (resisting impositions, experiencing mental invasion, and withstanding physiologic needs), optimizing health (accepting responsibility, valuing self-management, preventing disease progression, and preparing for and protecting a transplant), and becoming empowered (comprehending paradoxes, finding solutions, and mastering change and demands). LIMITATIONS: Limited data in non-English languages and low-income settings and for adults with CKD not treated with hemodialysis. CONCLUSIONS: Dietary and fluid restrictions are disorienting and an intense burden for patients with CKD. Patient-prioritized education strategies, harnessing patients' motivation to stay well for a transplant or to avoid dialysis, and viewing adaptation to restrictions as a collaborative journey are suggested strategies to help patients adjust to dietary regimens in order to reduce their impact on quality of life.
BACKGROUND: Managing the complex fluid and diet requirements of chronic kidney disease (CKD) is challenging for patients. We aimed to summarize patients' perspectives of dietary and fluid management in CKD to inform clinical practice and research. STUDY DESIGN: Systematic review of qualitative studies. SETTING & POPULATION: Adults with CKD who express opinions about dietary and fluid management. SEARCH STRATEGY & SOURCES: MEDLINE, EMBASE, PsycINFO, CINAHL, Google Scholar, reference lists, and PhD dissertations were searched to May 2013. ANALYTICAL APPROACH: Thematic synthesis. RESULTS: We included 46 studies involving 816 patients living in middle- to high-income countries. Studies involved patients treated with facility-based and home hemodialysis (33 studies; 462 patients), peritoneal dialysis (10 studies; 112 patients), either hemodialysis or peritoneal dialysis (3 studies; 73 patients), kidney transplant recipients (9 studies; 89 patients), and patients with non-dialysis-dependent CKD stages 1 to 5 (5 studies; 80 patients). Five major themes were identified: preserving relationships (interference with roles, social limitations, and being a burden), navigating change (feeling deprived, disrupting held truths, breaking habits and norms, being overwhelmed by information, questioning efficacy, and negotiating priorities), fighting temptation (resisting impositions, experiencing mental invasion, and withstanding physiologic needs), optimizing health (accepting responsibility, valuing self-management, preventing disease progression, and preparing for and protecting a transplant), and becoming empowered (comprehending paradoxes, finding solutions, and mastering change and demands). LIMITATIONS: Limited data in non-English languages and low-income settings and for adults with CKD not treated with hemodialysis. CONCLUSIONS: Dietary and fluid restrictions are disorienting and an intense burden for patients with CKD. Patient-prioritized education strategies, harnessing patients' motivation to stay well for a transplant or to avoid dialysis, and viewing adaptation to restrictions as a collaborative journey are suggested strategies to help patients adjust to dietary regimens in order to reduce their impact on quality of life.
Authors: Valeria M Saglimbene; Germaine Wong; Jonathan C Craig; Marinella Ruospo; Suetonia C Palmer; Katrina Campbell; Vanessa Garcia-Larsen; Patrizia Natale; Armando Teixeira-Pinto; Juan-Jesus Carrero; Peter Stenvinkel; Letizia Gargano; Angelo M Murgo; David W Johnson; Marcello Tonelli; Rubén Gelfman; Eduardo Celia; Tevfik Ecder; Amparo G Bernat; Domingo Del Castillo; Delia Timofte; Marietta Török; Anna Bednarek-Skublewska; Jan Duława; Paul Stroumza; Susanne Hoischen; Martin Hansis; Elisabeth Fabricius; Paolo Felaco; Charlotta Wollheim; Jörgen Hegbrant; Giovanni F M Strippoli Journal: J Am Soc Nephrol Date: 2018-04-25 Impact factor: 10.121
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Authors: Julia M T Colombijn; Anna A Bonenkamp; Anita van Eck van der Sluijs; Joost A Bijlsma; Arnold H Boonstra; Akin Özyilmaz; Alferso C Abrahams; Brigit C van Jaarsveld Journal: Am J Nephrol Date: 2021-09-10 Impact factor: 3.754
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Authors: Jaimon T Kelly; Marguerite Conley; Tammy Hoffmann; Jonathan C Craig; Allison Tong; Dianne P Reidlinger; Marina M Reeves; Kirsten Howard; Rathika Krishnasamy; Jagadeesh Kurtkoti; Suetonia C Palmer; David W Johnson; Katrina L Campbell Journal: Clin J Am Soc Nephrol Date: 2020-02-28 Impact factor: 8.237
Authors: Amanda Baumgart; Karine E Manera; David W Johnson; Jonathan C Craig; Jenny I Shen; Lorena Ruiz; Angela Yee-Moon Wang; Terence Yip; Samuel K S Fung; Matthew Tong; Achilles Lee; Yeoungjee Cho; Andrea K Viecelli; Benedicte Sautenet; Armando Teixeira-Pinto; Edwina A Brown; Gillian Brunier; Jie Dong; Nicole Scholes-Robertson; Tony Dunning; Rajnish Mehrotra; Saraladevi Naicker; Roberto Pecoits-Filho; Jeffrey Perl; Martin Wilkie; Allison Tong Journal: Nephrol Dial Transplant Date: 2020-11-01 Impact factor: 5.992