Mary Ann Sevick1, Beth M Piraino2, David E St-Jules3, Linda J Hough4, Joseph T Hanlon2, Zachary A Marcum2, Susan L Zickmund5, Linda G Snetselaar6, Ann R Steenkiste7, Roslyn A Stone8. 1. Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, New York, New York. Electronic address: mary.sevick@nyumc.org. 2. School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania. 3. Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, New York, New York. 4. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania. 5. School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania. 6. College of Public Health, University of Iowa, Iowa City, Iowa. 7. Veterans Research Foundation of Pittsburgh, Pittsburgh, Pennsylvania. 8. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
Abstract
OBJECTIVE: To evaluate the efficacy of behavioral counseling combined with technology-based self-monitoring for sodium restriction in hemodialysis (HD) patients. DESIGN: Randomized clinical trial. SUBJECTS:English literate adults undergoing outpatient, in-center intermittent HD for at least 3 months. INTERVENTIONS: Over a 16-week period, both the intervention and the attention control groups were shown 6 educational modules on the HD diet. The intervention group also received social cognitive theory-based behavioral counseling and monitored their diets daily using handheld computers. MAIN OUTCOME MEASURES: Average daily interdialytic weight gain (IDWGA) was calculated for every week of HD treatment over the observation period by subtracting the post-dialysis weight at the previous treatment time (t-1) from the pre-dialysis weight at the current treatment time (t), dividing by the number of days between treatments. Three 24-hour dietary recalls were obtained at baseline, 8 weeks, and 16 weeks and evaluated using the Nutrient Data System for Research. RESULTS:A total of 179 participants were randomized, and 160 (89.4%) completed final measurements. IDWGA did not differ significantly by treatment group at any time point considered (P > .79 for each). A significant differential change in dietary sodium intake observed at 8 weeks (-372 mg/day; P = .05) was not sustained at 16 weeks (-191 mg/day; P = .32). CONCLUSION: The BalanceWise Study intervention appeared to be feasible and acceptable to HD patients although IDWGA was unchanged and the desired behavioral changes observed at 8 weeks were not sustained. Unmeasured factors may have contributed to the mixed findings, and further research is needed to identify the appropriate patients for such interventions.
RCT Entities:
OBJECTIVE: To evaluate the efficacy of behavioral counseling combined with technology-based self-monitoring for sodium restriction in hemodialysis (HD) patients. DESIGN: Randomized clinical trial. SUBJECTS: English literate adults undergoing outpatient, in-center intermittent HD for at least 3 months. INTERVENTIONS: Over a 16-week period, both the intervention and the attention control groups were shown 6 educational modules on the HD diet. The intervention group also received social cognitive theory-based behavioral counseling and monitored their diets daily using handheld computers. MAIN OUTCOME MEASURES: Average daily interdialytic weight gain (IDWGA) was calculated for every week of HD treatment over the observation period by subtracting the post-dialysis weight at the previous treatment time (t-1) from the pre-dialysis weight at the current treatment time (t), dividing by the number of days between treatments. Three 24-hour dietary recalls were obtained at baseline, 8 weeks, and 16 weeks and evaluated using the Nutrient Data System for Research. RESULTS: A total of 179 participants were randomized, and 160 (89.4%) completed final measurements. IDWGA did not differ significantly by treatment group at any time point considered (P > .79 for each). A significant differential change in dietary sodium intake observed at 8 weeks (-372 mg/day; P = .05) was not sustained at 16 weeks (-191 mg/day; P = .32). CONCLUSION: The BalanceWise Study intervention appeared to be feasible and acceptable to HDpatients although IDWGA was unchanged and the desired behavioral changes observed at 8 weeks were not sustained. Unmeasured factors may have contributed to the mixed findings, and further research is needed to identify the appropriate patients for such interventions.
Authors: Anna Carrigan; Andrew Klinger; Suzanne S Choquette; Alexandra Luzuriaga-McPherson; Emmy K Bell; Betty Darnell; Orlando M Gutiérrez Journal: J Ren Nutr Date: 2014-01 Impact factor: 3.655
Authors: Manfred Hecking; Angelo Karaboyas; Marlies Antlanger; Rajiv Saran; Volker Wizemann; Charles Chazot; Hugh Rayner; Walter H Hörl; Ronald L Pisoni; Bruce M Robinson; Gere Sunder-Plassmann; Ulrich Moissl; Peter Kotanko; Nathan W Levin; Marcus D Säemann; Kamyar Kalantar-Zadeh; Friedrich K Port; Peter Wabel Journal: Am J Nephrol Date: 2013-07-06 Impact factor: 3.754
Authors: M Rahman; A Dixit; V Donley; S Gupta; T Hanslik; E Lacson; A Ogundipe; K Weigel; M C Smith Journal: Am J Kidney Dis Date: 1999-03 Impact factor: 8.860
Authors: Kamyar Kalantar-Zadeh; Deborah L Regidor; Csaba P Kovesdy; David Van Wyck; Suphamai Bunnapradist; Tamara B Horwich; Gregg C Fonarow Journal: Circulation Date: 2009-01-26 Impact factor: 29.690
Authors: Susan Stark; Linda Snetselaar; Beth Hall; Roslyn A Stone; Sunghee Kim; Beth Piraino; Mary Ann Sevick Journal: Top Clin Nutr Date: 2011-01 Impact factor: 0.508
Authors: Donna G Rhodes; Theophile Murayi; John C Clemens; David J Baer; Rhonda S Sebastian; Alanna J Moshfegh Journal: Am J Clin Nutr Date: 2013-04-03 Impact factor: 7.045
Authors: Jessica K Stevenson; Zoe C Campbell; Angela C Webster; Clara K Chow; Allison Tong; Jonathan C Craig; Katrina L Campbell; Vincent Ws Lee Journal: Cochrane Database Syst Rev Date: 2019-08-06
Authors: Nicholas I Cole; Pauline A Swift; Feng J He; Graham A MacGregor; Rebecca J Suckling Journal: J Hum Hypertens Date: 2018-11-09 Impact factor: 3.012
Authors: Muznah Mirza; Natalie Shahsavarian; David E St-Jules; Connie M Rhee; Mary Lou Pompeii; Kamyar Kalantar-Zadeh; Mary Ann Sevick Journal: Top Clin Nutr Date: 2017 Apr-Jun Impact factor: 0.441