Chronic Kidney Disease 5D, Hemodialysis, Hyperkalemia
Conditions
Keywords
Hemodialysis, Nurse-Led, Nutritional Education, Hyperkalemia Management, Interdialytic Weight Gain, Quality of Life
Brief summary
Why was this study done? Many dialysis centers in Morocco lack dietitians to provide proper, individualized dietary support to patients. High potassium levels (hyperkalemia) are a major risk factor for heart problems in dialysis patients. This study tested whether a simple nutritional education program, led by a nurse, could help patients better manage their diet and safely reduce their serum potassium levels. Who participated? Thirty (30) adult patients with end-stage renal disease receiving hemodialysis participated in the study. They were recruited from three public hemodialysis centers in Morocco that did not have permanent dietitians. What did participants do? The study was conducted from February to June 2025. Participants received an educational intervention led by a nurse. The sessions covered potassium content in food, fluid intake, thirst management, and physical activity. What did the study find (Results)? The educational program resulted in a statistically significant reduction in patients' serum potassium levels. The percentage of patients within the ideal potassium range (4 to 5 mmol/L) increased from 36.7% at the start to 46.7% at the end. This demonstrates that a nurse-led program is a practical and beneficial approach to help lower cardiovascular risk in resource-scarce settings. The study found no significant changes in Quality of Life (QoL) or interdialytic weight gain (IDWG).
Detailed description
This is a single-group, pre-post interventional study designed to evaluate the impact of a nurse-led nutritional education program on the management of End-Stage Renal Disease (ESRD) patients undergoing hemodialysis in a resource-limited setting in Morocco. The study enrolled 30 adult patients. The intervention was conducted over five months (February to June 2025). The program was delivered by a nurse and included face-to-face sessions as well as remote support (WhatsApp). The educational content focused on three main areas: Dietary management to reduce hyperkalemia (potassium content in food). Fluid restriction and thirst management. Salt restriction and low-impact physical activity. The primary outcome measure was the change in serum potassium levels (Kalemia) from baseline (T0) to post-intervention (T1). Secondary outcomes included changes in interdialytic weight gain (IDWG) and Quality of Life (QoL). The results demonstrated a statistically significant reduction in patients' serum potassium levels, supporting the practical benefits of the nurse-led program.
Interventions
BEHAVIORALNutritional Education Intervention
Educational sessions focused on dietary management of potassium and fluid restriction, salt intake, and low-impact physical activity (stretching). The program was delivered by a nurse in the Moroccan dialect via face-to-face and remote (WhatsApp) communication.
Sponsors
HASSAN 1st university
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
This is a pre-post experimental investigation. All participants were assigned to the single intervention group and acted as their own controls, with outcomes measured before (T0) and after (T1) the nurse-led nutritional education program. There was no separate control group.
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis. Participants must have provided written informed consent.
Exclusion criteria
* Patients who declined to participate; patients who were minors (under 18 years old); and patients with conditions impairing their ability to understand or receive educational content, such as severe hearing loss or cognitive impairment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Serum Potassium Level | From baseline to 12 weeks after the start of the intervention. | Change in serum potassium concentration measured at baseline (T0) and after the 12-week educational intervention (T1). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Interdialytic Weight Gain (IDWG) | 4 weeks before baseline and 4 weeks at the end of the 12-week intervention | Change in interdialytic weight gain, calculated as the mean IDWG during the 4 weeks before baseline and the 4 weeks at the end of the 12-week educational intervention |
| Change in Quality of Life (QoL) Index Score | From baseline to 12 weeks after the start of the intervention. | Measured using the validated Arabic version of the EuroQol 5 Dimensions (EQ-5D-5L) instrument. |
Countries
Morocco
Outcome results
None listed