Jennifer E. Flythe|Thomas W. Mangione|Steven M. Brunelli|Gary C. Curhan
Patient-Stated Preferences Regarding Volume-Related Risk Mitigation Strategies for Hemodialysis
Metabolism and Renal Physiology|Harvard University|John Snow (United States)|DaVita Clinical Research (United States)|Metabolism and Renal Physiology|Harvard University|Metabolism and Renal Physiology|Brigham and Women's Hospital
background objectives larger weight gain higher ultrafiltration rates associated poorer outcomes among patients dialysis dietary restrictions reduce fluidrelated risk however adherence challenging alternative fluid mitigation strategies include treatment time extension frequent dialysis adjunct peritoneal dialysis wearable ultrafiltration devices data regarding patient preferences fluid management exist survey designed tested administered assess patientstated preferences regarding fluid mitigation design setting participants measurements written survey concerning fluidrelated symptoms patient treatment characteristics fluid management preferences developed crosssectional survey completed 600 patients hemodialysis 18 geographically diverse ambulatory facilities comparisons patient willingness engage volume mitigation strategies across fluid symptom burden dietary restriction experience patient characteristics performed results final analyses included 588 surveys overall allowed liberalize fluid intake 446 patients willing extend treatment time 15 minutes willingness extend treatment time incrementally less longer treatment extensions 122 patients willing add fourth weekly treatment session 135 patients willing participate nocturnal dialysis three nights per week patients bothered fluid restrictions versus less bothered willing engage fluid mitigation strategies demographic characteristics symptoms cramping dyspnea consistently associated willingness engage proposed strategies 25 patients unsure dry weights typical interdialytic weight gains conclusions patients generally averse treatment time extension15 minutes patients bothered versus less bothered prescribed fluid restrictions willing engage volume mitigation strategies additional study patientstated preferences hemodialysis treatment practices needed guide patient care identify deficiencies patient treatment diseaserelated knowledge