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Abstract: SA-PO356

Awareness, Understanding, and Self-Reported Adherence to Fluid and Salt Restriction Amongst a Maintenance Haemodialysis Population: A Survey Study

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Zhang, Yimeng, University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, United Kingdom
  • Hameed, Mohammed Awais, University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, United Kingdom
  • Ng, Khai Ping, University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, United Kingdom

Fluid overload is a common complication amongst haemodialysis (HD) population and a major risk factor for cardiovascular and all-cause mortality. The majority of maintenance HD population are oligo-anuric, thus patients’ consistent adherence to salt and fluid restrictions are critical. However, low or non-adherence is not uncommon. This study aimed to (1) examine awareness of salt restriction (SR) and fluid restriction (FR); (2) evaluate self-reported adherence to SR/FR and (3) their effect on clinical recorded interdialytic weight gain (IDWG) in HD population.


It was a survey study of maintenance HD patients in two HD centres in Birmingham, UK, conducted in October 2021. The self-administered survey consists of 21 questions, focusing on participants’ awareness and adherence to SR/FR. Retrospective patient data were obtained from an electronic patient database (PROTON) on demographics, dialysis vintage and clinical recorded IDWG (mean of most recent six dialysis sessions). The data is analysed using SPSS version 27 and Microsoft Excel.


In total, 81 patients completed the questionnaires. The median age was 65 (SD=14) years, 33 (41%) were females, mean dialysis vintage of 4 (SD=4) years and mean IDWG of 1.8 (SD=0.9) kg.
Majority (70%) recalled being informed about FR but less so about SR (59%). Dialysis nurse was reported to be their key source of advice (57%), followed by dialysis doctor (43%), and renal dietician (27%). One in 5 did not recall advice on either restriction. Although the majority reported adherence to SR/FR as ‘very often’ (82%) or 'always' (67%), most have limited understanding on reasons of restriction with 21% not knowing the rationale. There was no significant difference in IDWG between participants who were aware of fluid restriction compared to those who were not (1.9kg vs 1.7kg, p=0.31). There was also no significant correlation between self-reported fluid intake, compliance to restriction IDWG and their clinical recorded IDWG.


A significant proportion of HD patients reported to have limited awareness and understanding of SR/FR despite dedicated renal dietitian input in each HD centres. Dialysis nurses played a key role in educating HD patients. Self-reported awareness or adherence to SR/FR did not appear to correlated with clinical IDWG in this HD cohort.