Abstract: TH-PO1298
Digital Cognitive Behavioral Therapy for Hyperkalemia in Patients on Maintenance Hemodialysis: A Prospective, Single-Center, Randomized Controlled Trial
Session Information
- Late-Breaking Research Posters
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Artificial Intelligence, Digital Health, and Data Science
- 300 Artificial Intelligence, Digital Health, and Data Science
Authors
- Lin, Hongli, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Zeng, Xin, The First Affiliated Hospital of Dalian Medical University, Dalian, China
Background
Hyperkalemia represents a serious complication in maintenance hemodialysis (MHD) patients, significantly increasing risks of all-cause mortality, cardiovascular events, and hospitalization. Current management is complicated by comorbidities, medication-related potassium elevation, and complex dietary restrictions, creating an urgent need for innovative strategies. Digital cognitive behavioral therapy (dCBT) offers a promising approach through behavior modification but its efficacy for hyperkalemia management remains unestablished.
Methods
This single-center randomized controlled trial enrolled 73 MHD patients with recurrent hyperkalemia. Participants were allocated to receive either 8 weeks of smartphone-based dCBT plus standard care (n=37) or standard care alone (n=36), followed by a 4-week observational follow-up. The primary outcome was change in serum potassium from baseline to week 8. Secondary outcomes included serum phosphate, quality of life (KDQOL-36), self-efficacy (GSES), and medication adherence (MMAS-8), assessed at baseline, week 4, week 8 (end of intervention), and week 12 (follow-up). Statistical analyses were performed using repeated-measures ANOVA with appropriate post-hoc testing.
Results
The dCBT group demonstrated significantly greater reduction in serum potassium compared to controls (group-by-time interaction P=0.002). Serum potassium decreased from 5.73±0.45 mmol/L to 5.02±0.47 mmol/L at week 8 in the dCBT group, remaining stable at follow-up (5.05±0.51 mmol/L), with significantly lower levels versus control (5.29±0.52 mmol/L) at week 8 (P=0.010). The dCBT group also showed substantial improvements in physical health-related quality of life, self-efficacy, and medication adherence. No significant between-group differences were observed in serum phosphate levels.
Conclusion
Digital cognitive behavioral therapy effectively reduces serum potassium levels and improves key patient-reported outcomes in MHD patients with hyperkalemia. The intervention demonstrates sustained effects and represents a comprehensive approach to hyperkalemia management that addresses both physiological and behavioral aspects of care. These findings support the integration of dCBT into standard renal care protocols for improved hyperkalemia management.