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Fluid and Dietary Restriction Behavior Among Chronic Kidney Disease Patients in Bangladesh

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Fluid and Dietary Restriction Behavior Among Chronic Kidney Disease Patients in Bangladesh International Academic Journal of Advanced Practices in Nursing ISSN Print : 2709-3271 | ISSN Online : 2709-3263 Frequency : Bi-Monthly Language : English Origin : Kenya Website : https://www.iarconsortium.org/journal-info/iajapn Research Article Fluid and Dietary Restriction Behavior among Chronic Kidney Disease Patients in Bangladesh Article History Abstract: Chronic Kidney Disease (CKD) is a global threat to health in general and for developing countries in particular, because therapy is expensive and life- Received: 05.09.2020 long. Dietary and fluid regimen for CKD patients is complicated and identifying Accepted: 28.09.2020 characteristics and reasons of those most likely to experience difficulty in Revision: 08.10.2020 adhering to dietary restrictions is important. Objective: The objective of this study Published: 10.10.2020 was to describe the fluid and dietary restriction behavior among admitted patients with chronic kidney disease. Methods: The descriptive study design was conducted among 100 admitted patients from NIKDU, Dhaka, by using purposive Author Details sampling technique. Data was collected by self-administered questionnaires. (1) Demographic Data Assessment Questionnaire, (2) Fluid restricted and (3) Diet 1 2 Hossain MA* and Sitara H Restriction Related Questionnaire. Pearson‟s correlation (r), T -Test (t) and Authors Affiliations ANOVA was used for data analysis. Results: The mean score of fluid restriction behavior is 2.04±.32 and diet restriction behavior is 2.28(±.41). A significant 1Faculty of Mental Health and Psychiatric relationship between fluid restriction behavior with age (p =.018) and Nutritional Nursing, National Institute of Adv anced education (p = .01). There is also another significant relationship between diet Nursing Education and Research (NIANER), restriction behavior and nutritional education (p= .006). Conclusion: Patients Bangladesh with Chronic Kidney Disease who have behavior with age and nutritional education, showed significantly higher fluid and diet restrictions behavior. 2Faculty of Social Welfar e, University of Hospital can consider those characteristics to guide Patients with Chronic Kidney Dhaka, Bangladesh Disease by nurses. Corresponding Author* Keywords: Fluid restriction, Diet restriction, chronic kidney disease. Hossain MA How to Cite the Article: INTRODUCTION Hossain MA and Sitara H(2020) Fluid and Background and Significance of the study Dietary Restriction Behavior among Chronic Chronic Kidney Disease (CKD) is a slow, progressive Kidney Disease Patients in Bangladesh. Int irreversible deterioration in renal function and the prevalence is estimated Aca. J Adv Prct. Nurs. 1(1)16-25. at 8-16% around in the world (Vivekanand, Guillermo, Kunoichi, Zou & Copyright @ 2020: This is an open-access article distributed under the terms of the Creative Saarlander, 2013). In the United States of America, 30 million people Commons Attribution license which permits suffering from chronic kidney disease. Kidney disease is the ninth leading unrestricted use, distribution, and reproduction cause of death in the United States. Approximately 19 million United in any medium for non commercial use States adults have chronic kidney disease, and an estimated 80,000 (NonCommercial, or CC-BY-NC) provided the original author and source are credited. persons have chronic kidney failure diagnosed annually is a global threat to health in general and for developing countries in particular, because therapy is expensive and life-long. (Kidney Disease Statistics for the United States, 2016). In India 90%, patients cannot afford the cost. Over 1 million people worldwide are alive on dialysis or with a functioning graft. Chronic kidney disease is rapidly growing disease in Bangladesh. Results of this study also demonstrated that most of the CKD patients had type 1 diabetes (39.02%) and type 2 diabetes (41.46%) mellitus. Only 5% of the CKD patients had undergone nephro -surgery. Around 24.30% of the CKD patients had hypertension (Jabur & Abdullah, 2016). Preventing progression from earlier stages of chronic kidney disease (CKD) to end-stage kidney disease and minimizing the risk for cardiovascular events and other complications is central to the management of CKD. Patients‟ active participation in their own care is critical, but may be limited by their lack of awareness and understanding of CKD (Lopez-Vargas et al., 2016). Dietary counseling and nutritional interventions are quintessential components in the management of chronic kidney disease (CKD) patients, including those who receive maintenance dialysis therapy. To that end, in the United States it is a regulatory requirement for an outpatient dialysis clinic to have an on-site registered dietitian to prov[ide dietary monitoring and counseling to all dialysis patients (Ikizler et al., 2014). Poor diet can have serious consequences for patients, including impaired physical abilities, depression, acute pulmonary edema, congestive heart failure, and death. A poor dietary habit is associated with low quality of life, and morbidity and mortality of patients on dialysis. 16 Hossain MA and Sitara H; Int Aca. J Adv Prct. Nurs; Vol-1, Iss- 1 (Sep-Oct, 2020): 16-25 Further, malnutrition and inflammation However, CKD is a progressive disease that increase cardiovascular risk and mortality in patients on cannot be reversed and can lead to kidney failure or hemodialysis. Both dietitians and nephrologists often end-stage renal disease (ESRD) if it is not detected and impose a number of dietary restrictions on their patients treated early (CDC and Prevention, 2012). Because of related to dietary phosphorus, potassium, sodium, fluid its chronic nature and potentially serious complications, intake, and macronutrients including carbohydrate and individuals suffering from CKD experience poor quality fat. Dietitians also emphasize the importance of high of life, financial burden, and significant life changes dietary protein intake in dialysis patients, while they affect their families (Nagelkerk, Reick, & Meengs, may also recommend weight loss efforts in patients 2006) CKD require dialysis or transplant at younger with morbid obesity(Streja et al., 2011). ages than any other group. These disparities in incidence and prevalence have been proven to be a Fluid restriction is considered the most function of high levels of CKD risk factors in African difficult to accomplish and this remains a major clinical Americans, including diabetes, hypertension, and problem in individuals with CKD (Lindberg, obesity (Castren, 2017). CKD patients face a complex 2010).Contributing to severe complications include treatment regimen and many of them have difficulty to intradialytic cramping and hypotensive episodes, manage fluid and diet restrictions, which is associated treatment related fatigue and dizziness, lower extremity with high risk of mortality and the increase of health oedema, ascites, left ventricular hypertrophy and care budgets. Nephrology nurses help patients with congestive heart failure, hypertension, shortness of CKD to manage their treatment, advising them about breath, and pulmonary vascular congestion or acute self-care measures related to changes in their health. To pulmonary oedema (Lindberg, 2010; Machek et al., understand how patients, deal with treatment and what 2009). are the most effective self-care measures to manage fluid and diet restrictions in renal patients under HD, CKD impairs the proper function of kidney for can contribute to a better nursing advice. This study removal of waste substances from the food and from the aims to identify the level of the fluid and dietary body. Due to CKD a person's diet must be changed to restriction behavior among admitted patients in the maximum of the remaining normal kidney function Bangladesh. (Castren, 2017).In the early stage of kidney disease for normal functioning of the kidneys restriction of dietary General Objective: To describe the fluid and dietary protein, sodium, phosphate, potassium and fluid can restriction behavior among admitted patients with help. Dietary and fluid management like as restriction chronic kidney disease. of sodium intake is important to reduce kidney disease, more sodium in the diet can cause kidney disease more Specific Objectives of the Study quickly (Castren, 2017).In the early stage of the disease 1. To describe socio-demographic characteristics dietary protein restriction is not required and could even among patients with chronic kidney disease. result in a decline in the patient´s nutritional status and 2. To assess fluid and dietary restriction behavior overall fitness, but can be implemented in later stages of among patients with chronic kidney disease. the disease. In the progression of the kidney disease and 3. To examine the relationship between socio- kidney declines function and the nutritional status demographic characteristics of fluid and dietary typically deteriorates (Castren, 2017). restriction behavior among patients with chronic kidney disease. The dietary restriction is also vital to maintain optimal health for the CRF patients, because certain ITERATURE EVIEW substances present in the foods and drinks, when taken L R in excess, damaged kidney may not be able to remove The study aimed to assess the perception the waste, which are harmful to the body. So the foods regarding Dietary and Fluid Restriction among the and drinks containing those substances, which are CKD patients who are admitted in National Institute of harmful to the body, must be regulated.
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