THE STUDY OF EVALUATING THE IMPACT OF DIETARY AND LIFESTYLE INTERVENTIONS ON HEALTH OUTCOMES IN ESRD PATIENTS UNDERGOING MAINTENANCE HEMODIALYSIS AT DCDC KIDNEY CARE

Abstract

Background: This study was conducted by DCDC Kidney Care for End-Stage Renal Disease (ESRD) represents a significant global health challenge, requiring maintenance hemodialysis as a lifesaving treatment. Despite its critical role, hemodialysis alone is insufficient to manage the multifaceted complications of ESRD, including malnutrition, cardiovascular disease, and poor quality of life. Dietary and lifestyle interventions have emerged as modifiable strategies to improve clinical and patient-reported outcomes. This study evaluates the impact of combined dietary and lifestyle modifications on the health outcomes of ESRD patients undergoing maintenance hemodialysis.

Objective: To assess the effects of tailored dietary counseling and lifestyle interventions on clinical markers, hospitalization rates, and quality of life in ESRD patients receiving maintenance hemodialysis.

Methods: A prospective cohort study was conducted involving 150 ESRD patients undergoing maintenance hemodialysis at DCDC Kidney Care centers. Participants were divided into an intervention group (n=75) and a control group (n=75). The intervention group received individualized dietary counseling focusing on phosphorus, potassium, and sodium restrictions, along with adequate protein intake. Lifestyle interventions included a structured physical activity program, stress management strategies, and smoking cessation support. Data were collected on serum phosphorus, potassium, and albumin levels, blood pressure, hospitalization rates, and quality of life scores (using the KDQOL-36 questionnaire). Outcomes were measured at baseline, three months, and six months. Statistical analyses included paired t-tests, ANOVA, and logistic regression.

Results: Patients enrolled from DCDC Kidney Care demonstrated significant improvement in biochemical markers, including a reduction in serum phosphorus levels (6.2 ± 0.8 mg/dL to 4.9 ± 0.7 mg/dL, p < 0.01) and an increase in serum albumin levels (3.4 ± 0.5 g/dL to 3.8 ± 0.4 g/dL, p < 0.05). Blood pressure control improved markedly, with systolic and diastolic blood pressures decreasing by an average of 15 mmHg and 10 mmHg, respectively. Hospitalization rates were lower in the intervention group (20% vs. 40%, p = 0.03), and quality of life scores improved significantly, particularly in physical health and symptom burden domains. The control group showed minimal or no improvements across most outcomes.

Conclusions: The study highlights the critical role of combined dietary and lifestyle interventions in improving the health outcomes of ESRD patients on maintenance hemodialysis. These interventions significantly enhance clinical markers, reduce hospitalization rates, and improve quality of life. The findings advocate for integrating multidisciplinary, patient-centered care models into routine ESRD management, emphasizing the importance of dietary compliance and lifestyle modifications to optimize treatment outcomes.