PDF(Pubmed)
Abstract：
Chronic kidney disease (CKD) globally represents a significant health challenge, particularly among patients undergoing chronic hemodialysis. A careful nutritional and pharmacological prescription plays a key role in the effective management of these patients to optimize serum electrolytes, such as potassium, phosphorus, and protein intake. Furthermore, these patients can suffer psychological distress due to dietary restrictions and tight medication schedules. The present study explores the effectiveness of the person-centered IARA model in improving physiological markers and quality of life in CKD patients undergoing hemodialysis treatment. To demonstrate the effectiveness of the IARA model, 60 patients (M = 40; F = 20; 60.5 ± 9.9 years) undergoing thrice-weekly hemodialysis sessions were enrolled and randomly and blindly assigned to the Control or IARA group. The reduction in abnormal blood potassium, phosphorus, and total protein levels was investigated, alongside the psychological state through the SF-12 questionnaire. Preliminary findings showed a discernible reduction in the frequency of abnormal blood K (> 5.0 mmol/L) and P (> 4.5 mmol/L) levels in the IARA group compared to the Control group. In particular, such reductions were approximately 40% for K (OR = 0.57; 95% CL = 0.23/1.46) and about 15% for P (OR = 0.86; 95% CL = 0.27/2.74). A similar tendency was also observed for patient fluid intake during each hemodialysis session, with the frequency of higher-risk patients in the IARA group being 50% lower (OR = 0.50; 95% CL = 0.07/3.79) than that of the Control group. Although preliminary findings from this study suggest that the IARA model may have a positive effect on CKD patients\' subjective wellbeing and quality of life (QoL), further research is needed to understand the long-term impact of the IARA intervention.
摘要：
慢性肾脏病（CKD）在全球范围内代表着重大的健康挑战，特别是在接受慢性血液透析的患者中。精心的营养和药物处方在有效管理这些患者以优化血清电解质方面起着关键作用，如钾，磷，和蛋白质的摄入。此外，由于饮食限制和严格的用药时间表，这些患者可能会遭受心理困扰。本研究探讨了以人为中心的IARA模型在改善接受血液透析治疗的CKD患者的生理指标和生活质量方面的有效性。为了证明IARA模型的有效性，纳入60例接受每周三次血液透析的患者（M=40；F=20；60.5±9.9岁），并随机和盲目地分配到对照组或IARA组。异常血钾的减少，磷，并调查了总蛋白质水平，通过SF-12问卷进行心理状态。初步发现显示，与对照组相比，IARA组异常血液K（>5.0mmol/L）和P（>4.5mmol/L）水平的频率明显减少。特别是,K降低约40%(OR=0.57;95%CL=0.23/1.46),P降低约15%(OR=0.86;95%CL=0.27/2.74).在每次血液透析期间，患者的液体摄入量也观察到类似的趋势。IARA组中高危患者的频率比对照组低50％（OR=0.50；95％CL=0.07/3.79）。尽管这项研究的初步结果表明，IARA模型可能对CKD患者的主观幸福感和生活质量（QoL）产生积极影响，需要进一步的研究来了解IARA干预的长期影响.
