Evidence mapPaperPMID 41209169Full record

ArticleKidney medicine2025

Reducing Excessive Interdialytic Weight Gain in Young Hemodialysis Patients: A Quality Improvement Initiative.

Malek Al Barbandi, Marissa J DeFreitas, Chryso P Katsoufis, Liz Bayes Santos, Vaka Sigurjonsdottir, Michelande Ridore, Beverley Jackson, Daniela Safina Vaccaro, Janette Weir, Melisa Oliva and 4 more

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Article in Kidney medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

14 authors.

Malek Al BarbandiHoltz Children's Hospital at Jackson Memorial Hospital, Miami, FL.
Marissa J DeFreitasHoltz Children's Hospital at Jackson Memorial Hospital, Miami, FL.
Chryso P KatsoufisHoltz Children's Hospital at Jackson Memorial Hospital, Miami, FL.
Liz Bayes SantosHoltz Children's Hospital at Jackson Memorial Hospital, Miami, FL.
Vaka SigurjonsdottirHoltz Children's Hospital at Jackson Memorial Hospital, Miami, FL.
Michelande RidoreHoltz Children's Hospital at Jackson Memorial Hospital, Miami, FL.
Beverley JacksonPediatric Dialysis Unit, Holtz Children's Hospital at Jackson Memorial Hospital, Miami, FL.
Daniela Safina VaccaroPediatric Dialysis Unit, Holtz Children's Hospital at Jackson Memorial Hospital, Miami, FL.
Janette WeirPediatric Dialysis Unit, Holtz Children's Hospital at Jackson Memorial Hospital, Miami, FL.
Melisa OlivaPediatric Behavioral Health, Jackson Memorial Hospital, Miami, FL.
Clara Lora OspinaBehavioral Health, Jackson Memorial Hospital, Miami, FL.
Wacharee SeeherunvongHoltz Children's Hospital at Jackson Memorial Hospital, Miami, FL.
Jayanthi C ChandarHoltz Children's Hospital at Jackson Memorial Hospital, Miami, FL.
Carolyn L AbitbolHoltz Children's Hospital at Jackson Memorial Hospital, Miami, FL.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Rationale & Objective: Excessive interdialytic weight gain (IDWG) is associated with increased cardiovascular risk in hemodialysis patients. We aimed to reduce excessive IDWG events by 50% over 2 years using a multi-interventional quality improvement approach. Study Design: Prospective, single-center, multimodal quality improvement initiative using Plan-Do-Study-Act cycles. Setting & Participants: All pediatric and young adult patients (<27 years old) receiving outpatient hemodialysis at a single pediatric dialysis center (n = 17; 4,166 sessions) from June 2020 to June 2022. Exposures: Interventions included individualized chairside education, dialysis nurse-driven patient communication, monthly IDWG tracking in team meetings, and a reduction in dialysate sodium concentration from 140 to 137 mEq/L. Outcomes: The primary outcome was percent of hemodialysis sessions with excessive IDWG (≥5%). Balancing measures included additional dialysis sessions, serum sodium levels, blood pressure trends, and dialysis nurse documentation burden. Analytical Approach: Statistical process control charts assessed outcome trends. Results: At baseline, 39% of dialysis sessions showed excessive IDWG. Following the full implementation of interventions, the mean shifted to 19%, representing a 51% reduction. The dialysate sodium change and nurse-driven communication had the greatest impact. There were no significant changes in blood pressure, serum sodium, or additional dialysis sessions. Documentation time added per session averaged <3 minutes. Limitations: We did not extract patient-level clinical data such as baseline hypertension, cardiac comorbid conditions, adherence metrics, level of engagement in psychology, or antihypertensive medication adjustments. Conclusions: A multidisciplinary, multimodal quality improvement intervention significantly reduced the frequency of excessive IDWG in pediatric dialysis patients. Lowering dialysate sodium and nurse-led counseling were particularly impactful without increasing treatment burden. Future work should focus on sustainability, behavioral health integration, and long-term cardiovascular outcomes.

Indexed as

Interdialytic weight gainpediatric dialysisquality improvement

Identifiers

PMID41209169
PMCPMC12595357

What Socratic holds

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.