Nutritional counseling regulates interdialytic weight gain and blood pressure in outpatients receiving maintenance hemodialysis

Maintenance hemodialysisoutpatients must limit salt and water intake to maintain electrolyte balance and blood pressure. In Kawashima Hospital, nationally registered dietitiansprovide hemodialysispatients with monthly nutritional counseling. We investigated whether nutritional counseling affects interdialytic weight gain (IDWG) and blood pressure. We investigated 48 hemodialysispatients whose monthly average IDWG ratio to dry weight exceeded 5.1% and who had not had a long-term hospital admittance of ＞1 month. After the 48-month nutritional counseling period, the IDWG ratio had improved in 37 of the patients (77.1%), significantly decreasing from 6.0±0.7 to 5.3±0.9%. Estimated salt and water intake decreased significantly from 13.3±2.7 to 11.8±2.4 g/day and 2528±455 to 2332±410 ml/day, respectively. During the intervention period, normalized protein catabolicrate and body mass index did not change substantially. Pre- hemodialysissystolic and diastolic blood pressures had significantly decreased from 149±19 to 134±18 mmHg, and 82±13 to 75±10 mmHg for 48 months after study initiation, respectively. The dosage of antihypertensive drugshad significantly decreased in the group that experienced improvement in the IDWG ratio. Long-term nutritional counseling by nationally registered dietitiansmay improve the IDWG ratio and blood pressure of hemodialysispatients by decreasing their salt and water intake.