Socioeconomic, clinical and nutritional factors on interdialytic weight gain in haemodialysis users

Zanandreia, Mary; Cattafesta, Monica; Martins, Cleodice Alves; Paixão, Mirian Patrícia Castro Pereira; Soares, Fabíola Lacerda Pires; Peterle, Fernanda Zobole; Santos Neto, Edson Theodoro Dos; Salaroli, Luciane Bresciani

doi:10.37689/acta-ape/2024AO00020622

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Brasil

Acta Paulista de Enfermagem

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Original Article • Acta Paul Enferm 37 • 2024 • https://doi.org/10.37689/acta-ape/2024AO00020622 copy

Socioeconomic, clinical and nutritional factors on interdialytic weight gain in haemodialysis users

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives

The study aimed to evaluate the factors associated with interdialytic weight gain in users of haemodialysis services in a metropolitan region of Brazil.

Methods

This is an cross-sectional epidemiological study with 1,024 individuals with chronic kidney disease on haemodialysis in Brazil. Interdialytic weight gain was evaluated by the percentage weight gain between one haemodialysis session and another. The variables included in the binary logistic regression analysis were selected by considering p< 0.10 in the bivariate test.

Results

We demonstrated that having more years of study (OR=0.537;CI 95% = 0.310–0.931; p=0.027) and be overweight (OR=0.661;CI 95% = 0.461–0.948; p=0.024) or obese (OR=0.387;CI 95% = 0.246–0.608; p=<0.001) reduced the chances of users having high interdialytic weight gain. Those who did not have paid work (OR=2.025;CI 95% = 1.218–3.365; p=0.007) and not adopting measures to reduce salt increased (OR=1.694;CI 95% = 1.085–2.645; p=0.020) increased the chances of interdialytic weight.

Conclusion

The results point to an association between the increase in interdialytic weight gain and the absence of paid work and the non-adoption of measures to reduce salt intake in the diet. Therefore, the need for knowledge about these associated factors can be an important alternative for the individual targeting of this population.

Feeding behavior; Weight gain; Renal dialysis; Nutritional status; Overweight; Obesity; Renal insufficiency, chronic

Variables	n(%)
Gender (n=1.024)
Female	443(43.3)
Male	581(56.7)
Age Group (n=1.024)
19 to 29 years	59(5.8)
30 to 59 years	528(51.5)
60 years or older	437(42.6)
Marital Status (n=1.024)
With partner	570(55.7)
Without partner	454(44.3)
Schooling (n=1.013)
≤ 8 years of study	523(51.6)
> 8 a ≤ 11 years of study	332(32.8)
> 11 years of study	158(15.6)
Color/Race (n=1.011)
White	274(27.1)
Black	241(23.8)
Brown	496(49.1)
Income (n=998) †
≤ 2 minimum wages	555(56.2)
> 2 minimum wages	433(43.8)
Occupation (n=1.009)
With work activity	348(34.5)
Old-age pensioner or away due to illness	547(54.2)
Without paid work	114(11.3)
Assistance modality (n=1.023)
Public	774(75.7)
Private	224(21.9)
Mixed	25(2.4)
Smoking (n=1.018)
No	593(58.3)
Ex smoker	372(36.5)
Yes	53(5.2)
Alcohol intake (n=1.024)
No	929(90.7)
Yes	95(9.3)
Physical Activity Level (n = 1.023)
Within the recommended	118(11.5)
Below recomendado	111(10.9)
Does not practice physical activity	794(77.6)
Time of chronic kidney disease (n=1.019)
< 5 years	525(51.5)
≥ 5 years	494(48.5)
Time of renal replacement therapy (n=967)
0 to 2 years	368(38.1)
3 to 5 years	252(26.1)
6 to 10 years	198(20.5)
Over 10 years	149(15.4)
Medicines used (n=947)
< 5 medicines	667(70.4)
≥ 5 medicines	280(29.6)
Adopts measures to reduce salt (n=1.011)
Yes	888(87.8)
No	123(12.2)
BMI (n=1.023)
< 18.5 kg/m²	62(6.1)
18.5 to 24.9 kg/m²	461(45.1)
25 to 29.9 kg/m²	306(29.9)
> 30 kg/m²	194(19.0)
Interdialytic weight gain (n=1.020)
Adequate	709(69.5)
High	311(30.5)

Variables	IDWG		p-value
	Adequate	High
	n(%)	n(%)
Gender (n=1.024)			0.681*
Female	304(68.8)	138(31.2)
Male	405(70.1)	173(29.9)
Age Group (n=1.024)			0.014
19 to 29 years	35(59.3)	24(40.7)
30 to 59 years	353(67.0)	174(33.0)
60 years or older	321(74.0)	113(26.0)
Marital Status (n=1.024)			0.682*
With partner	391(69.0)	176(31.0)
Without partner	318(70.2)	135(29.8)
Schooling (n=1.013)			0.078
≤ 8 years of study	352(67.7)	168(32.2)
> 8 a ≤ 11 years of study	229(69.0)	103(31.0)
> 11 years of study	121(77.1)	36(22.9)
Color/Race (n=1.011)			0.009
White	208(76.5)	64(23.5)
Black	155(64.3)	86(35.7)
Brown	339(68.6)	155(31.4)
Income (n=998)			0.094*
≤ 2 minimum wages	373(67.3)	181(32.7)
> 2 minimum wages	311(72.3)	119(27.7)
Occupation (n=1.009)			0.063
With work activity	240(69.0)	108(31.0)
Old-age pensioner or away due to illness	389(71.6)	154(28.4)
Without paid work	69(60.6)	45(39.5)
Assistance modality (n=1.023)			0.004
Public	516(66.9)	255(33.1)
Private	170(76.2)	53(23.8)
Mixed	22(88)	3(12.0)
Smoking (n=1.018)			0.426
No	411(69.3)	182(30.7)
Ex smoker	260(70.5)	109(29.5)
Yes	32(61.5)	20(38.5)
Alcohol intake (n=1.024)			0.046*
No	652(70.5)	273(29.5)
Yes	57(60.0)	38(40.0)
Physical Activity Level (n = 1.023)			0.492
Within the recommended	81(69.8)	35(30.2)
Below recomendado	71(64.5)	39(35.5)
Does not practice physical activity	556(70.1)	237(29.9)
Time of chronic kidney disease (n=1.019)			0.221*
< 5 years	373(71.2)	151(28.8)
≥ 5 years	332(67.6)	159(32.4)
Time of renal replacement therapy (n=967)			0.012
0 to 2 years	273(74.6)	93(25.4)
3 a 5 years	181(71.8)	71(28.2)
6 to 10 years	126(64.0)	71(36.0)
Over 10 years	94(63.1)	55(36.9)
Medicines used (n=947)			0.588*
< 5 medicines	460(69.2)	205(30.8)
≥ 5 medicines	199(71.1)	81(28.9)
Adopts measures to reduce salt (n=1.011)			0.002*
Yes	631(71.3)	254(28.7)
No	70(56.9)	53(43.1)
BMI (n=1.023)			<0.001
< 18.5 kg/m²	286(62.4)	172(37.6)
18.5 to 24.9 kg/m²	43(69.4)	19(30.6)
25 to 29.9 kg/m²	222(72.8)	83(27.2)
> 30 kg/m²	158(81.4)	36(18.6)

Variables	Crude				Adjusted
	p-value	OR	CI_95%		p-value	OR	CI_95%
	p-value	OR	Under	Upper	p-value	OR	Under	Upper
Age Group (n=1.024)
19 to 29 years		1				1
30 to 59 years	0.240	0.719	0.415	1.246	0.309	0.704	0.358	1.384
60 years or older	0.020	0.513	0.293	0.900	0.078	0.526	0.257	1.075
Schooling (n=1.013)
≤ 8 years of study		1				1
> 8 a ≤ 11 years of study	0.695	0.942	0.701	1.268	0.375	0.847	0.587	1.222
> 11 years of study	0.026	0.623	0.412	0.944	0.027	0.537	0.310	0.931
Color/Race (n=1.011)
White		1				1
Black	0.003	1.803	1.227	2.649	0.237	1.308	0.838	2.041
Brown	0.022	1.486	1.059	2.085	0.415	1.178	0.794	1.748
Income (n=998)
≤ 2 minimum wages		1				1
> 2 minimum wages	0.092	0.789	0.598	1.039	0.336	1.192	0.833	1.707
Occupation (n=1.009)
With work activity		1				1
Old-age pensioner or away due to illness	0.393	0.880	0.656	1.180	0.613	0.915	0.649	1.290
Without paid work	0.097	1.449	0.934	2.248	0.007	2.025	1.218	3.365
Assistance modality (n=1.023)
Public		1				1
Private	0.008	0.631	0.448	0.889	0.252	0.776	0.502	1.198
Mixed	0.038	0.276	0.082	0.931	0.089	0.269	0.059	1.220
Smoking (n=1.018)
No		1				1
Ex smoker	0.036	1.592	1.031	2.458	0.247	1.350	0.812	2.244
Alcohol intake
No		1				1
Yes	0.036	1.592	1.031	2.458	0.177	1.413	0.856	2.331
Time of renal replacement therapy (n=967)
0 to 2 years		1				1
3 to 5 years	0.444	1.151	0.802	1.653	0.520	1.138	0.768	1.685
6 to 10 years	0.008	1.654	1.138	2.405	0.221	1.300	0.853	1.981
Over 10 years	0.009	1.718	1.143	2.582	0.151	1.393	0.886	2.191
Adopts measures to reduce salt (n=1.011)
Yes		1				1
No	0.001	1.881	1.279	2.765	0.020	1.694	1.085	2.645
BMI (n=1.023)
< 18.5 kg/m²	0.291	0.735	0.415	1.302	0.342	0.735	0.389	1.387
18.5 to 24.9 kg/m²		1				1
25 to 29.9 kg/m²	0.003	0.622	0.454	0.852	0.024	0.661	0.461	0.948
> 30 kg/m²	<0.001	0.379	0.252	0.570	<0.001	0.387	0.246	0.608

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
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[1] Corresponding author: Luciane Bresciani Salaroli E-mail: lucianebresciani@gmail.com