No Difference in Average Interdialytic Weight Gain Observed in a Randomized Trial With a Technology-Supported Behavioral Intervention to Reduce Dietary Sodium Intake in Adults Undergoing Maintenance Hemodialysis in the United States: Primary Outcomes of the BalanceWise Study

Mary Ann Sevick; Beth M Piraino; David E St-Jules; Linda J Hough; Joseph T Hanlon; Zachary A Marcum; Susan L Zickmund; Linda G Snetselaar; Ann R Steenkiste; Roslyn A Stone

doi:10.1053/j.jrn.2015.11.006

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No Difference in Average Interdialytic Weight Gain Observed in a Randomized Trial With a Technology-Supported Behavioral Intervention to Reduce Dietary Sodium Intake in Adults Undergoing Maintenance Hemodialysis in the United States: Primary Outcomes of the BalanceWise Study

Journal article

Peer reviewed

No Difference in Average Interdialytic Weight Gain Observed in a Randomized Trial With a Technology-Supported Behavioral Intervention to Reduce Dietary Sodium Intake in Adults Undergoing Maintenance Hemodialysis in the United States: Primary Outcomes of the BalanceWise Study

Mary Ann Sevick, Beth M Piraino, David E St-Jules, Linda J Hough, Joseph T Hanlon, Zachary A Marcum, Susan L Zickmund, Linda G Snetselaar, Ann R Steenkiste and Roslyn A Stone

Journal of renal nutrition, Vol.26(3), pp.149-158

05/2016

DOI: 10.1053/j.jrn.2015.11.006

PMCID: PMC5031139

PMID: 26868602

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Abstract

To evaluate the efficacy of behavioral counseling combined with technology-based self-monitoring for sodium restriction in hemodialysis (HD) patients. Randomized clinical trial. English literate adults undergoing outpatient, in-center intermittent HD for at least 3 months. Over a 16-week period, both the intervention and the attention control groups were shown 6 educational modules on the HD diet. The intervention group also received social cognitive theory-based behavioral counseling and monitored their diets daily using handheld computers. Average daily interdialytic weight gain (IDWGA) was calculated for every week of HD treatment over the observation period by subtracting the post-dialysis weight at the previous treatment time (t-1) from the pre-dialysis weight at the current treatment time (t), dividing by the number of days between treatments. Three 24-hour dietary recalls were obtained at baseline, 8 weeks, and 16 weeks and evaluated using the Nutrient Data System for Research. A total of 179 participants were randomized, and 160 (89.4%) completed final measurements. IDWGA did not differ significantly by treatment group at any time point considered (P > .79 for each). A significant differential change in dietary sodium intake observed at 8 weeks (-372 mg/day; P = .05) was not sustained at 16 weeks (-191 mg/day; P = .32). The BalanceWise Study intervention appeared to be feasible and acceptable to HD patients although IDWGA was unchanged and the desired behavioral changes observed at 8 weeks were not sustained. Unmeasured factors may have contributed to the mixed findings, and further research is needed to identify the appropriate patients for such interventions.

United States

Humans

Middle Aged

Male

Treatment Outcome

Ethnic Groups

Renal Dialysis - adverse effects

Female

Sodium, Dietary - administration & dosage

Aged

Nutritional Status

Weight Gain

Behavior Therapy - methods

Details

Title: Subtitle: No Difference in Average Interdialytic Weight Gain Observed in a Randomized Trial With a Technology-Supported Behavioral Intervention to Reduce Dietary Sodium Intake in Adults Undergoing Maintenance Hemodialysis in the United States: Primary Outcomes of the BalanceWise Study
Creators: Mary Ann Sevick - Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, New York, New York. Electronic address: mary.sevick@nyumc.org
Beth M Piraino - School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
David E St-Jules - Center for Healthful Behavior Change, Department of Population Health, New York University School of Medicine, New York, New York
Linda J Hough - Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
Joseph T Hanlon - School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
Zachary A Marcum - School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
Susan L Zickmund - School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
Linda G Snetselaar - College of Public Health, University of Iowa, Iowa City, Iowa
Ann R Steenkiste - Veterans Research Foundation of Pittsburgh, Pittsburgh, Pennsylvania
Roslyn A Stone - Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
Resource Type: Journal article
Publication Details: Journal of renal nutrition, Vol.26(3), pp.149-158
DOI: 10.1053/j.jrn.2015.11.006
PMID: 26868602
PMCID: PMC5031139
NLM abbreviation: J Ren Nutr
ISSN: 1051-2276
eISSN: 1532-8503
Publisher: United States
Grant note: P30 AG024827 / NIA NIH HHS R01 NR010135 / NINR NIH HHS K24 NR012226 / NINR NIH HHS T32 AG021885 / NIA NIH HHS K07 AG033174 / NIA NIH HHS R01 AG027017 / NIA NIH HHS
Language: English
Date published: 05/2016
Academic Unit: Epidemiology; Internal Medicine
Record Identifier: 9983995152402771

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