Nutrition Education on Health Outcomes in Hemodialysis Patients

Abstract

Malnutrition is a prevalent issue among patients with End-Stage Renal Disease (ESRD) on hemodialysis, contributing to increased morbidity and mortality. Common challenges include poor dietary adherence, protein-energy wasting, and electrolyte imbalances. Nutritional education has been proposed as a key intervention to improve health outcomes in this population. This systematic review aimed to evaluate the effectiveness of nutritional education interventions on clinical outcomes, dietary adherence, and quality of life among ESRD patients undergoing hemodialysis. A total of 22 studies, including randomized controlled trials, quasi-experimental, and observational designs, were analyzed. The review followed PRISMA guidelines to ensure a comprehensive assessment of the literature. Data were extracted using an adapted Cochrane template, and study quality was assessed using the Cochrane Risk of Bias Tool. Interventions included telehealth counseling, in-person sessions, group education, and educational materials. Nutritional education interventions significantly improved key biochemical markers, such as potassium and phosphorus levels. Improvements were also observed in malnutrition rates, muscle mass, and adherence to dietary guidelines, with personalized approaches, including telehealth and one-on-one counseling, yielding the best outcomes. Quality of life and self-management behaviors showed positive trends, although results varied due to differences in study designs and intervention formats. Nutritional education is effective in improving clinical outcomes, dietary adherence, and quality of life for ESRD patients on hemodialysis. Despite the benefits, the variability in approaches and outcomes highlights the need for a more standardized and consistent delivery of nutrition education.