Views and practices of renal nurses in monitoring residual renal function for haemodialysis patients
School of Nursing and Midwifery
Background: Haemodialysis is a treatment option offered to patients with end-stage kidney disease. Patients who commence haemodialysis will often have some degree of residual renal function (RRF) with a continued urine output between treatment schedules. Efforts to preserve the remaining RRF can offer several health benefits for haemodialysis patients. Aim: To explore the views and practices of Australian and New Zealand renal nurses in monitoring RRF of haemodialysis patients between treatment schedules. Methods: This study used a cross-sectional research design. Participants were recruited through distribution of an electronic survey. Quantitative descriptive data were analysed and presented as frequencies, percentages, medians, and interquartile ranges. Reporting of this study adhered to the STROBE checklist. Findings: Fifty-five renal nurses completed the survey. Of these, 10 (18.2 %) always, 41 (74.5 %) sometimes, and 3 (5.5 %) never discussed urine output with patients before commencing haemodialysis. Eight (14.5 %) participants indicated ultrafiltration goals did not include calculations based on urine output between treatment schedules. Discussion: The monitoring of RRF provides several health benefits for patients requiring maintenance haemodialysis. Practice differences in fluid assessment policies did not always account for self-reported urine output. The inclusion of an estimated daily urine output between treatment schedules has the potential to lower ultrafiltration goals minimising the risk of intradialytic hypotension. Conclusion: The survival and quality of life for patients requiring maintenance haemodialysis can be improved by the preservation of RRF. Findings from this study suggest practice differences occur among renal nurses in the monitoring of urine output.