Key result
Targeted risk management strategies significantly reduced the incidence of complications to 10.0% compared to 27.5% with standard care in hemodialysis patients with heart failure.
Why the study?
Heart failure is a common and serious complication in maintenance hemodialysis patients that significantly affects prognosis and quality of life.
Does targeted risk management reduce psychological distress and complications in maintenance hemodialysis patients with heart failure?
RCT (n=170)
Single-blind
Randomized
No
Does targeted risk management reduce psychological distress and complications in maintenance hemodialysis patients with heart failure?
In hemodialysis patients with heart failure, targeted risk-stratified nursing management significantly improves psychological well-being, enhances quality of life, and reduces the incidence of clinical complications.
Background Heart failure (HF) is a common and serious complication in maintenance hemodialysis (MHD) patients, significantly affecting their prognosis and quality of life. This study aims to identify risk factors for HF and evaluate targeted, risk-based nursing interventions. Methods A total of 170 MHD patients admitted between January 2022 and January 2024 were divided into HF (n = 80) and non-HF groups (n = 90) based on the presence or absence of HF. Risk factors were analyzed using univariate and multivariate logistic regression. Subsequently, 80 HF patients were randomized to standard group (n = 40) or study group receiving targeted risk management strategies (n = 40). The intervention lasted 8 weeks and included comprehensive nursing measures based on individualized risk profiles. Outcome measures included Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), complications, quality of life (SF-36), and nursing satisfaction. Results Univariate analysis identified age (OR = 1.076), dialysis duration (OR = 1.054), hypertension (OR = 3.391), diabetes (OR = 2.874), coronary heart disease (OR = 3.115), smoking history (OR = 1.976), HbA1c (OR = 18.675), and C-reactive protein (CRP; OR = 1.466) as risk factors for HF in MHD patients (P < 0.05). Multivariate logistic regression analysis confirmed age (OR = 1.079), HbA1c (OR = 20.371), and CRP (OR = 1.542) as independent risk factors. After management, compared with the standard group, the study group showed significant reductions in SAS and SDS scores and complication incidence (P < 0.05). The quality of life and nursing satisfaction significantly improved in the study group (P < 0.05). Conclusion Age, hyperglycemia, inflammation, and comorbidities (hypertension, diabetes, coronary heart disease) independently increase HF risk in MHD patients. Targeted risk management reduces psychological distress, complications, and enhances care outcomes.
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Sai Chen (2025) conducted an RCT in Maintenance hemodialysis complicated with heart failure (n=170). Targeted risk management strategies vs. Standard care was evaluated on Overall incidence of complications (p=0.045). Targeted risk management strategies significantly reduced the incidence of complications to 10.0% compared to 27.5% with standard care in hemodialysis patients with heart failure.
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