Bridging the nutritional care gap: nurse-led education for potassium control in hemodialysis patients

In Morocco, a persistent gap exists between recommended standards of care and routine clinical practice in hemodialysis units, largely due to the high clinical workload of nephrologists and the absence of dietitians in several public hemodialysis centers. This shortage restricts individualized dietary and lifestyle counseling. This study aimed to explore the feasibility and potential clinical relevance of a simple, nurse-led educational intervention designed for hemodialysis centers operating without nutrition specialists.

A quasi-experimental, single-arm, pre-post pilot study was conducted from February to June 2025 among 30 hemodialysis patients from three Moroccan centers with no permanent or visiting dietitians. The educational program focused on dietary potassium management, fluid intake control, thirst management strategies, and basic physical activity recommendations. Outcomes included serum potassium levels, quality of life (EQ-5D-5L), and interdialytic weight gain, assessed at baseline (T0) and post-intervention (T1).

Serum potassium levels significantly decreased after the intervention (p = 0.002), and the proportion of patients within the recommended range (4-5 mmol/L) increased from 36.7% at T0 to 46.7% at T1. No statistically significant changes were observed in quality of life or interdialytic weight gain.

In this pilot study, a nurse-led educational intervention was associated with improved serum potassium control among hemodialysis patients in resource-limited settings lacking specialized nutrition personnel. However, no meaningful changes were observed in interdialytic weight gain or quality of life, suggesting that more intensive or individualized interventions may be required to influence these outcomes.