Nursing Journal Volume 10.
Issue 2.
Page 202-207 e-ISSN: 2354-6050 https://ejurnal.
id/index.
php/JKep DOI: https://doi.
org/10.
32668/jkep.
KNOWLEDGE AND FLUID INTAKE MANAGEMENT LEAD
MAINTENANCE DRY WEIGHT OF PATIENT UNDERGOING
HEMODIALYSIS
Ace Sudrajat* Muhammad Syahrul Hajriyanto Nelly Yardes Dewi Lusiani Santa Manurung Tri Endah Pangastuti Politeknik Kesehatan Kemenkes Jakarta i.
Bekasi.
West Java.
Indonesia email: ace.
sudrajat1963@gmail.
Keywords:
Knowledge.
Fluid Intake Management.
Dry Weight.
Hemodialysis Abstract The incidence of end-stage renal disease in the worldwide.
Approximately 70% .
hree million people worldwid.
progress from renal failure to hemodialysis therapy.
Renal failure is associated with a risk of fluid and electrolyte imbalance.
Dry body weight is an indicator of adherence to fluid management, and the risk of complications prevents critical conditions.
Risk of various complications, such as hypotension or hypertension, categories of knowledge, and lifestyle of fluid restriction.
Knowledge of the relationship between knowledge and management of fluid intake retrieved from dry body weight hemodialysis patients.
Quantitative Research with Cross-sectional Data Respondents and population comprised outpatients in the hemodialysis wards of the Jakarta Islamic Hospital Cempaka Putih zone in mid-year 2024.
spearman rank statistical test knowledge with dry body weight p-value .
<0.
correlation coefficient 0.
fluid intake management, with a dry body weight p-value .
009 <0.
correlation coefficient of 0.
Conclusion: There was a significant relationship between knowledge and fluid intake management and dry body weight of hemodialysis patients.
Future researchers should explore factors that can affect dry body weight.
Received: October 2025 Accepted: October 2025 Published: November 2025 A year The Authors.
Published by Published Jurusan Keperawatan.
Politeknik Kesehatan Kemenkes Jakarta i.
This is Open Access article under the CC-BY-SA License .
ttp://creativecommons.
org/licenses/by-sa/4.
0/).
DOI:
https://doi.
org/10.
32668/jkep.
INTRODUCTION
Globally, millions of people live with end-stage renal disease >30mg/mmol, indicating CKD.
At this stage, renal replacement therapy such as hemodialysis is necessary 4.
and many require renal replacement therapy such as The Indonesian Renal Registry (IRR) reported 17,193 new please replace this sentence with precise, cited patients and 11,689 patients undergoing ESRD in Indonesia in epidemiologic statistics.
According to the World Health 2019, with 2,221 hemodialysis patient deaths 5.
Nutritional Organization (WHO), chronic kidney disease (CKD) accounts education and counseling are vital for maintaining kidney for approximately 9% of the global health burden.
In a survey of function and reducing morbidity in ESRD patients 6.
165 countries, 50% of them offered hemodialysis services 1.
Uncontrolled fluid intake often leads to death by increasing the 2020, kidney failure cases rose to 1.
79 million, with renal dry weight gain 7.
Hemodialysis causes protein and amino acid replacement therapy costs reaching 2.
24 trillion 2.
The primary loss, negatively affecting the protein balance (Ministry of Health issue is kidney failure in eliminating metabolic waste and of the Republic of Indonesia, 2023 8.
Poor fluid management maintaining fluid and electrolyte balance 3.
Hypertension, can cause complications, such as fluid overload, weight gain, glomerulonephritis, and diabetes mellitus affect 90% of ESRD heart failure, and pulmonary edema 9.
The increase in Elevated serum blood urea nitrogen (BUN) leads to hemodialysis patients is due to low public awareness of signs of azotemia, renal glycosuria, increased granularity, glomerular chronic kidney failure and the importance of self-examination.
filtration rate (GFR) levels below 15 ml/min/1.
73m^2, urine Knowledge improves the understanding of disease conditions, albumin content over 300mg/g, and albumin creatinine JKEP (Jurnal Keperawata.
Vol 10 Issue 2.
November 2025.
Page 202-207 e-ISSN: 2354-6050 and highly educated individuals exhibit better self-care than questionnaire were utilized, and reliability and validity tests those with lower education levels 10.
were conducted on 30 respondents.
The knowledge questionnaire demonstrated validity .
652> r Table Previous research has categorized CKD knowledge among .
and reliability .
> .
, while the fluid intake respondents into low .
%), moderate .
7%), and high management questionnaire exhibited validity .
> r .
3%).
The interdialysis body weight for CKD respondents Table .
and reliability .
> .
, indicating their was classified as good .
%), sufficient .
3%), or poor .
7%).
The Spearman rank test indicated a significant suitability for use.
Inclusion Criteria Adults aged 18Ae59 difference in interdialytic weight gain (IDWG) knowledge years,Currently undergoing hemodialysis therapy, informed among patients with chronic kidney failure (P < 0.
consent signed.
One-day-time patients.
Consented to complete the required survey instrument.
and Have been undergoing A previous study divided patients into three categories: good hemodialysis for more than 3 months.
Exclusion Criteria fluid intake .
1%), sufficient fluid intake .
5%), and poor Hearing impairment.
Age over 60 years.
Decreased fluid intake .
4%).
Interdialytic body weight gain (IDWG) in consciousness and Inpatients .
ospitalized patient.
The hemodialysis patients was classified as heavy .
6%), moderate Univariate data analysis was performed on respondent .
%), or light .
%).
The Spearman rank test confirms a characteristics .
ge, sex, education, occupation, and duration of relationship between fluid intake and IDWG in hemodialysis hemodialysi.
and research variables .
nowledge, fluid intake patients 12 .
Previous studies have shown a strong, significant management, and dry weigh.
The strength of the relationship relationship between knowledge and dry weight of between the independent and dependent variables was hemodialysis patients, as well as between fluid intake determined using bivariate analysis with SpearmanAos rank test.
management and dry weight.
As a nurse, it is very important to understand the knowledge and management of fluid intake in RESULTS AND DISCUSSION CKD patients to improve the quality of nursing care.
This study aimed to investigate the correlation between knowledge and The analysis shows that the majority of respondents fluid intake management with the dry weight of hemodialysis were middle-aged .
, with 55 individuals .
3%),
The incidence of end-stage renal disease (ESRD) is predominantly male at 41 .
7%), mainly high school increasing globally.
educated at 39 .
%), and most had undergone METHODS hemodialysis for over 12 months, totaling 58 .
3%).
According to Table 2, data analysis indicated that the This research is quantitative, with statistical analysis and a non- variables of Knowledge.
Fluid Intake Management, and experimental cross-sectional research type.
Nonprobability Dry Body Weight in Hfemodialysis Patients were purposive sampling for sampling techniques.
Using SlovinAos median-split due to non-normal distribution, with an ycA formula ycu = 1 ycA.
2 applied to a population of 204 individuals alpha value of 0.
The analysis showed that with a 10% error tolerance, the calculated sample size of 67.
knowledge was mostly in the good category .
, was rounded to 68 and subsequently increased by 10% to yield 7%).
Fluid Intake Management was predominantly a final requirement of 75 participants.
The type of data is the good .
, 56.
0%), and the Dry Body Weight of primary data .
esearch instrument.
answered by respondents, hemodialysis patients was generally good .
, 46.
and the dry weight observation data.
The study was conducted A Spearman correlation coefficient .
ho = 0.
in April-May 2024 at the Jakarta Islamic Hospital Cempaka indicates a weak-to-moderate positive association Putih.
between knowledge and dry weight.
the clinical A validated and reliable modified dry weight knowledge relevance should be interpreted cautiously.
This finding questionnaire and dry weight fluid intake management aligns with Kartini's study, which also demonstrated a JKEP (Jurnal Keperawata.
Vol 10 Issue 2.
November 2025.
Page 202-207 significant relationship between patient knowledge and Variables dry weight gain in patients with chronic kidney failure e-ISSN: 2354-6050 Frequency .
(%) Median was in line with 13 who reported that hemodialysis Knowledge Poor (O 75%) Good (Ou76%) Fluid Intake Management Poor (O 75%) Good (Ou76%) Dry Weight Bad ( Ou 3%) Good ( < 3%) patients had a good understanding of their disease and A study at Cempaka Putih Islamic Hospital investigated the This aligns with the findings, which identified a association between knowledge, fluid intake management, and relationship between age, sex, education level, and dry body weight in 75 hemodialysis patients.
Most were middle- adherence to fluid restrictions in chronic kidney failure aged men with secondary education, unemployed, and patients undergoing hemodialysis at Kajen Regional undergoing hemodialysis for over 12 months.
The majority had Hospital.
Pekalongan Regency 14.
It shows respondents good knowledge and fluid intake management, and a dry body Putih's weight of less than three percent was more common.
hemodialysis ward were predominantly middle-aged Spearman's rank tests showed significant relationships between males with high school and college education, and had knowledge and fluid intake management with dry body weight.
been on hemodialysis for over a year.
A study conducted The strength of the relationship between knowledge and by Trisnaningtyas et al.
also showed that male patients management of fluid intake with dry weight showed a are more at risk of developing chronic kidney failure moderately strong relationship.
This indicates that the role of because men's work is heavier than women's, and nurses is very important in increasing patient knowledge and women have more estrogen hormones that can inhibit improving patient dry weight monitoring.
undergoing hemodialysis (P < 0.
Spearman's rank test p-value 0.
Most of the participants in this study had good knowledge and good fluid intake management, which Jakarta Islamic Hospital Cempaka the formation of cytokines 19.
Experience and education influence knowledge.
Higher Table 1.
Characteristics of the Study Participants Characteristics Age Early Adulthood .
Middle Adult .
Gender Man Woman Education Primary school High School College/academy Job Not Working Working Hemodialysis Duration 3-6 Months 6-12 Months > 12 Months education enhances an individualAos understanding of their disease conditions and enables better self-care.
Therefore, more Frequency (%) personal or other experiences 11,10,16.
According to findings, which is often acquired through the senses, particularly sight and educated individuals are better at acquiring and processing information than less educated.
Learning can occur through a person's learning ability depends on the information source.
Many respondents preferred to receive education from health workers during hemodialysis sessions.
a better level of knowledge will improve patient self-care.
This is in line with a study the study found that the duration of hemodialysis can affect self-care management and Interdialytic Body Weight Gains (IDWG) 18.
Table 2.
Frequency Distribution of Respondents Based on Knowledge.
Fluid Intake Management and Dry Body Weight Sixteen respondents demonstrated poor knowledge, particularly regarding the definition, influencing factors, indications, and complications associated with dry weight.
These respondents showed limited understanding of the good dry weight gain JKEP (Jurnal Keperawata.
Vol 10 Issue 2.
November 2025.
Page 202-207 e-ISSN: 2354-6050 percentages and complications arising during dialysis.
in patients with kidney failure in regulating fluid intake.
Insufficient knowledge negatively impacts dry weight gain in Managing fluid intake is complicated for patients with CKD.
hemodialysis patients as they fail to comprehend critical Effective management of IDWG is facilitated by a high level of information about their therapy.
Fluid intake is critical for body self-care management, which is influenced by various factors, function for several reasons.
It directly contributes to weight such as personal traits, available resources, daily activities, and gain, particularly in individuals with chronic kidney disease lifestyle choices 18.
Fluid and sodium intake in dialysis patients (CKD), in which fluid removal is compromised due to impaired is managed by adjusting salt and fluid removal through dialysis, kidney function.
This impairment leads to interdialytic weight restricting salt intake, and replenishing fluids between sessions.
gain (IDWG) as excess fluid accumulates in the body, causing Typically, this is done by adjusting the dry weight.
Increasing weight gain between dialysis sessions 12.
the duration or frequency of dialysis sessions for patients with high interdialytic weight gain or fluid intolerance is an effective This study showed that there was a significant relationship solution, as it reduces intradialytic hemodynamic stress and between knowledge and fluid intake management with dry enhances the accuracy of volume assessments through This is in line with a study that reported a significant documented fluid intake and output 4.
Hemodialysis patients relationship between high knowledge and compliance with fluid with dry weight exceeding three percent are prone to intake restrictions in hemodialysis patients 17.
Respondents complications, with factors such as age, sex, education, and with high knowledge were 3.
4 times more likely to comply with duration of hemodialysis contributing to the relationship fluid intake restrictions.
According to a study, showed that between fluid intake management and dry weight 19.
knowledge of fluid restrictions is crucial for effective fluid
Respondents with high knowledge levels tend
CONCLUSION
to have good self-control, self-discipline, and limited In a study conducted at Cempaka Putih Islamic hemodialysis fluids, thus affecting normal dry body weight 11.
Respondents with lower knowledge levels tend to exhibit Hospital, the knowledge, fluid intake control, and excessive fluid intake, leading to higher interdialytic body dry body weight of 75 hemodialysis patients were weight gain (IDWG) 11.
The majority were middle-aged men who had completed secondary school, were The strength of the relationship between knowledge and jobless, and had been receiving hemodialysis for management of fluid intake with dry weight showed a more than a year.
A dry body weight of less than moderately strong relationship.
This indicates that the better the three percent was more prevalent, and most knowledge and management of fluid intake, the better the individuals had a strong understanding and patient's dry weight.
This is due to the learning process and effective fluid intake management.
Significant support from nurses regarding the disease process, treatment procedures, diet, medication, and fluid intake management.
This correlations between dry body weight and fluid is in line with the research, which shows that the existence of intake control and knowledge were found using nurse information support regarding fluid intake management Spearman's rank tests.
There was a moderately during the hemodialysis process is one of the main sources of substantial correlation between dry weight and patients, thus triggering patients to maintain their dry weight 22.
knowledge and fluid intake control.
This suggests that nurses play a critical role in enhancing patient This study is not in accordance with research, which found that dry weight the level of knowledge has no significant relationship to fluid intake with dry 10.
This can be caused by a lack of motivation monitoring and raising patient JKEP (Jurnal Keperawata.
Vol 10 Issue 2.
November 2025.
Page 202-207 Kesehatan Republik Indonesia Tentang Pedoman Nasional Pelayanan Kedokteran Tata Laksana Ginjal Kronik.
NOMOR
HK.
07/MENKES/1634/202.
Hinkle.
Cheever.
Brunner&suddarth's Textbook Of Medical Surgical Nursing Edition.
Philadelphia: Wolters Kluwer Wahyuni.
, & Indarti.
Hubungan Karakteristik.
Pengetahuan Tentang Asupan Natrium Dan Cairan Dengan Interdialytic Weight Gain (IDWG) Pada Penderita Gagal Ginjal Kronik Yang Menjalani Hemodialisis (H.
Holistik Jurnal Kesehatan, 2019.
, 102Ae113.
https://doi.
org/10.
33024/hjk.
Kartini.
Hubungan Pengetahuan Pasien Gagal Ginjal Kronik Dengan Interdialytic Weight Gain (IDWG) Di Ruang Hemodialisis Rsud Sultan Imanuddin Pangkalan Bun.
Skripsi.
Sekolah Tinggi Ilmu Kesehatan Borneo Cendekia Medika.
1Ae105.
Agustin.
Hubungan Asupan Cairan Dengan Interdialytic Weight Gain ( IDWG ) Pada Pasien Chronic Kidney Disease Di Ruang Hemodialisa Rsd Balung Dan Rs Citra Husada Jember Hubungan Asupan Cairan Dengan Interdialytic Weight Gain ( IDWG ) Pada Pasien Chronic Kidney.
Lestari.
Prawito, and Rustanty.
Hubungan Pengetahuan Pasien Tentang Penyakit Gagal Ginjal Kronis Dengan Kepatuhan Diet Di Ruang Hemodialisis RSUD Lawang.
Prima Wijayata Health.
IV 16Ae29.
Komariyah.
Aini.
, & Prasetyorin.
Hubungan Usia.
Jenis Kelamin Dan Tingkat Pendidikan Dengan Kepatuhan Pembatasan Cairan Pada Pasien Gagal Ginjal Kronik Yang Menjalani Hemodialisis.
Jurnal Ilmiah Permas:
Jurnal Ilmiah STIKES Kendal, .
1107Ae1116.
http://journal2.
id/index.
php/PSK M/article/view/2018/1270 Wawan dan Dewi M.
Pengetahuan.
Sikap.
Dan Perilaku Manusia.
Yogakarta: Nurul Medika Anggraini.
, & Nurvinda.
Hubungan Pengetahuan dan Dukungan Keluarga Dalam Kepatuhan Pembatasan Asupan Cairan Pasien Hemodialisa Di RSBT Pangkalpinang.
Jurnal Kesehatan Saelmakers PERDANA, .
357Ae366.
https://doi.
org/10.
32524/jksp.
Wicaksono.
Hubungan Self Care Management Dan Lama Menjalani Hemodialisis Dengan Interdialytic Weight Gain ( IDWG ) Pada ACKNOWLEDGMENT The researcher would like to express his gratitude to the directors of Hospital and all the respondents involved in this study.
REFERENCES