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Background <p>The adverse effect of chronic kidney disease extends far beyond the primary impact on kidney function. Children undergoing Haemodialysis (HD) develop several oral complications such as decreased salivary flow rate and xerostomia. This creates a vicious cycle where the compulsive urge to drink further contributes to fluid overload. Providing a standalone program may not be sufficient to ensure full adherence to fluid restrictions. Auricular Acupressure (AA) induces parasympathetic stimulation which increases salivary flow rate and alleviate persistent feeling of thirst.</p> Aim <p>to assess the effect of bundling AA and fluid restriction program on salivary flow rate and fluid control adherence among children undergoing HD.</p> Methods <p>A single-blinded randomized control trial was conducted at Alexandria University Children’s Hospital in Smouha, Egypt. A sample of 60 children receiving HD was randomly assigned to two parallel groups. The control group received the fluid restriction program through general small-group discussion sessions, individualized consultations, and follow-up. The study group also received the intervention bundle: the fluid restriction program and twelve sessions of AA on four acupoints: Shenmen, Kidney Concha, Point Zero, and Upper Tragus.</p> Results <p>Subjective assessment revealed significant differences in all the parameters of salivary flow rate, such as difficulty in swallowing (<i>p</i> = 0.005), saliva rate in mouth (<i>p</i> = 0.016), dryness in mouth (0.009), dryness in lips (<i>p</i> = 0.002). The objective assessment of the salivary flow rate unveiled that applying the intervention bundle resulted in a notable increase in salivation level (from 33.3 to 86.7%) with <i>p</i>-value &gt; 0.001 compared to a slight increase in the control group (23.3–36.7%). There was a significant improvement in the overall fluid control adherence in both groups with favor to the study group who received the intervention bundle as <i>p</i>-values were &lt; 0.001and 0.047 respectively.</p> Conclusion <p>Bundling AA and fluid restriction programs effectively improved salivary flow rate and fluid control adherence among children undergoing HD attending the HD unit in Alexandria University Children’s Hospital at Smouha, Egypt. Therefore, nurses working in HD units may adopt this intervention bundle as a cost-effective, safe, and complementary tool to promote sustainable patient adherence to fluid-restriction regimen.</p> Trial registration number <p>[NCT06562959], ClinicalTrails.gov, Retrospectively registered (April 8th, 2024), URL of trial registry record: <a href="https://clinicaltrials.gov/study/NCT06562959">https://clinicaltrials.gov/study/NCT06562959</a>.</p>

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Effect of bundling auricular acupressure and fluid restriction program on salivary flow rate and fluid control adherence among children undergoing hemodialysis: a randomized control trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月1日

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  • Zohour Ibrahim Rashwan,
  • Marwa Mohamed Mahmoud Abdellah,
  • Ferial Moursi,
  • Esraa Mohammed Abd El-Samie Ismail

摘要

Background

The adverse effect of chronic kidney disease extends far beyond the primary impact on kidney function. Children undergoing Haemodialysis (HD) develop several oral complications such as decreased salivary flow rate and xerostomia. This creates a vicious cycle where the compulsive urge to drink further contributes to fluid overload. Providing a standalone program may not be sufficient to ensure full adherence to fluid restrictions. Auricular Acupressure (AA) induces parasympathetic stimulation which increases salivary flow rate and alleviate persistent feeling of thirst.

Aim

to assess the effect of bundling AA and fluid restriction program on salivary flow rate and fluid control adherence among children undergoing HD.

Methods

A single-blinded randomized control trial was conducted at Alexandria University Children’s Hospital in Smouha, Egypt. A sample of 60 children receiving HD was randomly assigned to two parallel groups. The control group received the fluid restriction program through general small-group discussion sessions, individualized consultations, and follow-up. The study group also received the intervention bundle: the fluid restriction program and twelve sessions of AA on four acupoints: Shenmen, Kidney Concha, Point Zero, and Upper Tragus.

Results

Subjective assessment revealed significant differences in all the parameters of salivary flow rate, such as difficulty in swallowing (p = 0.005), saliva rate in mouth (p = 0.016), dryness in mouth (0.009), dryness in lips (p = 0.002). The objective assessment of the salivary flow rate unveiled that applying the intervention bundle resulted in a notable increase in salivation level (from 33.3 to 86.7%) with p-value > 0.001 compared to a slight increase in the control group (23.3–36.7%). There was a significant improvement in the overall fluid control adherence in both groups with favor to the study group who received the intervention bundle as p-values were < 0.001and 0.047 respectively.

Conclusion

Bundling AA and fluid restriction programs effectively improved salivary flow rate and fluid control adherence among children undergoing HD attending the HD unit in Alexandria University Children’s Hospital at Smouha, Egypt. Therefore, nurses working in HD units may adopt this intervention bundle as a cost-effective, safe, and complementary tool to promote sustainable patient adherence to fluid-restriction regimen.

Trial registration number

[NCT06562959], ClinicalTrails.gov, Retrospectively registered (April 8th, 2024), URL of trial registry record: https://clinicaltrials.gov/study/NCT06562959.