Blended Education and Ice Cube Sipping Intervention in Fluid Restriction Management for Patients with Chronic Kidney Disease (CKD)
Keywords:
blended education, chronic kidney disease, fluid restriction, hemodialysis, sipping ice cube, thirst managementAbstract
Fluid restriction is a crucial component in the management of patients with Chronic Kidney Disease undergoing hemodialysis. However, adherence to fluid restriction remains a significant challenge due to limited patient understanding and the frequent occurrence of excessive thirst. Health education and non-pharmacological interventions, such as ice cube sipping, are considered potential strategies to help patients better manage fluid intake. This literature review aims to analyze the effectiveness of blended education and ice cube sipping interventions in managing fluid restriction among CKD patients. The study employed a systematic review approach based on PRISMA 2020. Literature searches were conducted through Scopus, PubMed, Google Scholar, ProQuest, and ScienceDirect using relevant keywords. Inclusion criteria included full-text articles published between 2016 and 2026 in Indonesian or English. A total of 983 articles were identified from five databases. After the screening and critical appraisal process, 8 eligible studies met the inclusion criteria and were analyzed. The findings indicate that health education interventions significantly improve patient knowledge and adherence to fluid restriction while reducing interdialytic weight gain (IDWG). Additionally, ice cube sipping has been shown to effectively reduce thirst levels, thereby supporting better compliance. Overall, integrating technology-based education with simple thirst-management strategies has strong potential to enhance adherence and improve quality of life in CKD patients.
References
Alilu, L., Pazirofteh, S., Habibzadeh, H., & Rasouli, J. (2024). The impact of teach-back training method (TBTM) on treatment adherence in hemodialysis patients: a randomized controlled trial. Annals of Medicine & Surgery, 86(5), 2723–2728. https://doi.org/10.1097/ms9.0000000000001906
Anggraeni, R., Putri, T. A. R. K., & Agustiyowati, T. H. R. (2023). The Effect of Ice Cubes Sipping on Reducing Thirst Among Hemodialysis Patients. Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal), 9(4). https://doi.org/10.33755/jkk.v9i4.648
Apriyani, Zulaikha, & Putri, A. Dela. (2025). Ice Cube ’ S Therapy for Reducing Thirst Intensity in Kidney Failure. Jurnal Keperawatan Malang, 10(01), 74–80.
Arad, M., Goli, R., Parizad, N., Vahabzadeh, D., & Baghaei, R. (2021). Do the patient education program and nurse-led telephone follow-up improve treatment adherence in hemodialysis patients? A randomized controlled trial. BMC Nephrology, 22(1), 1–13. https://doi.org/10.1186/s12882-021-02319-9
Armiyati, Y., Khoiriyah, K., & Mustofa, A. (2019). Optimization of Thirst Management on CKD Patients Undergoing Hemodialysis by Sipping Ice Cube. Media Keperawatan Indonesia, 2(1), 38. https://doi.org/10.26714/mki.2.1.2019.38-48
Başer, E., & Mollaoğlu, M. (2019). The effect of a hemodialysis patient education program on fluid control and dietary compliance. Hemodialysis International, 23(3), 392–401. https://doi.org/10.1111/hdi.12744
Kara, B. (2016). Determinants of thirst distress in patients on hemodialysis. International Urology and Nephrology, 48(9), 1525–1532. https://doi.org/10.1007/s11255-016-1327-7
Mahyuvi, T., & Hasina, S. N. (2021). Improving the Compliance of Fluid Diet of Patients with Chronic Kidney Failure with Family Support-Based Health Education. Journal for Quality in Public Health, 5(1), 348–353. https://doi.org/10.30994/jqph.v5i1.277
Mailani, F., Muthia, R., Herien, Y., Huriani, E., Chan, C. M., & Abdullah, K. L. (2021). The Fluid Management Experience in Patients with Chronic Kidney Disease Undergoing Hemodialysis in Indonesia: A Qualitative Study. Nurse Media Journal of Nursing, 11(3), 389–403. https://doi.org/10.14710/nmjn.v11i3.38838
Sari, M., & Bayhakki. (2026). Edukasi Pembatasan Cairan Pada Pasien Ckd Yang Menjalani Hemodialisis Dengan Intervensi Sipping Ice Cube Melalui E-Booklet Di Ruang Penyakit Dalam Rsud Arifin Achmad Provinsi Riau. 10, 1226–1230.
Torabikhah, M., Farsi, Z., & Sajadi, S. A. (2023). Comparing the effects of mHealth app use and face-to-face training on the clinical and laboratory parameters of dietary and fluid intake adherence in hemodialysis patients: a randomized clinical trial. BMC Nephrology, 24(1), 1–12. https://doi.org/10.1186/s12882-023-03246-7
Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., … Straus, S. E. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. In Annals of Internal Medicine (Vol. 169, Issue 7, pp. 467–473). American College of Physicians. https://doi.org/10.7326/M18-0850
Parker J. R. (2019). Use of an Educational Intervention to Improve Fluid Restriction Adherence in Patients on Hemodialysis. Nephrology nursing journal : journal of the American Nephrology Nurses' Association, 46(1), 43–47.
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