Clinical and genetic characterization of BEST1-associated retinal dystrophies in the Norwegian population.

Rapid population aging in Korea has contributed to a growing prevalence of chronic diseases []. Among these, chronic kidney disease is a major condition that necessitates renal replacement therapy for survival. According to the 2024 Korean Renal Data System Annual Report published by the Korean Society of Nephrology (KSN), 117,933 patients (84.6%) were receiving hemodialysis in 2023, and individuals aged 65 years or older accounted for 59.8% of this population, indicating a pronounced aging trend among patients undergoing dialysis []. These demographic shifts underscore the increasing importance of structured educational interventions aimed at enhancing patients’ self-management capacity []. Although hemodialysis is a life-sustaining therapy, it alone is insufficient to adequately control electrolyte balance and remove metabolic waste, making strict dietary management essential []. Dietary adherence in hemodialysis patients is closely associated with key physiological indicators, including interdialytic weight gain (IDWG), hemoglobin (Hb), total protein (TP), albumin (Alb), serum potassium (K), calcium (Ca), and phosphorus (P) [,]. However, despite receiving dietary education, many hemodialysis patients forget the information over time or struggle to maintain appropriate dietary practices. This suggests that single-session education has limitations in promoting long-term behavioral change []. Although these challenges affect many patients undergoing hemodialysis, they may be particularly pronounced among older adults and individuals with low health literacy. Patients with limited health literacy often experience difficulty understanding complex dietary recommendations and translating such knowledge into sustained dietary practices [,]. Spaced repetition, a learning strategy involving repeated exposure to information at regular intervals, has been shown to strengthen long-term memory retention and delay forgetting []. Previous studies have demonstrated that repetitive dietary education significantly improves dietary knowledge and self-care adherence in hemodialysis patients [,]. Such an approach may be particularly beneficial for patients who experience difficulty retaining or applying dietary information in daily life.