Adherence of adult Chronic Kidney Disease patients with regard to their dialysis, medication, dietary and fluid restriction

Abstract

Objective: Chronic Kidney Disease (CKD) has become a major health problem as a result of complicated interrelationships with diabetes mellitus, hypertension and other associated diseases. Effective management of CKD depends on patient's adherence to their dialysis plan, medications, dietary and fluid restrictions. This study aimed at systematically reviewing the adherence of adult Chronic Kidney Disease (CKD) patients with regard to their dialysis, medication, dietary and fluid restriction.Methods: Key words were used for the search in various data bases: "adherence", "Chronic Kidney Disease", "dialysis", "medication", "dietary" and "fluid restriction". Online data bases namely Medline, PubMed, Ebsco Host, CINAHL, google scholar and grey literature were used to identify published research from 1993 -2016. Forty three (43) articles were identified regarding adherence of CKD patients to dialysis, medication, dietary and fluid restriction.Results: Medication non adherence ranged from 3 to 80% through self-report, structured interview and biological markers. Fluid non-adherence was 10-74%. Using self-report and biological markers, nonadherence to diet was 2-39% and 19-57% respectively. With regards to dialysis, skipping and shortening hemodialysis adherence ranged from 2.5% -19% and 20.3% -32.3 % respectively. Globally, adherence rates to CAPD are not well documented in literature. Conclusion:Non-adherence to dialysis, medication, dietary and fluid restriction is an area of concern internationally in CKD population. Furthermore, non-adherence rates are not well researched and documented in African literature. Therefore, Nephrology professionals in clinical practice are agents of improving adherence of CKD patients to ensure effective management of the disease.Keywords: Adherence and non-adherence to medication, fluid, diet and dialysis, Chronic Ambulatory Peritoneal Dialysis (CAPD), Chronic Kidney Disease (CKD) and hemodialysis. Méthodes: Les mots clés suivants ont été utilisés pour la recherche: l'observance, la maladie rénale chronique, la dialyse, la médication, la restriction alimentaire et la restriction des fluides. La recherche a identifié 47 articles qui quantifient l 'adhérence des patients CKD à la dialyse, à la médication, à la restriction alimentaire et à la restriction des fluides.Résultats: La non-adhésion aux médicaments variait de 3 à 80% grâce à l'auto-évaluation, à l'entrevue structurée et aux marqueurs biologiques. La non-adhésion fluide de 30-74% en utilisant l'auto-rapport et de 10 à 60% sur la base d'un gain de poids interdialytique inapproprié. À l'aide de marqueurs biologiques et d'auto-évaluation, la nonadhésion à l'alimentation était respectivement de 2 à 39% et de 19 à 57%. En ce qui concerne la dialyse, le saut et le raccourcissement de l'hémodialyse ont varié respectivement de 2,5% à 19% et de 20,3% à 32,3%. Globalement, les taux d'adhésion à la CAPD ne sont pas bien documentés dans la littérature. Conclusion:Des preuves documentées ont révélé une non-adhésion à la dialyse, aux m...

Adherence to Hemodialysis and Associated Factors among End Stage Renal Disease Patients at Selected Nephrology Units in Rwanda: A Descriptive Cross-Sectional Study

“…It cannot be overstated that nonadherence has significant poor health outcomes and therefore patients with ESRD and undergoing hemodialysis should be encouraged to complete their dialysis sessions as prescribed. Findings of our study differ considerably from the findings of developed countries such as Japan and Sweden, where the missed dialysis sessions were nearly zero [ 17 ]. It is also noted that the shortening dialysis session in the present study was observed among 5% of the participants.…”

“…The findings from this study revealed low adherence in 49% of ESRD participants. The findings are consistent with findings from other studies that estimated 50% of patients on hemodialysis not adhering to at least part of their dialysis regimen [ 16 , 17 ]. Similarly, thirty-nine percent of the study population missed their dialysis sessions at least once.…”

Factors associated with adherence to dietary prescription among adult patients with chronic kidney disease on hemodialysis in national referral hospitals in Kenya: a mixed-methods survey

“…Most accessible studies reporting on adherence to dietary restrictions among patients with CKD are outside the African continent [7,[22][23][24]. In Kenya, documented research on adherence to dietary prescriptions among adults with CKD on hemodialysis is either non-existent or, if there is, non-accessible.…”

The effect of nutritional education based on health belief model on nutritional knowledge, Health Belief Model constructs, and dietary intake in hemodialysis patients

“…[2] Nutritional treatment in Chronic Kidney Disease (CKD) reduces symptoms of uremia and anemia, decreases the imbalances of fluid and electrolyte, reduces vulnerability of patients to infections, and restricts catabolism. [3] Patients undergoing HD often struggle to cope with their conditions and deny their need for treatment regimens until the complications of non-observance appear and become intolerable. If patients are aware of the rationale of following the diet and the complications of non-adherence and believing that these complications can endanger their life, they may be more likely to act on recommendations.…”