Prevalence and Predictors of Nonadherence to Hemodialysis

Abstract

Background: The prevalence of nonadherence to dialysis (NAD) presents a wide variation, depending on the parameters used and demographic regions studied. This study aimed to assess the prevalence and predictors of NAD of patients with chronic kidney disease undergoing hemodialysis (HD). Materials and Methods: This was a cross-sectional study with 255 adult patients receiving HD for >3 months. Skipping a session per month, shortening a session for at least 10 min, phosphorus >7.5 mg/dl, potassium >6.0 mmol/l and interdialytic weight gain (IDWG) >5.7% of body weight were indicative of NAD. The association of sociodemographic and clinical variables with NAD was assessed using logistic regression. Results: Mean age was 50 ± 13.1 years, 62.7% were male, 85.5% were of African descent and 62% were married. The prevalence rates of NAD were: 49% of shortening sessions, 18% of hyperkalemia, 12% of hyperphosphatemia, 9% of IDWG >5.7% of dry weight and 8% of skipping HD. Independent predictors of NAD were: age ≤50 years, not being married, living alone, living in Salvador, attending dialysis without a companion, ethnic African descent, Kt/V <1.3 and residual diuresis <100 ml/day. Conclusion: NAD is frequent and distinct sociodemographic and clinical variables predict different parameters.

Factors associated with treatment adherence of Brazilian patients undergoing hemodialysis

“…This same association was observed in other studies addressing adherence to different aspects of the treatment (Alkatheri et al, 2014;Dantas et al, 2013;Sgnaolin, Prado & Figueiredo, 2012).…”

“…were higher than those observed in previous studies (Dantas et al, 2013;Ibrahim, Hossam & Belal, 2015).…”

Psychiatric disorders, body mass index and C-reactive protein in dialysis patients

“…The annual mortality rate in dialysis patients is approximately 21% (77), and the main causes of death are cardiovascular diseases (78,79). Non-adherence to hemodialysis, dietary restrictions and excessive interdialytic fluid weight gain are all risk factors for premature death (80). Refusing treatment or committing suicide is also a reason for premature death in international studies in this population group (78).…”

The effect of a hemodialysis patient education program on fluid control and dietary compliance

“…In several other studies conducted on the issue, it was concluded that as age increased so did adherence. [31][32][33] These results can be interpreted as the fact that physical activity decreases in elderly individuals due to physiological processes, and thus they tend to eat and drink less. 34 In conclusion, the participants' adherence to diet and fluid restriction increased in the intervention group after the repetitive and planned training sessions they were given by nurses.…”

“…The comparison of the results of the present study in terms of the participants' age demonstrated that nonadherence to diet and fluid restrictions decreased as their age increased. In several other studies conducted on the issue, it was concluded that as age increased so did adherence . These results can be interpreted as the fact that physical activity decreases in elderly individuals due to physiological processes, and thus they tend to eat and drink less…”