Objectively measured and self-reported nonadherence among Jordanian patients receiving hemodialysis

This study assessed nonadherence behavior to diet and fluid restrictions and examined the association between nonadherence behavior and demographic and clinical characteristics among Jordanian adults with end-stage renal disease receiving hemodialysis. A descriptive, correlational, cross-sectional design was used. The patients were interviewed within the first 90 minutes of dialysis session using the Dialysis Dietary and Fluid Nonadherence questionnaire (DDFQ). Demographic and clinical data were gathered from the patients and the medical records. The objective markers of dietary and fluid nonadherence (potassium, phosphorus, blood urea nitrogen, and interdialytic weight gain) were followed for the last 3 months, and average values were calculated. Diet and fluid nonadherence was common among Jordanian hemodialysis patients as 17-80% were nonadherent using different measures. Significant strong associations were found between the DDFQ subscales, and significant moderate associations between DDFQ and objective markers of dietary and fluid nonadherence. Youth, male gender, smokers, prolonged dialysis vintage, and less residual renal function were associated with nonadherence regardless of the measures used. There was substantial consistency between the DDFQ and objective measures of dietary and fluid nonadherence among Jordanian adults with end-stage renal disease receiving hemodialysis. Future interventional research should incorporate DDFQ and objective markers to measure dietary and fluid nonadherence and health-related outcomes.