Predictors of nonadherence with blood pressure regimens in hemodialysis

Hypertension is very poorly controlled in patients on hemodialysis (HD). Demographic and psychosocial predictors of nonadherence with blood pressure (BP) regimens in HD have not been investigated. A study of 118 HD patients from six outpatient HD units was conducted to determine the relationship between demographic/psychosocial factors and adherence with BP-related regimens, ie, fluid restriction, BP medication adherence, and HD treatment adherence.

Descriptive statistics, Pearson correlations, and multiple regressions were conducted to analyze and determine the relationships between variables.

Younger age was related to increased fluid gains (r = -0.37, P < 0.01), decreased medication adherence (r = -0.19, P = 0.04), increased missed HD treatments (r = -0.37, P < 0.01), and diastolic BP (r = -0.60, P < 0.01). Female sex was significantly related to decreased fluid gains (r = -0.28, P < 0.01). Race was related to increased missed HD treatments (r = 0.22, P = 0.02). Increased social support was related to decreased missed HD treatments (r = -0.22, P = 0.02). Depression scores were inversely related to decreased medication adherence scores (r = 0.24, P = 0.01).

By identifying risk factors for nonadherence with BP-related regimens (young age, male sex, decreased social support, and depression), health care providers can plan early clinical intervention to minimize the risk of nonadherence.