Nonadherence in Hemodialysis Patients and Related Factors: A Multicenter Study

Area of Science:

• Nephrology
• Public Health
• Patient Adherence Research

Background:

• Nonadherence to treatment regimens significantly increases hospitalization and mortality risks in hemodialysis (HD) patients.
• Sociodemographic, biochemical, and psychosocial factors (e.g., depression, anxiety) influence nonadherence, but their relative importance requires further clarification.

Purpose of the Study:

• To identify specific factors contributing to nonadherence in patients undergoing hemodialysis.
• To investigate nonadherence to dietary and fluid restrictions, HD sessions, and prescribed medications.

Main Methods:

• A descriptive study involving 274 HD patients across four centers in Turkey.
• Nonadherence assessed via dialysis session adherence, Kt/V levels, dietary/fluid intake parameters (serum phosphorus, potassium, weight gain), and medication adherence scales.
• Logistic regression analysis was employed to identify predictors of nonadherence.

Main Results:

• High rates of nonadherence observed: 39.1% for dietary/fluid restrictions, 33.6% for HD, and 20.1% for medication.
• Risk factors for nonadherence included higher educational status (diet/fluid), male gender (HD), and central venous catheter use (HD).
• Longer duration of HD treatment was associated with a decreased risk of nonadherence.

Conclusions:

• Educational background, male sex, central venous catheter presence, and shorter HD duration are significant risk factors for nonadherence.
• Healthcare providers, particularly nurses, should routinely assess patient adherence to all aspects of the treatment plan at each visit.