Non-compliance to diet and fluid restrictions in haemodialysis patients

Compliance with fluid and dietary instructions is a critically significant factor in the health and well-being of haemodialysis patients. Serial measurement of serum potassium (K) and interdialytic weight gain (IWG) were carried out in 50 haemodialysis patients at the Kidney Centre over a period of one month. Sixty-two percent were males. Ages ranged from 19-69 years (mean 49 years). Duration on dialysis varied from 6 months to 9 years. Patients with an IWG > 1.5 Kg and/or serum K+ > 5.5 m Eq/L were defined as non-compliant. Thirty-two patients (64%) were non-compliant in either diet or fluid. In 13 of these cases, both serum K and IWG were elevated. In the remaining 19, only one value was high. Predictors of non-compliance to diet and fluid regimens were older age (81%), males (68%), less education (75%), single (90%) depression (59%) and not feeling responsible for one's own well-being (85%). Attempts to improve compliance should be aimed by exposing the non-compliant group to nutritional and psychosocial therapy.