Hemodialysis patients’ compliance and adherence behaviors to renal replacement therapy in two dialysis centers in Iloilo City

Abstract

Introduction: Approximately 120 per million population develop kidney failure, translating to about 10,000 Filipinos needing to replace their kidney function per year. If without the appropriate intervention, those having kidney failure will surely die. The study aims to evaluate the compliance of hemodialysis (HD) patients to renal replacement therapy (RRT) in two dialysis centers in Iloilo City, and to compare the prevalence of non-adherence in between groups.

Methods: A cross-sectional study where subjects answered the End-Stage Renal Disease–Adherence Questionnaire (ESRD-AQ).

Results: Of the 102 patients, 59.8% (n=61) were enrolled. The mean age was 47 years with average HD vintage of 30 months. More females were non-adherent to HD treatment, 17.1% vs.15.4%; whereas more males were non-adherent to the remainder descriptors (medications, 11.5% vs. 8.6%; fluid restriction, 23.1% vs. 17.1%; and diet recommendations 30.8% vs. 25.7%). There were less non-adherent patients than adherent ones (HD attendance, 9,803.92 vs. 50,000; medications, 5,882.35 vs. 53,921.57; fluid restriction, 11,764.71 vs. 48,039.22; and diet, 16,666.67 vs. 43,137.25 per 100,000). There were significant differences in their behaviors toward HD attendance (p=0.000); shortening of HD treatment (p=0.000); duration of shortening HD (p=0.000); adherence to medications (p=0.000); to fluid (p=0.000); and to diet (p=0.000). Both groups demonstrated the same level of perception and understanding towards the importance of HD (p=0.306 and 0.096, respectively). There was no significant difference in their perception to medications (p=0.427); however, figures illustrate a significant difference in their levels of understanding towards its importance (p=0.001). Adherent subjects have better perception and understanding in fluid restriction regimen and dietary recommendations as data show significant differences in between groups (p=0.000 and 0.000; and p=0.001 and 0.004, respectively).

Conclusion: The compliance of adherent subjects to HD treatment, medications, fluid restriction protocol and dietary recommendations was more adequate. The non-adherent subjects were less prevalent than adherent subjects.