Non-adherence to hemodialysis, perception of the illness, and severity of advanced nephropathy

Abstract

Introduction: Hemodialysis (HD) is a complex therapy that imposes several changes in the patient's life. Failure to follow therapy recommendations is called non-adherence (NA). The patient's illness perception, severity of chronic kidney disease, and individual strategies for coping with HD can have an impact on NA to the demands of therapy. Methods: This was a cross-sectional study with end-stage renal disease patients on conventional HD in Salvador, Bahia. We evaluated attendance to treatment and interdialytic weight gain (IDWG) as parameters of NA to HD, and investigated its association with clinical aspects and measures of disease perception (illness effects questionnaire - IEQ) and severity of nephropathy (end stage renal disease severity index - ESRD-SI), by analyzing Pearson or Spearman correlation. Results: 79 patients were evaluated, 57% male, aged 53.1 ± 12.3 years, with length of HD of 108 (89 - 131.5) months. Age correlated with ESRD-SI (r = 0.43) and NA parameters: negative correlation with relative IDWG (r = -0.41) and reduction in sessions (r = -0.31) and positive correlation with %HD performed (r = 0.25). The scores on the IEQ and ESRD-SI showed a positive correlation (r = 0.44; p <0.001), but did not show any correlation with the analyzed NA parameters. Conclusions: We did not find a correlation between illness perception and severity index of advanced nephropathy with the behaviors of NA to chronic HD. In this study, age correlated both with the perception of severity of advanced nephropathy and the parameters of NA to chronic HD.

Adherence to treatment in patients with chronic kidney disease undergoing hemodialysis

“…The patient's understanding that he/she has some control over the therapy can encourage absences and reduced sessions. Other justifications that may motivate absences include rigid schedules, length of stay during the session, and the existence of post-HD symptoms 26 .…”

“…Excessive IDWG constitutes non-compliance with water and nutritional recommendations and generates the risk of hypervolemia with potential complications 26 . People who do not comply with water restrictions present with more symptoms.…”

Quality of life in the older adults: The protective role of self-efficacy in adequate coping in patients with chronic diseases

“…For example, owing to negative emotions, patients perceive that the duration of the disease is much longer and the consequences to be more severe while greater personal and treatment control corresponds to a less severe perception of the consequences of the disease. This is observed in chronic diseases in general ( Özkan Tuncay et al, 2018 ; Cheng et al, 2020 ; Giuffrida et al, 2021 ; Szabó-Bartha and Mirnics, 2021 ) and cases of chronic renal failure ( Dantas et al, 2020 ), multiple sclerosis ( Timkova et al, 2021 ), hepatitis B and C ( Ekmen et al, 2021 ), leukemia ( Arrato et al, 2022 ), and systemic lupus erythematosus ( Elefante et al, 2020 ).…”