Non-Compliance of Hemodialysis and Related Factors among End-Stage Renal Disease Patients

Abstract

Objective:

This cross-sectional study was conducted to find out the frequency and factors responsible for treatment noncompliance among patients with End-Stage Renal Disease (ESRD) on hemodialysis.
Methods:

This cross-sectional study was conducted at Sindh Institute of Urology and Transplantation (SIUT) Karachi, Pakistan from March 2014 to July 2015. ESRD patients of either gender aged 18 to 60 years, who were on maintenance hemodialysis were included. The missing of at least one hemodialysis sessions per month was labeled as non-compliance. Moreover, detrimental factors like age, gender, duration of dialysis, lack of family support, lack of transport facility, and financial constraint were observed. 

Results:

Out of 952 patients, 238 (25%) were non-compliant. A significantly higher rate of non-compliance was reported in
patients with more than 40 years of age (p-value <0.001) and those on dialysis for more than 12 months (p-value <0.001). Among the non-compliant patients, lack of transportation 56.3% (134/238) was the commonest reason of non-compliance followed by lack of family support 35.7% (85/238) and financial constraint 11.76% (28/238) cases. The financial constraint as a reason for compliance was significantly related to gender (p<0.001) and duration of dialysis (p 0.035) while the absence of transportation facilities as the reason for non-compliance was associated with age (p-value <0.001) and dialysis length (p-value <0.001). Whereas the absence of family support was associated only with dialysis duration (p-value <0.001). 

Conclusion:

Missing of dialysis treatment sessions affects a big proportion of maintenance hemodialysis patients. Lack of transportation was reported as the most common reason for non-compliance.