| Non-adherence in patients on chronic hemodialysis: an international comparison study. | |
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MedLine Citation:
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PMID: 20954134 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Background: Adherence to diet and fluid restrictions by adults on hemodialysis treatment is challenging. This study compared non-adherence (NA) to diet and fluid restrictions between adult US and German hemodialysis patients, and assessed potential predictors for NA. Methods: A cross-sectional multicenter comparative study of 456 adult hemodialysis patients was conducted in 12 outpatient-based hemodialysis centers in the United States and Germany. NA was based on self-report using the Dialysis Diet and Fluid Non-adherence Questionnaire (DDFQ). Laboratory marker, interdialytic weight gain (IDWG) and dialysis adequacy (Kt/V) information were obtained from medical records. Mean time on dialysis was 50 months (range 3-336); mean age was 62 years (range 19-91), with the majority of patients (89.7%) being white. Results: Self-reported frequency of NA to diet was 80.4% and to fluid 75.3% in the total sample. The degree of NA to diet and fluid differed significantly, with the US patients (68.1% vs. 61.1%) reporting less NA when compared with German (81.6% vs. 79.0%) patients (p<0.0001). Phosphorus, albumin, IDWG and Kt/V levels were higher in the US compared with the German subsample (all p<0.0001; IDWG p<0.003). Generalized regression models revealed that education (p<0.01) and smoking (p<0.01) predicted NA to diet, whereas single marital status (p<0.008) and male sex (p<0.04) were independent predictors for NA to fluid. Conclusions: NA persists as one of the most challenging tasks in health care of patients with chronic conditions, including hemodialysis patients. Our findings suggest that patient, condition-related, socioeconomic and health care system-related factors may contribute to NA to diet and fluid restrictions. |
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Authors:
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Christiane Kugler; Ilona Maeding; Cynthia L Russell |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of nephrology Volume: 24 ISSN: 1724-6059 ISO Abbreviation: J. Nephrol. Publication Date: 2011 May-Jun |
Date Detail:
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Created Date: 2011-05-12 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9012268 Medline TA: J Nephrol Country: Italy |
Other Details:
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Languages: eng Pagination: 366-75 Citation Subset: IM |
Affiliation:
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1 Division of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, ?Hannover - Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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