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논문분류	춘계학술대회 초록집
제목	Non-Adherence to Dialysis among Saudi Patients- Causes and Consequences
저자	Abdulla Al-Sayyari, Alanoud Alhawery, Fayez Hejaili
출판정보	2019; 2019(1):
키워드	Non adherence \| Kt/V \| Dialysis \| ntradialytic weight gain
초록	Dialysis non-adherence among Saudi hemodialysis (HD) patients has not been studied previously. We study its prevalence, causes and consequences of non-adherence. All HD patients in our center were studied. Their demographics as well as Hb, Kt/v, K, and phosphate, dialysis type, dialysis vintage, duration and shift were recorded. Non-adherence, defined as missed dialysis session or patient –derived shortening of the dialysis session by > 10 minutes over a month’s period were recorded. We analyzed the relationship of on-adherence to hospitalizations, interdialytic weight gain , intradialytic symptoms., home to hospital distance and smoking habits 265 patients were included; mean age was 61.8± 18.2 years, 47.3% were male, dialysis vintage was 3.8± 3.3 years, and 65.9% were on HD and 34.1 % on hemodiafiltraion (HDF) The non-adherence rate was 25% for missed dialysis session and 72% for shortened dialysis for at least on one occasion. No adherence was more likely to occur in males (75% and 66% respectively (p= 0.05), smokers (57.1 % versus 21.7% (p=0.0003) and night rather than day shifts ( 33.6% versus 20.6 % (p=0.042) Non adherent patients had lower Kt/V (1.22± 0.2 and 1.31± 0.2 respectively (p=0.01), higher mean intradialytic weight gain (2.7 ±1.0 and 2.4± 1.0 Kgs respectively (p=0.02) and are more likely to be hospitalized ( 50% versus 32% (p= 0.01) On the other hand, no difference between non adherent and adherent were observed in serum P, K or hemoglobin levels or intradialytic symptoms, education, employment, in the distance between the dialysis unit and home, type of dialysis, Charlson comorbidity index or the dialysis vintage. Non adherence in our group was comparable to other reports and more likely to occur in male patients, smokers and in night shifts. It is associated with lower dialysis adequacy, higher mean intradialytic weight gain weight and higher hospitalization rate.
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