Factors Associated with Nonadherence to Dietary Prescriptions among Hemodialysis Patients, Makkah, Saudi Arabia

Abstract

The nonadherence of hemodialysis (HD) patients correlates with morbidity and mortality. Despite severe consequences, noncompliance with their medical regimen is the norm for HD patients rather than the exception. Factors associated with nonadherence to dietary restrictions among HD patients have been explored in many studies; however, most were in Western countries and there is a remarkable paucity of studies in Saudi Arabia. HD patients have several features that put them at an increased risk of nonadherence to dietary restrictions, including prolonged, intensive treatment, and their medical regimens are easily determined with objective measures. This crosssectional study aimed to determine factors related to nonadherence to dietary restrictions among 361 HD patients randomly selected from HD centers in Makkah, Saudi Arabia. Individuals were assessed for adherence using the End-Stage Renal Disease – Adherence Questionnaire in addition to clinical examinations and laboratory investigations. Female patients were more likely to be nonadherent to dietary restrictions. Adherence to dietary restrictions was relatively higher among non-Saudi patients, older people, those who are married, those with university qualifications, those who are employed, and those with higher monthly incomes; nevertheless, these differences were not statistically significant. Despite the relatively higher frequency of adherence to dietary restrictions among patients with a duration of dialysis of <60 months, hypertensive patients, patients with a previous kidney transplant, and those with a previous history of psychiatric illnesses, these differences were not statistically significant. Patients with factors associated with nonadherence to dietary restrictions deserve special attention and support to improve their adherence.