Patients' adherence to aspects of haemodialysis regimens in tropical north Queensland, Australia.

Background: Patients with end-stage kidney disease often have difficulty in adhering to aspects of their haemodialysis regimens.
Objectives: This study aimed to quantify the number of patients who attended 100% of their scheduled haemodialysis sessions, and the number of patients who gained no more than one kilogram per day between dialysis sessions, over a three-month period.
Design: Retrospective chart audit
Participants: Patients undergoing haemodialysis at an in-hospital centre in tropical Australia.
Methods: A renal nurse audited the 72 charts pertaining to a 12-week period in 2013.
Results: Patients attended 90.1% of all scheduled dialysis sessions. Forty-one patients attended all sessions, with the remaining 31 missing at least one scheduled session. One patient missed 16 scheduled sessions. The following were statistically less likely to attend all their scheduled sessions: Aboriginal and Torres Strait Islander patients; patients on a three times per week dialysis schedule; patients who had relocated from rural or regional towns and younger patients. The average daily weight gain ranged from 0.414 kg to 1.017 kg (mean = 0.885 kg). Younger patients were statistically less likely to adhere to fluid restrictions; patients without diabetes were more likely to adhere to the fluid allowances.
Conclusions and Applications to Practice: Renal services need to assist patients to adhere to their regimens. Initially, this service will examine strategies to maximise the likelihood of patients attending all of their dialysis sessions. Such an outcome will help to delay deterioration in the patients' health status, while minimising additional strain on the health service.
(© 2015 European Dialysis and Transplant Nurses Association/European Renal Care Association.)