Adherence of adult Chronic Kidney Disease patients with regard to their dialysis, medication, dietary and fluid restriction
Objective: Chronic Kidney Disease (CKD) has become a major health problem as a result of complicated interrelationships with diabetes mellitus, hypertension and other associated diseases. Effective management of CKD depends on patient's adherence to their dialysis plan, medications, dietary and fluid restrictions. This study aimed at systematically reviewing the adherence of adult Chronic Kidney Disease (CKD) patients with regard to their dialysis, medication, dietary and fluid restriction.
Methods: Key words were used for the search in various data bases: “adherence”, “Chronic Kidney Disease”, “dialysis”, “medication”, “dietary” and “fluid restriction”. Online data bases namely Medline, PubMed, Ebsco Host, CINAHL, google scholar and grey literature were used to identify published research from 1993 – 2016. Forty three (43) articles were identified regarding adherence of CKD patients to dialysis, medication, dietary and fluid restriction.
Results: Medication non adherence ranged from 3 to 80% through self-report, structured interview and biological markers. Fluid non-adherence was 10-74%. Using self-report and biological markers, nonadherence to diet was 2-39% and 19-57% respectively. With regards to dialysis, skipping and shortening hemodialysis adherence ranged from 2.5% - 19% and 20.3% - 32.3 % respectively. Globally, adherence rates to CAPD are not well documented in literature.
Conclusion: Non-adherence to dialysis, medication, dietary and fluid restriction is an area of concern internationally in CKD population. Furthermore, non-adherence rates are not well researched and documented in African literature. Therefore, Nephrology professionals in clinical practice are agents of improving adherence of CKD patients to ensure effective management of the disease.
Keywords: Adherence and non-adherence to medication, fluid, diet and dialysis, Chronic Ambulatory Peritoneal Dialysis (CAPD), Chronic Kidney Disease (CKD) and hemodialysis.