Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 5:18:143-150.
doi: 10.2147/IJNRD.S511221. eCollection 2025.

Adherence to Treatment Regimens Among End-Stage Renal Disease Patients: A Cross-Sectional Study

Fatima Sameer Belhmer  1 , Mohammed Abdullah Al Amad  1 , Mogahed H Albitahi  2 , Fatma K Babattah  3
Affiliations

Adherence to Treatment Regimens Among End-Stage Renal Disease Patients: A Cross-Sectional Study

Fatima Sameer Belhmer et al. Int J Nephrol Renovasc Dis. .

Abstract

Purpose: Adherence to treatment regimens is crucial to enhance the clinical outcomes of patients with End-Stage Renal Disease (ESRD). In Yemen, there is a gap in information about this issue. Hence, this study aimed to assess the adherence and associated factors of ESRD patients to the four adherence domains, including HD session attendance, medication, dietary modification, and fluid management.

Patients and methods: A descriptive cross-sectional study of ESRD patients was conducted. End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ) was used to collect data through face-to-face interviews. The scoring system was used. The mean of the gained scores was calculated and divided by expected maximum scores and the resulting percentage was used to rank the level of adherence as good ≥ 83%, moderate ≥58- <83% and poor <58%). Non-parametric tests to assess the mean differences with selected variables at p-value <0.005.

Results: The overall (mean ±SD) scores of 393 patients for the four adherence domains (HD, medication, fluid restrictions, and dietary recommendations) were 933.5+210 indicating an overall moderate level of adherence. Good adherence to HD and moderate adherence to medication, diet and fluids were observed (88.5%, 76.7%, 61.9%, and 61.6%, respectively). Significantly higher mean scores among patients with urban residency (941.8 vs 869.4, p=0.03), HD duration < 5 years (949.2 vs 908.0, p=0.02), the overall perception of treatment (956.7 vs 653.3, p=<0.001), patients who had a perception of medication (942.0 vs 734.3, p=0.002), fluid restriction (958.9 vs 727.3, p=<0.001), and diet recommendations (969.8 vs 715.2, p=<0.001). Significantly lower mean scores were observed among patients who had not received counseling regarding the importance of dietary and fluid restriction (962.8 vs 920.5, p=0.02) and (965.6 vs 919.0, p=0.02, respectively).

Discussion: This study is the first in our country to provide baseline information on adherence toward different treatment domains and their associated factors among patients with ESRD. The adherence level among patients with ESRD was moderate in general and good for HD. There was a significant association between adherence and residency, HD duration, overall perception of treatment, perception of medication, fluid and dietary restrictions, and poor counseling. Regular counseling should be provided to enhance adherence levels. A multicenter study is recommended to assess the causal relationship between adherence and the factors affecting adherence.

Keywords: ESRD-AQ; Yemen; adherence; end stage renal disease; hemodialysis.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

References

    1. Vaidya SR, Aeddula NR. Chronic Kidney Disease. Treasure Island (FL) with ineligible companies: StatPearls; 2024. Disclosure: Narothama Aeddula declares no relevant financial relationships with ineligible companies.: StatPearls PublishingCopyright © 2024.
    1. CDC. Chronic kidney disease initiative. chronic kidney disease basics. Available from: https://www.cdc.gov/kidneydisease/basics.html. Accessed May 28, 2025.
    1. Lv J-C, Zhang L-X. Prevalence and disease burden of chronic kidney disease. Renal Fibrosis. 2019;3–15. - PubMed
    1. Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl. 2022;12(1):7–11. doi:10.1016/j.kisu.2021.11.003 - DOI - PMC - PubMed
    1. Fiseha T, Osborne NJ. Burden of end-stage renal disease of undetermined etiology in Africa. Ren Replace Ther. 2023;9(1):44. doi:10.1186/s41100-023-00497-w - DOI

LinkOut - more resources