Factors Associated with Hemodialysis Adherence Among Patients with Chronic Kidney Disease at Murni Teguh Memorial Hospital, Medan, in 2025
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Abstract
Background: Hemodialysis adherence requires sustained engagement with a demanding treatment regimen. Objective: To examine factors associated with adherence at Murni Teguh Memorial Hospital, Medan. Methods: This analytical cross-sectional study included 172 purposively selected patients. Adherence was assessed using a modified six-item End-Stage Renal Disease Adherence Questionnaire. Associations were examined using chi-square tests and multivariable logistic regression. Results: Overall, 115 patients (66.9%) were adherent. Education, knowledge, and family support were associated with adherence (all p < 0.001), whereas age, sex, and dialysis duration were not (p = 0.866, 0.357, and 0.212, respectively). Adherence was 92.6% with good family support and 5.9% with poor support. Family support was the only significant adjusted term (Exp[B] = 416.36; 95% confidence interval [CI], 43.08–4024.31); sparse discordant observations and the wide interval limited precision. A post hoc unadjusted Firth analysis yielded an odds ratio of 164.10 (95% CI, 51.86–694.10). Conclusion: Family support was strongly associated with self-reported adherence. Family-centered counseling merits evaluation, but the cross-sectional design and imprecise estimates preclude causal interpretation.
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