Factors Associated with Hemodialysis Adherence Among Patients with Chronic Kidney Disease at Murni Teguh Memorial Hospital, Medan, in 2025
Article metrics
OJS usage and citation sourcesViews and downloads are recorded by OJS; statistics processing may be delayed. A dash means the source count is unavailable. Search Google Scholar
Article Sidebar
Tiomsar Sianturi, Kesaktian Manurung, Janno Sinaga, Rahmat Alyakin Dachi, Frida Lina Tarigan (2026). Factors Associated with Hemodialysis Adherence Among Patients with Chronic Kidney Disease at Murni Teguh Memorial Hospital, Medan, in 2025. Journal of Pharmaceutical and Sciences, JPS Volume 9 Nomor 3 (2026). https://doi.org/10.36490/journal-jps.com.v9i3.1927
Main Article Content
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.
Article Details
Section
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
How to Cite
References
Francis A, Harhay MN, Ong ACM, Tummalapalli SL, Ortiz A, Fogo AB, et al. Chronic kidney disease and the global public health agenda: an international consensus. Nat Rev Nephrol 2024;20(7):473–85. https://doi.org/10.1038/s41581-024-00820-6.
Liyanage T, Toyama T, Hockham C, Ninomiya T, Perkovic V, Woodward M, et al. Prevalence of chronic kidney disease in Asia: a systematic review and analysis. BMJ Glob Health 2022;7(1):e007525. https://doi.org/10.1136/bmjgh-2021-007525.
Bello AK, Okpechi IG, Osman MA, Cho Y, Htay H, Jha V, et al. Epidemiology of haemodialysis outcomes. Nat Rev Nephrol 2022;18(6):378–95. https://doi.org/10.1038/s41581-022-00542-7.
Badan Penelitian dan Pengembangan Kesehatan. Laporan Nasional Riskesdas 2018. Jakarta: Kementerian Kesehatan Republik Indonesia; 2019.
Nissenson AR, Fine RN, Mehrotra R, Zaritsky J, editors. Handbook of Dialysis Therapy. 6th ed. Elsevier; 2022.
Kammerer J, Garry G, Hartigan M, Carter B, Erlich L. Adherence in patients on dialysis: strategies for success. Nephrol Nurs J 2007;34(5):479–86.
Kim Y, Evangelista LS, Phillips LR, Pavlish C, Kopple JD. The End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ): testing the psychometric properties in patients receiving in-center hemodialysis. Nephrol Nurs J 2010;37(4):377–93.
Ozen N, Cinar FI, Askin D, Mut D, Turker T. Nonadherence in hemodialysis patients and related factors: a multicenter study. J Nurs Res 2019;27(4):e36. https://doi.org/10.1097/jnr.0000000000000309.
Dantas LGG, de Seixas Rocha M, Moura Junior JA, Paschoalin EL, Paschoalin SRKP, Sampaio Cruz CM. Non-adherence to haemodialysis, interdialytic weight gain and cardiovascular mortality: a cohort study. BMC Nephrol 2019;20:402. https://doi.org/10.1186/s12882-019-1573-x.
Halle MP, Nelson M, Kaze FF, Jean Pierre NM, Denis T, Fouda H, et al. Non-adherence to hemodialysis regimens among patients on maintenance hemodialysis in sub-Saharan Africa: an example from Cameroon. Ren Fail 2020;42(1):1022–8. https://doi.org/10.1080/0886022X.2020.1826965.
Alatawi AA, Alaamri M, Almutary H. Social support and adherence to treatment regimens among patients undergoing hemodialysis. Healthcare (Basel) 2024;12(19):1958. https://doi.org/10.3390/healthcare12191958.
Yasin F, Khraim F, Santos M, Forgrave D, Hamad A. Factors influencing self-care management in adult hemodialysis patients: an integrative review. Qatar Med J 2024;2024(1):12. https://doi.org/10.5339/qmj.2024.12.
Mailani F, Febriyana I, Rahman D, Sarfika R, Muliantino MR. Good health literacy leads to better quality of life and medication adherence among hemodialysis patients. J Ners 2024;19(1):103–11. https://doi.org/10.20473/jn.v19i1.49247.
Rahmawati BA, Rochmawati E. Trying to understand the illness: a qualitative investigation of health literacy of patients undergoing maintenance hemodialysis. Nurs Health Sci 2024;26(2):e13120. https://doi.org/10.1111/nhs.13120.
Waldman M, Rigassio Radler D, Zelig R. A narrative review of the association between varying levels of health literacy and nutrition-related adherence in adults on hemodialysis. J Ren Nutr 2025;35(1):15–24. https://doi.org/10.1053/j.jrn.2024.06.008.
Hamza MA, Ullah S, Ahsan H, Ali W, Masud M, Ahmed A. Health literacy, illness perception, and their association with medication adherence in end-stage renal disease. Int Urol Nephrol 2025;57(9):2979–94. https://doi.org/10.1007/s11255-025-04472-8.
Al-Muchtari TAZ, Syukri M, Yusni Y. Association between caregiver burden in family and hemodialysis compliance of chronic kidney disease patients in Aceh, Indonesia. Narra J 2023;3(3):e255. https://doi.org/10.52225/narra.v3i3.255.
Lidiasari A, Rahayuningsih N, Nofianti T. The relationship between family support and compliance of chronic kidney failure patients in undergoing hemodialysis therapy at Ciamis District Hospital. J Ilmu Kefarmasian Indones 2025;23(2):325–35. https://doi.org/10.35814/jifi.v23i2.1659.
Heinze G, Schemper M. A solution to the problem of separation in logistic regression. Stat Med 2002;21(16):2409–19. https://doi.org/10.1002/sim.1047.
Mansournia MA, Geroldinger A, Greenland S, Heinze G. Separation in logistic regression: causes, consequences, and control. Am J Epidemiol 2018;187(4):864–70. https://doi.org/10.1093/aje/kwx299.
Liu Y, Wei Z, Jing L, Sui Z, Fu P, Chen X, et al. Associations between dyadic coping, mutuality, and quality of life among maintenance hemodialysis patients and caregivers: an actor–partner interdependence mediation model. Qual Life Res 2025;34:2393–404. https://doi.org/10.1007/s11136-025-03991-2.
Liu Y, Wen X. Developing a nomogram prediction model for dietary behavior adherence in hemodialysis patients. Patient Prefer Adherence 2025;19:3889–900. https://doi.org/10.2147/PPA.S559708.
Alroshodi A, Al-Harbi F, Alayed R, Alharbi F, Alkhalifah K, Alawaji M, et al. Factors impacting hemodialysis treatment adherence in end-stage renal disease patients receiving in-center hemodialysis in Qassim region. Georgian Med News 2025;(364–365):180–7.
Liu X, Chen P, Liu Y, Jia X, Xu D. Medication burden in patients with dialysis-dependent CKD: a systematic review. Ren Fail 2024;46(1):2353341. https://doi.org/10.1080/0886022X.2024.2353341.
Zhang L, Chen Y, Tang W, Wang Q, Zou L, Zhou L. Effects of dyadic psychoeducational interventions for haemodialysis patients and their family caregivers: a randomised controlled trial. BMC Nurs 2025;24:244. https://doi.org/10.1186/s12912-025-02835-1.
Fatona EA. Strategies to reduce caregiver burden among family caregivers of patients on hemodialysis. Nephrol Nurs J 2026;53(2):115–74. https://doi.org/10.37526/1526-744X.2026.53.2.115.
Calik Kus A, Ersoy S. A story-based digital game to reduce anxiety and improve treatment adherence in patients receiving hemodialysis: a cluster-randomized controlled trial. Ther Apher Dial 2026 [published online]. https://doi.org/10.1002/1744-9987.70162.