Factors Associated With Treatment Adherence and Symptom Burden among Patients Receiving Maintenance Hemodialysis in Pakistan: A Cross-Sectional Study
Keywords:
Renal Dialysis, Kidney Failure, Medication Adherence, Treatment Adherence, Hemodialysis, PakistanAbstract
OBJECTIVES
This study aimed to assess treatment adherence, symptom burden, and factors associated with adherence among adults receiving maintenance hemodialysis in Pakistan.
METHODOLOGY
A cross-sectional study was conducted from January to July 2026 in the Dialysis Unit of District Headquarters Hospital, Kohat, Pakistan. A total of 141 adults receiving maintenance hemodialysis were recruited consecutively. Data were collected using a structured questionnaire, the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ), and the Dialysis Symptom Index (DSI). Descriptive statistics were used to summarise participant characteristics and adherence-related behaviours.
RESULTS
The mean age was 44.01 ± 14.40 years, and 55.3% of participants were male. Self-rated overall treatment compliance was excellent in 69.5%, very good in 21.3%, and good in 9.2%. No dialysis session was missed by 74.5% of participants during the reported period. Difficulties were reported with medication-taking (44.0%), fluid restriction (68.8%), and dietary recommendations (58.9%).
CONCLUSION
Most participants reported high overall treatment compliance; however, clinically relevant difficulties with medication use, fluid restriction, and dietary adherence remained common. Structured education, individualised counselling, and practical support for treatment barriers should be integrated into routine dialysis care. Validated DSI results and appropriately reanalysed association models are required before conclusions regarding symptom burden and independent predictors can be finalised.
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Copyright (c) 2026 Muhammad Mamoon, Ifrah Riaz, Fakhar Zaman, Zahid Ullah , Anum Essa, Muhammad Haroon
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