Dietary and fluid compliance in Chinese hemodialysis patients

The current cross-sectional study examined dietary and fluid compliance behaviors in Chinese hemodialysis (HD) patients and identified variables related to compliance. Sixty-two chronic HD patients participated and information was obtained about their knowledge of dietary and fluid restrictions related to dialysis, health beliefs, personal and medical characteristics, and self-reported compliance. In addition, serum levels of potassium (K) and phosphate (PO4) and interdialytic daily weight gain were retrieved from the medical records. Dietary and fluid compliance was observed in only 35.5% and 40.3% of the patients, respectively. No direct relationship was observed between dietary knowledge and any compliance measures. ‘Perceived barriers’ was the only variable of the health belief model that showed associations with the compliance measures, implying that patients who perceived less barriers in following the dietary instructions showed better compliance. Residual urine output volume was positively correlated with the level of fluid compliance. Patients with more hours on HD per week were found to be more fluid noncompliant. Working patients and those whose diet was prepared by someone else in the family were also more likely to be noncompliant. Health professionals should be aware of the factors behind noncompliance in HD patients and assist them in making life-style changes. Patient education with family involvement, identification of at-risk patients for noncompliance and assisting patients to identify and manage difficulties with life-style changes related to HD are important elements in promoting compliance.