Fatores associados à adesão ao tratamento de pessoas com doença renal crônica em hemodiálise

Ingrid Fernanda de Oliveira Vieira; Mônica La Salette da Costa Godinho; Zélia Marilda Rodrigues Resck; Denismar Alves Nogueira; Patrícia Scotini Freitas; Fábio de Souza Terra

doi:10.36517/2175-6783.20262796259

Authors

Ingrid Fernanda de Oliveira Vieira Federal University of Alfenas https://orcid.org/0000-0001-6171-6852
Mônica La Salette da Costa Godinho Federal University of Alfenas https://orcid.org/0000-0003-3332-547X
Zélia Marilda Rodrigues Resck Federal University of Alfenas https://orcid.org/0000-0002-3752-8381
Denismar Alves Nogueira Federal University of Alfenas https://orcid.org/0000-0003-2285-8764
Patrícia Scotini Freitas Federal University of Alfenas https://orcid.org/0000-0002-8270-8955
Fábio de Souza Terra Federal University of Alfenas https://orcid.org/0000-0001-8322-3039

DOI:

https://doi.org/10.36517/2175-6783.20262796259

Keywords:

Renal Dialysis; Renal Insufficiency; Treatment Adherence and Compliance; Nursing.

Abstract

Objective: to analyze factors associated with treatment adherence among individuals with chronic kidney disease undergoing hemodialysis. Methods: a cross-sectional, descriptive-analytical study conducted with 142 hemodialysis patients at a philanthropic general hospital. A validated instrument was used to assess treatment adherence and a questionnaire including sociodemographic and clinical variables. Associations were analyzed using the Mann-Whitney test, with a significance level of 5% (p<0.05). Results: most participants were male, aged 60 to 69 years, Catholic, with incomes up to R$1,500.00, married or in a stable union, with diabetes mellitus as the cause of the disease, and up to one year of treatment. An association was observed between the hemodialysis adherence domain and four independent variables; medication, with three; fluid restriction, with nine; dietary adherence, with eleven. Conclusion: the associations identified between adherence domains and independent variables such as marital status, monthly family income, and hemodialysis duration, among others, expand the understanding of factors influencing adherence to hemodialysis treatment, contributing to the strengthening, knowledge, and interaction of healthcare professionals in health education. Contributions to practice: the study provides support for improving nursing practice, reinforcing professionals’ engagement in promoting adherence among patients undergoing hemodialysis.

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References

1. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group, Stevens PE, Ahmed SB, Carrero JJ, Foster B, Francis A, et al. KDIGO 2024 Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2024;105(4S):117-314. doi: https://doi.org/10.1016/j.kint.2023.10.018

2. Aguiar LK, Prado RR, Gazzinelli A, Malta DC. Factors associated with chronic kidney disease: epidemiological survey of the National Health Survey. Rev Bras Epidemiol. 2020;23:e200044. doi: https://doi.org/10.1590/1980-549720200044

3. Sousa CND, Araújo DAM, Sousa WGS, Lemos MHS, Rocha NRA, Negreiros ALB. Perception of chronic kidney disease patients about hemodialytic treatment. Saúde Coletiva (Barueri). 2021;11(64):5594-603. doi: http://doi.org/10.36489/saudecoletiva.2021v11i64p5594-5603

4. Menezes HF, Camacho ACLF, Sousa PAF, Primo CC, Ferreira LB, Silva RAR. Validation of Nursing Diagnoses for people with chronic kidney conditions on conservative treatment. Rev Esc Enferm USP. 2021;55:e20200396. doi: https://doi.org/10.1590/1980-220X-REEUSP-2020-0396

5. Vijay V, Kang HK. The worldwide prevalence of nonadherence to diet and fluid restrictions among hemodialysis patients: a systematic review and meta-analysis. J Ren Nutr. 2022;32(6):658-69. doi: https://doi.org/10.1053/j.jrn.2021.11.007

6. 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 [Internet]. 2010 [cited Nov 10, 2025]; 37(4):377-93. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3077091/

7. Lins SMSB, Leite JL, Godoy S, Fuly PSC, Araújo STC, Silva IR. Validation of the adherence questionnaire for Brazilian chronic kidney disease patients under hemodialysis. Rev Bras Enferm. 2017;70(3):558-65. doi: https://dx.doi.org/10.1590/0034-7167-2016-0437

8. Denhaerynch K, Manhaeve D, Dobbels F, Garzoni D, Nolte C, Geest S. Prevalence and consequences of nonadherence to hemodialysis regimens. Am J Crit Care. 2007;16(3):222-35. doi: https://doi.org/10.4037/ajcc2007.16.3.222

9. Haynes RB, Ackloo E, Sahota N, McDonald HP, Yao X. Intervention for enhancing medication adherence. Cochrane Database Syst Rev. 2008;16(2):CD000011. doi: https://dx.doi.org/10.1002/14651858.CD000011.pub3

10. Silva LJA. Avaliação da ansiedade e da autoestima em renais crônicos submetidos ao tratamento hemodialítico [Internet] 2020 [cited Nov 10, 2025]. Available from: https://bdtd.unifal-mg.edu.br:8443/handle/tede/1569

11. Nascimento MRA, Borborema LR, Magalhães LC, Gonçalves CR, Faria ALC, Veloso FMF, et al. Percepção negativa de saúde em pacientes submetidos à hemodiálise: prevalência de fatores associados. Rev Interfaces Saúde Hum Tecnol. 2024;12(1):3848-55. doi: https://doi.org/10.16891/2317-434X.v12.e1.a2024.pp3848-3855

12. Vieira JL, Silva CLLD, Queiroz PBD. Doença renal crônica e envelhecimento: retrato do tratamento hemodialítico em um hospital do Distrito Federal. Health Resid J. 2022;3(15):202-23. doi: https://doi.org/10.51723/hrj.v3i15.429

13. Piccoli C, Santos FNSN, Costa LD, Menetrier JV, Roque MS, Oliveira EM, et al. Epidemiological and clinical profile of accompanied patients in a model program for attention to chronic conditions. Ciênc Cuid Saúde. 2020;19:e50327. doi: https://doi.org/10.4025/ciencuidsaude.v19i0.50327

14. Firmiano PHS, Barbosa JS, Souza AM. Elaboração de manual orientativo para paciente com doença renal crônica. Rev Ibero-Am Hum Ciênc Educ. 2023;9(9):1356-87. doi: https://dx.doi.org/10.51891/rease.v9i9.11297

15. Fernandes HMA, Santos KC, Cruz DDB, Lima CGF. Epidemiologia, alterações metabólicas e recomendações nutricionais na Doença Renal Crônica (DRC). In: Oliveira HC, organizador. Estudos multidisciplinares em ciências da saúde [Internet]. 2023 [cited Nov 10, 2025];81-104. Available from: https://editoralicuri.com.br/index.php/ojs/article/view/166/127

16. Oliveira ES, Ferreira RBS, Rios MA, Mussi RFF. Fatores associados à percepção de incômodo com a restrição hídrica e alimentar entre pacientes com insuficiência renal crônica. Enferm Actual Costa Rica. 2020;(39):86-99. doi: http://dx.doi.org/10.15517/revenf.v0i39.39991

17. Pontes G, Vinhal LB, Morais ER. Perfil clínico e epidemiológico dos pacientes renais crônicos de um hospital estadual de urgências de Goiânia-GO. Movimenta. 2021;14(3):927-37. doi: https://doi.org/10.31668/movimenta.v14i3.12504

18. Santos MVB, Lira GG, Fernandes FECV. Medication adherence by the chronic renal patient on hemodialysis. Rev Enferm UFPE Online. 2020;14:e243294. doi: https://dx.doi.org/10.5205/1981-8963.2019.243294

19. Win KCM, Zhou H, Patton V, Steen M, Della P. Factors contributing to non-adherence to treatment among adult patients with long-term haemodialysis: an integrative review. Nurs Rep. 2025;15(9):314. doi: https://dx.doi.org/10.3390/nursrep15090314

20. Visiedo L, Rey L, Rivas F, López F, Tortajada B, Giménez R, et al. The impact of nutritional status on health-related quality of life in hemodialysis patients. Sci Rep. 2022;12(1):3029. doi: https://doi.org/10.1038/s41598-022-07055-0

21. Campos F, Kleibert KRU, Pretto CR, Klein KB, Stumm EMF, Colet CF. Uso de medicamentos e interações medicamentosas em pacientes renais crônicos em hemodiálise. Saúde (Santa Maria). 2021;47(1):e40770. doi: https://dxdoi.org/10.5902/2236583440770

22. Santos GMR, Albuquerque FJ, Oliveira JDS, Braga VAB, Cabral NL. Influence of spirituality on the quality of life of elderly people on hemodialysis. Rev Enferm UFPE online. 2021;15(2):e244752. doi:https://doi.org/10.5205/1981-8963.2021.244752

23. Pradila DA, Satiadarma MP, Dharmawan US. The resilience of elderly patients with chronic kidney disease undergoing hemodialysis. Proceedings of the International Conference on Economics, Business, Social, and Humanities (ICEBSH 2021). Ad Soc Sci Educ Hum Res. 2021;570:1191-6. doi: https://doi.org/10.2991/assehr.k.210805.187

24. Raashid S, Arshad AR, Mir AW. Adherence to management in patients with end stage renal disease. Pak Armed Forces Med J. 2021;71(3):805-9. doi: https://doi.org/10.51253/pafmj.v71i3.3082

25. Costalonga AS, Melo ACBPO, Zanetti ET, Drumond DMM, Magalhães FF, Biondi IO, et al. O papel da dieta com muito baixo teor de proteínas na doença renal crônica. Rev Ibero-Am Hum Ciênc Educ. 2023;9(11):1723-30. doi: http://doi.org/10.51891/rease.v9i11.12411

26. Akhavanrad S, Hosseinigolafshani S, Yekkehfallah L. Pre-transplant experiences: a phenomenological study with hemodialysis patients awaiting transplantation. J Nurs Adv Clin Sci. 2024;1(3):149-59. doi: https://doi.org/10.32598/JNACS.2406.1039

27. Camelo LB, Santos RC, Monteiro GKNA, Silva Júnior JNB, Santos RC, Oliveira LM. Evaluation of the quality of life of patients undergoing hemodialysis and post renal transplantation. Rev Enferm Atual In Derme. 2021;95(36):e-021181. doi: https://doi.org/10.31011/reaid-2021-v.95-n.36-art.1249

28. Moreira ASA, Guerra GM, Silva ERD. Adesão e qua- lidade de vida dos jovens adultos em tratamento de hemodiálise. Rev Recien. 2023;13(41):125-34. doi: http://10.24276/rrecien2023.13.41.125-134