Patient knowledge and adherence to maintenance hemodialysis: an International comparison study.

Autor: Miyata KN; Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA. kananoshiro@gmail.com.; Division of Nephrology and Hypertension, Mount Sinai Beth Israel, New York, USA. kananoshiro@gmail.com., Shen JI; Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA, 90502, USA., Nishio Y; Division of Nephrology, Department of Medicine, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan., Haneda M; Division of Nephrology, Department of Medicine, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan., Dadzie KA; Division of Nephrology and Hypertension, Mount Sinai Beth Israel, New York, USA., Sheth NR; Division of Nephrology and Hypertension, Mount Sinai Beth Israel, New York, USA., Kuriyama R; Kokubunji Minamiguchi Clinic, Tokyo, Japan., Matsuzawa C; Kotobukichou Jin Naika Clinic, Tokyo, Japan., Tachibana K; Tachibana Clinic, Tokyo, Japan., Harbord NB; Division of Nephrology and Hypertension, Mount Sinai Beth Israel, New York, USA., Winchester JF; Division of Nephrology and Hypertension, Mount Sinai Beth Israel, New York, USA.
Jazyk: angličtina
Zdroj: Clinical and experimental nephrology [Clin Exp Nephrol] 2018 Aug; Vol. 22 (4), pp. 947-956. Date of Electronic Publication: 2017 Nov 28.
DOI: 10.1007/s10157-017-1512-8
Abstrakt: Background: Non-adherence to hemodialysis (HD) is associated with increased morbidity and mortality. In this cross-sectional study, we compared correlates and rates of non-adherence between the US and Japan to determine if differences in patient knowledge about HD might account for international variation in adherence.
Methods: We evaluated 100 US and 116 Japanese patients on maintenance HD. Patient knowledge was scored based on the identification of their vascular access, dry weight, cause of kidney disease, and ≥ 3 phosphorus- and potassium-rich foods. Patients were considered non-adherent if they missed > 3% of HD sessions in 3 months.
Results: 23% of the US and none of the Japanese patients were non-adherent. Using logistic regression, we found that in the US non-adherence was more common in black patients [Odds ratio (OR) 3.98; 95% confidence interval (CI) 1.42-11.22], while high school graduates (OR 0.20; 95% CI 0.05-0.81) and those on the transplant waiting list (OR 0.25; 95% CI 0.083-0.72) were less likely to miss their treatments. There was no significant association between knowledge and non-adherence in the US. However, Japanese patients had significantly higher levels of HD knowledge than US patients after adjusting for age (p < 0.001).
Conclusion: Age-adjusted HD knowledge was higher and non-adherence rates were lower in Japan vs. the US. However, because of the unexpected finding of 100% adherence in Japan, we were unable to formally test whether knowledge was significantly associated with adherence across both countries. Further research is needed to understand the reasons behind the higher non-adherence rates in the US.
Databáze: MEDLINE
Externí odkaz: