Treatment Adherence in Elderly Hemodialysis Patients: A Literature Review


Authors : Anya Mae A. Quion; Aldin D. Gaspar

Volume/Issue : Volume 10 - 2025, Issue 5 - May


Google Scholar : https://tinyurl.com/3h5kfma3

DOI : https://doi.org/10.38124/ijisrt/25may1427

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.


Abstract : This literature review examines current research and articles addressing treatment adherence among elderly patients undergoing maintenance outpatient hemodialysis. Studies were identified through an English-language of studies from 2010 to the present using the following electronic databases: Proquest, PubMed, Cochrane, and GoogleScholar. A comprehensive search strategy was done using the following keywords: "end stage renal disease" or "kidney failure, chronic" and "hemodialysis" and "adults" and "adherence" or "treatment adherence" or "treatment regimen adherence" or "intention" or "intention to adhere". The review analyzes selected research papers, organizing them according to sociodemographic factors and treatment adherence. The review further identifies key factors influencing adherence in this population, including the complexity of treatment regimens, age-related changes, and the impact of comorbidities.

References :

  1. United States Renal Data System. (2015). USRDS Annual Data Report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD.
  2. GMA Integrated News. (2024). Dialysis patients increased by 42% in 2023 from 2022. https://www.gmanetwork.com/news/topstories/nation/908664/dialysis-patients-increased-by-42-in-2023-from-2022/story/
  3. Philippine Society of Nephrology. (2024). Rising incidence of chronic kidney disease in the Philippines sparks call for kidney health awareness: The Philippine Society of Nephrology urges Filipinos to take proactive measures. https://psn.org.ph/2024/03/01/rising-incidence-of-chronic-kidney-disease-in-the-philippines-sparks-call-for-kidney-health-awareness-subtitle-the-philippine-society-of-nephrology-urges-filipinos-to-take-proactive-measures/
  4. Kang, K. I. (2016). Factors affecting treatment adherence in elderly patients with end-stage renal disease. Korean journal of adult nursing, 28(4), 444-454.
  5. Lysaght M. J. (2002). Maintenance dialysis population dynamics: current trends and long-term implications. Journal of the American Society of Nephrology : JASN, 13 Suppl 1, S37–S40.
  6. Department of Health (2013). Mortality. Retrieved from http://www.doh.gov.ph/mortality
  7. Suriyong, P., Ruengorn, C., Shayakul, C., Anantachoti, P., & Kanjanarat, P. (2022). Prevalence of chronic kidney disease stages 3-5 in low- and middle-income countries in Asia: A systematic review and meta-analysis. PloS one, 17(2), e0264393. https://doi.org/10.1371/journal.pone.0264393
  8. Pajimna, J. a. T., Orpilla, G. a. L., Milan, M. J. D., Virtucio, C. T. S., & Pamatian, J. V. M. (2023). Gaps and challenges in the provision of treatment for patients with end-stage renal disease: perspectives from the Philippines. The Lancet Regional Health - Western Pacific, 38, 100889. https://doi.org/10.1016/j.lanwpc.2023.100889
  9. Matsuzawa, R., Hoshi, M., Yoneki, K., & Matsunaga, M. (2016). Self-management behavior of patients receiving hemodialysis: Relationships with clinical indicators, background factors, and social support. Nephrology Nursing Journal, 43(1), 15-25.
  10. Bazrafshan, M. R., Navabpour Tehrani, S., & Ahmadizar, F. (2023). The relationship between spiritual well-being and adherence to hemodialysis treatment regimen in hemodialysis patients: A systematic review and meta-analysis. BMC nephrology, 24(1), 1-13.
  11. Ghimire, S., Peterson, G. M., Castelino, R. L., Jose, M. D., Zaidi, S. T. R., & Bereznicki, B. J. (2015). A systematic review of factors influencing medication adherence in patients with end-stage renal disease. Nephrology, 20(4), 253-266.
  12. Reach, G., Pechtner, V., & Pawin, G. (2023). Psychosocial factors influencing therapeutic inertia and adherence to treatment in patients with type 2 diabetes and chronic kidney disease. Cardiovascular Diabetology, 22(1), 1-18.
  13. Saglimbene, V. M., Wong, G., & Palmer, S. C. (2021). The impact of dietary restrictions on the quality of life of adults with chronic kidney disease. Journal of renal nutrition, 31(3), 237-245.
  14. Piccoli, G. B., Deagostini, M., & Consiglio, V. (2020). Vegetarian low-protein diets in CKD. Nutrients, 12(1), 195.
  15. Ekramzadeh, M., Ebrahimi, M., Hayati, M., Sharafkhah, M., & Esmaily, H. (2014). The relationship between malnutrition and quality of life in hemodialysis patients. Iranian journal of kidney diseases, 8(1), 22.
  16. National Kidney Foundation Inc. (2025). Fluid overload in a dialysis patient. https://www.kidney.org/kidney-topics/fluid-overload-dialysis-patient
  17. World Health Organization. (2003). Adherence to long-term therapies: evidence for action.
  18. Özkan, S., & Taylan, S. (2022). Quality of life in hemodialysis patients: A single-center experience. The European Research Journal, 8(1), 75-81.
  19. Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211. https://doi.org/10.1016/0749-5978(91)90020-t
  20. Sheikh, M. A., Ghafoor, M. M., Nawaz, A., & Asif, M. (2022). Treatment adherence behavior of elderly patients undergoing hemodialysis during COVID-19 pandemic and its relationship with identified factors. BMC geriatrics, 22(1), 1-12.
  21. Heller, L. J., Skinner, C. S., Tomiyama, A. J., Epel, E. S., Hall, P. A., Allan, J., LaCaille, L., Randall, A. K., Bodenmann, G., Li-Tsang, C. W. P., Sinclair, K., Creek, J., Baumann, L. C., Karel, A., Andersson, G., Hanewinkel, R., Morgenstern, M., Puska, P., Bucks, R. S., . . . Denollet, J. (2012). Theory of reasoned action. In Springer eBooks (pp. 1964–1967). https://doi.org/10.1007/978-1-4419-1005-9_1619
  22. Chisholm, M. A., Mulloy, L. L., & Gopalakrishnan, M. (2007). A pilot study examining psychosocial predictors of immunosuppressant medication adherence in heart transplant recipients. Journal of heart and lung transplantation, 26(11), 1145-1151.
  23. Hugon, A., Metge, C. J., Durand, Z., Kamar, N., Ladrière, M., & Péré, H. (2014). Psychosocial factors associated with medication adherence in renal transplant recipients: A systematic review. Transplantation reviews, 28(1), 13-23.
  24. Kidney International. (2024). KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. International Society of Nephrology, 105 (Suppl 4S), S117–S314. https://kdigo.org/wp-content/uploads/2024/03/KDIGO-2024-CKD-Guideline.pdf
  25. Wouk, K. A. (2021). Monitoring and evaluation of adult patients receiving maintenance hemodialysis. American journal of kidney diseases, 77(3), 456-466.
  26. Ashby, D., Borman, N., Burton, J., Corbett, R., Davenport, A., Farrington, K., Flowers, K., Fotheringham, J., Fox, R. N. A., Franklin, G., Gardiner, C., Gerrish, R. N. M., Greenwood, S., Hothi, D., Khares, A., Koufaki, P., Levy, J., Lindley, E., Macdonald, J., . . . Wilkie, M. (2019). Renal Association Clinical Practice Guideline on Haemodialysis. BMC Nephrology, 20(1). https://doi.org/10.1186/s12882-019-1527-3
  27. Power, A., & Brown, E. A. (2014). The growing problem of older patients on renal replacement therapy. Clinical medicine, 14(6), 641.
  28. Weinger, K., Beverly, C. J., & Smaldone, A. M. (2014). “Special issues” of diabetes in the older adult. Current diabetes reports, 14, 1-11.
  29. Washington, T. L. (2013). Self-management behaviors in older adults with end-stage renal disease. Nephrology nursing journal, 40(1), 71.
  30. National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Effects of chronic kidney disease in adults study: CRIC. https://www.niddk.nih.gov/about-niddk/research-areas/kidney-disease/ effects-chronic-kidney-disease-adults-study-cric
  31. Brown, E. A. (2010). Can quality of life be improved for the increasing numbers of older patients with end-stage kidney disease? Expert Review of Pharmacoeconomics & Outcomes Research, 10(6), 661-6. http://dx.doi.org/10.1586/erp.10.78
  32. Ford-Anderson, R. M. (2010). Predictors of adherence to the hemodialysis treatment regimen (Doctoral dissertation, Capella University).
  33. Movahedi, M. M., Shojaei, S., & Bastani, P. (2023). The relationship between general health and demographic characteristics with treatment adherence in hemodialysis patients. BMC nephrology, 24(1), 1-10.
  34. Ossareh, S., Tabrizian, S., & Rassouli, M. (2014). Factors affecting adherence to hemodialysis in hemodialysis patients. Global journal of health science, 6(5), 128.
  35. Mohamedi, A. K., & Mosha, F. W. (2022). Factors associated with adherence to hemodialysis therapy among patients attending Muhimbili National Hospital, Dar es Salaam, Tanzania: A cross-sectional study. BMC nephrology, 23(1), 1-11.
  36. Ross, B. (2017). Demographic factors that correlate with adherence to hemodialysis treatment regimen (Order No. 10606553). Available from ProQuest Dissertations & Theses Global. (2026768967). https://search.proquest.com/docview/2026768967?accountid=47253
  37. Mirzaei-Alavijeh, M., Peyman, N., & Jalilian, M. (2023). The effect of education based on the health belief model on medication adherence in elderly patients with chronic kidney disease: A quasi-experimental study. BMC geriatrics, 23(1), 1-11.
  38. Waku, M., Asakura, K., Hamano, T., Wada, A., & Fukui, M. (2021). Medication adherence among elderly patients receiving hemodialysis: A single-center study. Renal Replacement Therapy, 7(1), 1-8.
  39. Kang, A. W. C. (2016). Psychological distress and physical multimorbidity: The example of coexisting diabetes mellitus and end-stage renal disease (Order No. 10754599). Available from ProQuest Central; ProQuest Dissertations & Theses Global. (1999313359). Retrieved from https://search.proquest.com/docview/1999313359?accountid=47253
  40. Dagli, R. J., & Sharma, A. (2014). Polypharmacy in elderly: need for concern. Journal of pharmacology and pharmacotherapeutics, 5(1), 12.
  41. Larsen, J., Stovring, H., Kragstrup, J., & Hansen, D. G. (2009). Can differences in medical drug compliance between European countries be explained by social factors: analyses based on data from the European Social Survey, round 2. BMC Public Health, 9(1). https://doi.org/10.1186/1471-2458-9-145
  42. Ibrahim, S., Hossam, M., & Belal, D. (2015). Study of non-compliance among chronic  hemodialysis patients and its impact on patients' outcomes. Saudi journal of kidney  diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 26(2), 243–249.
  43. Kovesdy, C. P. (2022). Sex differences in chronic kidney disease progression. Kidney international, 101(5), 874-876.
  44. Hashmi, M., Benjamin, O., & Lappin, S. L. (2023). Epidemiology of End Stage Renal Disease. In StatPearls [Internet]. StatPearls Publishing.
  45. Rafiee, F., & Shafie, H. (2017). Dialysis adequacy and treatment adherence status of hemodialysis patients referred to dialysis centers of Hajar hospital, Shahrekord, Iran. International Journal of Nursing and Midwifery, 4(1), 1-7.
  46. Nakao, M., Gorayeb, R., & Cardeal da Costa, I. (2016). Hemodialysis adherence: psychobiological aspects and related factors. Jornal Brasileiro de Nefrologia, 38, 218-226.
  47. Alhomayani, F., Bukhara, M., Al-ghamdi, J., Ali, R., and Al-Amri, L. (2021). Demographic factors affecting level of adherence amongst hemodialysis patients in a single center of Taif, Saudi Arabia. Ann. RSCB 25, 8627–8646.
  48. Mukakarangwa, M. C., Chironda, G., Bhengu, B., & Katende, G. (2018). Adherence to  Hemodialysis and Associated Factors among End Stage Renal Disease Patients at  Selected Nephrology Units in Rwanda: A Descriptive Cross-Sectional Study. Nursing research and practice, 2018, 4372716. https://doi.org/10.1155/2018/4372716
  49. Raghupathi, V., & Raghupathi, W. (2020). The influence of education on health: an empirical assessment of OECD countries for the period 1995-2015. Archives of Public Health=Archives Belges de Santé Publique,78(1), 20–20. https://doi.org/10.1186/s13690-020-00402-5
  50. Chironda, G., Bhengu, B. & Manwere, A. (2019). Models and theories of  care applicable to predicting and improving adherence behaviours among Chronic Kidney Disease (CKD) patients. Rwanda Journal of Medicine and Health Sciences, 2(1), 48-58. https://dx.doi.org/10.4314/rjmhs.v2i1.9.
  51. Ng, M. S. N., Chan, D. N. S., Cheng, Q., Miaskowski, C., & So, W. K. W. (2021). Association between Financial Hardship and Symptom Burden in Patients Receiving Maintenance Dialysis: A Systematic Review. International journal of environmental research and public health, 18(18), 9541. https://doi.org/10.3390/ijerph18189541
  52. Tang, C. H., Chen, H. H., Wu, M. J., Hsu, B. G., Tsai, J. C., Kuo, C. C., Lin, S. P., Chen, T. H., & Sue, Y. M. (2019). Out-of-pocket costs and productivity losses in haemodialysis and peritoneal dialysis from a patient interview survey in Taiwan. BMJ open, 9(3), e023062. https://doi.org/10.1136/bmjopen-2018-023062
  53. Galvez, D. (2025, February 7). SC justice says PhilHealth bankrupt; not so, says Recto. The Philippine Star. Retrieved from https://www.philstar.com/headlines/2025/02/07/2419778/sc-justice-says-philhealth-bankrupt-not-so-says-recto
  54. Manahan, E. (2024, October 18). PhilHealth must settle its debts. Philippine Daily Inquirer. Retrieved from https://opinion.inquirer.net/177647/philhealth-must-settle-its-debts
  55. Sidani, S. & Fox, M. (2020). The Role of Treatment Perceptions in Intervention Evaluation: A Review. Science of Nursing and Health Practices / Science infirmière et pratiques en santé, 3(2), 1–15. https://doi.org/10.31770/2561-7516.1079
  56. Hussain, F., Ashraf, S., Arshad, M., Rehman, M. M. U., Khan, F. S., Ahmad, M. A., Ali, S.,  Asif, M. A., Munawar, A., & Mehmood Qadri, H. (2023). Knowledge, Adherence,  and Perception of Patients on Maintenance Hemodialysis to Treatment Regimens at a Tertiary Care Hospital in Pakistan. Cureus, 15(12), e51341. https://doi.org/10.7759/cureus.51341
  57. Naalweh, K. S., Barakat, M. A., Sweileh, M. W., Al-Jabi, S. W., Sweileh, W. M., & Zyoud, S.H. (2017). Treatment adherence and perception in patients on maintenance hemodialysis: a cross - sectional study from Palestine. BMC nephrology, 18(1), 178. https://doi.org/10.1186/s12882-017-0598-2
  58. Ghimire, S., Castelino, R. L., Jose, M. D., & Zaidi, S. T. R. (2017). Medication adherence perspectives in haemodialysis patients: a qualitative study. BMC nephrology, 18(1), 167. https://doi.org/10.1186/s12882-017-0583-9
  59. Chertow, G. M., Johansen, K. L., Lew, N., Lazarus, J. M., & Lowrie, E. G. (2000). Vintage, nutritional status, and survival in hemodialysis patients. Kidney international, 57(3),  1176–1181. https://doi.org/10.1046/j.1523-1755.2000.00945.x
  60. Zhu, L., Li, X. L., Shi, R., & Wang, D. G. (2023). Dialysis vintage is associated with a high prevalence and severity of unpleasant symptoms in patients on hemodialysis. Renal failure, 45(1), 2201361. https://doi.org/10.1080/0886022X.2023.2201361
  61. Ohya, M., Iwashita, Y., Kunimoto, S., Yamamoto, S., Mima, T., Negi, S., & Shigematsu, T. (2019). An Analysis of Medication Adherence and Patient Preference in Long-term Stable Maintenance Hemodialysis Patients in Japan. Internal medicine (Tokyo, Japan), 58(18), 2595–2603. https://doi.org/10.2169/internalmedicine.2676-19
  62. Iqbal, M. S., Iqbal, Q., Iqbal, S., & Ashraf, S. (2021). Hemodialysis as long term treatment: Patients satisfaction and its impact on quality of life. Pakistan Journal of Medical Sciences, 37(2). https://doi.org/10.12669/pjms.37.2.2747
  63. Lewis, R. A., Bohm, C., Fraser, F., Fraser, R., Woytkiw, L., Jurgutis, S., Rubin, M., Smith, G.,  Buenafe, J., Verdin, N., Hutton, J., & Tonelli, M. (2022). Transportation Burden Associated With Hemodialysis in Canada: A Qualitative Study of Stakeholders. Kidney medicine, 5(2), 100571. https://doi.org/10.1016/j.xkme.2022.100571
  64. Chan, K. E., Thadhani, R. I., & Maddux, F. W. (2014). Adherence barriers to chronic dialysis in the United States. Journal of the American Society of Nephrology : JASN, 25(11), 2642–2648. https://doi.org/10.1681/ASN.2013111160
  65. Walker, R. C., Howard, K., & Morton, R. L. (2017). Home hemodialysis: a comprehensive review of patient-centered and economic considerations. ClinicoEconomics and  outcomes research : CEOR, 9, 149–161. https://doi.org/10.2147/CEOR.S69340
  66. Ang, Y.T.I., Gan, S.W.S., Liow, C.H. et al (2022). Patients’ perspectives of home and self-assist haemodialysis and factors influencing dialysis choices in Singapore. Ren Replace Ther 8, 42. https://doi.org/10.1186/s41100-022-00430-7
  67. A.Alzahrani, A. M., & Al-Khattabi, G. H. (2021). Factors Influencing Adherence to Hemodialysis Sessions among Patients with End-Stage Renal Disease in Makkah City. Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 32(3), 763–773. https://doi.org/10.4103/1319-2442.336772
  68. Clark-Cutaia, M. N., Sevick, M. A., Thurheimer-Cacciotti, J., Hoffman, L. A., Snetselaar, L., Burke, L. E., & Zickmund, S. L. (2019). Perceived Barriers to Adherence to Hemodialysis Dietary Recommendations. Clinical nursing research, 28(8), 1009–1029. https://doi.org/10.1177/1054773818773364
  69. Drageset J. Social Support. 2021 Mar 12. In: Haugan G, Eriksson M, editors. Health Promotion in Health Care – Vital Theories and Research [Internet]. Cham (CH): Springer; 2021. Chapter 11. Available from: https://www.ncbi.nlm.nih.gov/books/NBK585650/. https://10.1007/978-3-030-63135-2_11
  70. Alatawi, A. A., Alaamri, M., & Almutary, H. (2024). Social Support and Adherence to Treatment Regimens among Patients Undergoing Hemodialysis. Healthcare (Basel, Switzerland), 12(19), 1958. https://doi.org/10.3390/healthcare12191958
  71. Kim, H., & Cho, M.-K. (2021). Factors Influencing Self-Care Behavior and Treatment Adherence in Hemodialysis Patients. International Journal of Environmental  Research and Public Health, 18(24), 12934. https://doi.org/10.3390/ijerph182412934

This literature review examines current research and articles addressing treatment adherence among elderly patients undergoing maintenance outpatient hemodialysis. Studies were identified through an English-language of studies from 2010 to the present using the following electronic databases: Proquest, PubMed, Cochrane, and GoogleScholar. A comprehensive search strategy was done using the following keywords: "end stage renal disease" or "kidney failure, chronic" and "hemodialysis" and "adults" and "adherence" or "treatment adherence" or "treatment regimen adherence" or "intention" or "intention to adhere". The review analyzes selected research papers, organizing them according to sociodemographic factors and treatment adherence. The review further identifies key factors influencing adherence in this population, including the complexity of treatment regimens, age-related changes, and the impact of comorbidities.

Never miss an update from Papermashup

Get notified about the latest tutorials and downloads.

Subscribe by Email

Get alerts directly into your inbox after each post and stay updated.
Subscribe
OR

Subscribe by RSS

Add our RSS to your feedreader to get regular updates from us.
Subscribe