Influence of family carers on haemodialyzed patients' adherence to dietary and fluid restrictions: an observational study

ABSTRACT: Aim.  To determine the influence of a family carer on haemodialyzed patients''adherence'. Background.  There is extensive evidence showing that successful treatment of patients with end-stage renal disease is directly related to patients''adherence'. The parameters indicative of a good adherence are potassium and phosphate serum levels and the interdialytic weight gain. Haemodialyzed patients may have scarce adherence to food and fluid intake restrictions, and medications schedule. Design.  Case-control study carried out in a haemodialysis centre in Italy. Data sources.  The data were collected during 2010. Methods.  A total of 72 subjects with end-stage renal disease participated in the study. The subjects assisted by a family carer were identified as cases (n = 36), whereas those who did not have a family carer, as controls (n = 36). All subjects were followed up (4 months) and checked up regarding interdialytic weight gain, and serum levels of potassium and phosphate. Important differences in potassium and phosphate serum level and interdialytic weight gain between the two groups were evaluated separately using a repeated measures anova test. Results.  Participants in the case group showed significantly lower phosphate and potassium serum levels and a lower interdialytic weight gain during follow-up when compared to controls. Conclusions.  The presence of a family carer improves patients' adherence, particularly as far as phosphate levels are concerned, since phosphate intake plays a fundamental role in avoiding long-term complications in end-stage renal disease patients.