Nonadherence in dialysis patients: prevalence, measurement, outcome, and psychological determinants

Sarah Clark, Ken Farrington, Joseph Chilcot

Research output: Contribution to journalReview article

69 Citations (Scopus)


Nonadherence to aspects of the management of End-Stage Kidney Disease (ESKD) is common. Estimates of nonadherence vary with assessment method. Whilst readily available and free from report bias, physiological proxies-frequently used as measures of adherence-are often confounded by clinical factors including residual kidney function and dialysis adequacy. Despite variation in estimates of its prevalence, it is clear that suboptimal adherence to dialysis prescriptions, medication and diet can lead to adverse clinical outcomes. Several factors can help explain nonadherence in ESKD including mood, self-efficacy, social support, illness, and treatment perceptions. Psychological interventions have been shown to improve ESKD adherence, yet achieving long-term behavior change remains challenging. Identifying individuals who struggle to adhere to aspects of the dialysis regime, and tailoring theory-led interventions to improve and support adherence is a clear clinical need requiring further empirical enquiry.

Original languageEnglish
Pages (from-to)42-9
Number of pages8
JournalSeminars in Dialysis
Issue number1
Publication statusPublished - 30 Oct 2013


  • Attitude to Health
  • Biomarkers
  • Depression
  • Health Behavior
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Kidney Failure, Chronic
  • Patient Compliance
  • Prevalence
  • Renal Dialysis
  • Self Efficacy
  • Self Report
  • Social Support
  • Surveys and Questionnaires
  • Journal Article
  • Review


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