Adherence to Hemodialysis Dietary Sodium Recommendations: Influence of Patient Characteristics, Self-Efficacy, and Perceived Barriers

Objective: To identify characteristics of hemodialysis patients most likely to experience difficulty adhering to sodium restrictions associated with their dietary regimen. Design: Secondary analysis using baseline data from an ongoing randomized clinical trial examining the effects of a technology-supported behavioral intervention on dietary sodium intake in hemodialysis patients. Setting: Thirteen dialysis centers in southwestern Pennsylvania. Subjects: We included 122 participants (61% women; 48% African American) aged 61 +/- 14 years undergoing maintenance, intermittent hemodialysis for end-stage renal disease. Main Outcome Measures: Normalized dietary sodium intake, adjusted interdialytic weight gain, perceived problems, and self-efficacy for restricting dietary sodium. Results: Younger participants were more likely to report problems managing their hemodialysis diet and low self-efficacy for restricting sodium intake. Consistent with these findings, younger participants had a higher median sodium intake and higher average adjusted interdialytic weight gain. Females reported more problems managing their diet. Race, time on dialysis, and perceived income adequacy did not seem to influence outcome measures. Conclusion: Our findings suggest that patients who are younger and female encounter more difficulty adhering to the hemodialysis regimen. Hence, there may be a need to individualize counseling and interventions for these individuals. Further investigation is needed to understand the independent effects of age and gender on adherence to hemodialysis dietary recommendations and perceived self-fficacy. (C) 2014 by the National Kidney Foundation, Inc. All rights reserved.