Impact of Hemodialysis Adherence on Biochemical Markers in Chronic Kidney Disease Patients: A Comparative Study

Abstract

Background: Chronic Kidney Disease (CKD) is a global health burden associated with progressive renal impairment and multiple comorbidities. Adherence to hemodialysis  schedules, dietary restrictions, and prescribed medications significantly influences disease progression and biochemical profiles.

Aim: To compare specific biochemical markers between adherent and non-adherent CKD patients on hemodialysis, assess the effect of delayed dialysis on these markers, and explore associations with demographic variables.

Methods: A cross-sectional study was conducted among 50 CKD patients receiving hemodialysis in two tertiary care hospitals. Participants were classified as adherent or non-adherent based on hemodialysis attendance and compliance with treatment. Data included demographic details and biochemical parameters — serum creatinine, blood urea, serum potassium, serum calcium, and hematocrit levels — measured pre-dialysis. Analysis involved descriptive statistics, Mann-Whitney U tests, and Kruskal-Wallis tests for group comparisons, with chi-square tests for demographic associations.

Results: Serum creatinine differed significantly between adherent (2.60 ± 1.30 mg/dl) and non-adherent patients (2.80 ± 1.31 mg/dl; p = 0.054). Other parameters showed no statistically significant differences. Missing two hemodialysis sessions was associated with notably higher creatinine (3.27 mg/dl) and altered potassium levels (p < 0.001). Gender, diet type, residence, and hospital distance were significantly associated with selected biochemical markers.

Conclusion: While most biochemical parameters did not differ significantly, serum creatinine and potassium levels were sensitive to treatment adherence and missed hemodialysis sessions. Tailored adherence interventions, patient education, and logistical support can enhance biochemical stability and overall patient outcomes.