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      Compliance in Hemodialysis Patients: Unanticipated Monitoring of Biochemical Indices

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          Compliance with the prescribed medical regimen is a critical factor for the continued well-being of hemodialysis patients. As compliance is a multifactorial problem, numerous approaches have been utilized to quantify the compliance of hemodialysis patients. In the present study, we have attempted to examine whether unanticipated control of biochemical indices might predict the compliance status of hemodialysis patients. We compared unanticipated mid-month values of blood urea nitrogen (BUN), serum potassium (K) and phosphate (PO<sub>4</sub>) values of 54 maintenance hemodialysis patients with the scheduled, regular first-week measurements during a 6-month study period. The interdialytic weight gain (IWG) levels of the corresponding weeks were also compared. Mid-month analysis revealed a significant deviation in the compliance status of the study population as BUN, serum K and IWGs were concerned (p < 0.05). The mid-month serum PO<sub>4</sub> levels were also higher but the difference was not significant (p < 0.05). In conclusion, the differences observed in biochemical indices upon change of test request timing were distinctive. It suggests that unanticipated control of biochemical indices might contribute to the actual assessment of compliance in hemodialysis patients.

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          Assessment of compliance in hemodialysis adaptation.

          Research in hemodialysis adaptation has been facilitated by the use of reliable outcome measures such as BUN, K, and interdialysis weight gain. Their use, however, has at times been impressionistic, without reference to the actual range and distribution of those markers in a large population of dialysis patients over a long period of time. This study is a retrospective review to determine that range and distribution at one center. We found the interdialysis weight gains for most patients to be much higher than the levels used in the literature as cut-off points in determining 'non-compliance'. High levels on non-compliance in previous reports may be inflated. Significant correlations among the three biological markers and between each marker and staff assessment of compliance validate the use of inter-dialysis weight gain. Suggestions are made for interpreting such data in the future.
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            Sodium balance and blood pressure response to salt ingestion in uninephrectomized rats


              Author and article information

              Blood Purif
              Blood Purification
              S. Karger AG
              October 1998
              29 January 1999
              : 16
              : 5
              : 275-280
              School of Medicine, Department of Internal Medicine, Division of Nephrology and Hemodialysis Center, Hacettepe University, Ankara, Turkey
              14345 Blood Purif 1998;16:275–280
              © 1998 S. Karger AG, Basel

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              Page count
              Figures: 1, References: 17, Pages: 6
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              Original Paper

              Cardiovascular Medicine, Nephrology

              Compliance, Hemodialysis, Biochemical measures


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