Younger Dialysis Patients and Those With Depression More Likely to Struggle With Prescribed Treatment Regimen, American Kidney Fund Survey Finds

Nationwide survey explores five key areas of nonadherence and barriers to treatment self-management

Rockville, Maryland

ROCKVILLE, Maryland, March 21, 2018 (GLOBE NEWSWIRE) -- A nationwide survey released today found that patients aged 18 to 39 are more likely to struggle with their prescribed treatment regimen for kidney failure than are older patients. These younger patients also reported feeling depressed nearly twice as often as older patients. Depression emerged as a leading contributing factor to treatment nonadherence across all age groups in the American Kidney Fund (AKF) Adherence Survey, which analyzed responses from nearly 1,200 dialysis patients who have received financial grants from AKF, along with responses from 400 renal professionals, including about 250 dialysis social workers.

“The treatment regimen for people living with kidney failure is complex and demanding, yet following the prescribed treatment plan is essential for patients to have the best health outcomes possible,” said LaVarne A. Burton, president and CEO of the American Kidney Fund. “Living with kidney failure is enormously challenging for patients, and we want this survey to foster a deeper understanding of patient experiences and challenges so that the entire renal community may more effectively support patients.”

The top findings unveiled in AKF’s “Barriers to Treatment Adherence for Dialysis Patients” report include: 

  • Overall, 30 percent of patients surveyed reported leaving dialysis sessions early, while 18 percent said they skipped sessions altogether.
  • Among patients aged 18 to 39, fully half left dialysis sessions early, and 30 percent reported skipping sessions. They also reported medication nonadherence at a higher rate (38 percent) than older patients, and they were the least adherent to their prescribed diets (71 percent).
  • Forty-two percent of patients indicated that depression, nervousness or fear had kept them from activities they wanted or needed to perform in the last month.
  • Patients aged 18-39 reported higher rates of debilitating feelings of sadness (36 percent) than patients aged 40-49 (18 percent), 50-59 (20 percent) and 60+ (18 percent).
  • Among patients who reported experiencing depression twice a month or more, 28 percent skipped a dialysis session, compared to 14 percent of patients who never felt depressed.
  • Patients who felt depressed at least once a month skipped medication at higher rates (30 percent) than patients who never felt depressed (18 percent).

Because nonadherence to treatment can lead to hospitalizations, adverse health effects and even death, AKF undertook the survey to understand better how widespread nonadherence is among dialysis patients, some of the factors that make it difficult for patients to follow their treatment plans, and interventions that could help patients improve their treatment self-management.

“A diagnosis of kidney failure is life-changing, and dialysis can be challenging, especially at the outset, when many patients report feeling depressed,” Burton said. ”Because depression plays such a large role in treatment nonadherence, it’s incumbent upon the entire renal community to work together to find ways to address this and support patients.”

The survey, which was funded by a grant from Amgen, also found:

  • Forgetfulness was the top reason for medication nonadherence (69 percent), and 23 percent of patients who reported missing one pill or dose of medication said they had skipped more than one in the previous week.
  • The most common reasons patients gave for skipping dialysis or ending a session early were feeling sick and having conflicting medical appointments.
  • Ineffective communication between patients and health care providers emerged as a factor contributing to nonadherence. Providers said having insufficient time and resources to communicate health information contributes to patient nonadherence, and they cited language barriers as an obstacle to communicating effectively with patients.
  • Support from non-medical caregivers, such as family members, can improve adherence to diet and exercise regimens.
  • Sadness, nervousness or fear had prevented more than 40 percent of patients from complying with required treatments in the previous month.
  • More than half (58 percent) of patients reported nonadherence to diet recommendations, citing the desire to take a break from the strict diet (45 percent) and difficulty following the diet when dining out (39 percent).

“Though our survey results are specific to dialysis patients, we believe they may provide insights that can be applied to patients dealing with other chronic health conditions, as well,” Burton said.

Based on information revealed by the Adherence Survey, AKF has developed programs, educational tools and new materials designed to support patient self-management:

To download AKF’s “Barriers to Treatment Adherence for Dialysis Patients” report, visit

About the American Kidney Fund

As the nation’s leading nonprofit working on behalf of the 30 million Americans with kidney disease, the American Kidney Fund is dedicated to ensuring that every kidney patient has access to health care, and that every person at risk for kidney disease is empowered to prevent it. AKF provides a complete spectrum of programs and services: prevention outreach, top-rated health educational resources, and direct financial assistance enabling 1 in 5 U.S. dialysis patients to access lifesaving medical care, including dialysis and transplantation. AKF holds the highest ratings from the nation’s charity watchdog groups, including Charity Navigator, which includes AKF on its “top 10” list of nonprofits with the longest track records of outstanding stewardship of the donated dollar, and GuideStar, which has awarded AKF its Platinum Seal of Transparency.

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