Abstract: Objective  To investigate medication adherence and social support status among patients undergoing maintenance hemodialysis (MHD).  Methods  Patients receiving MHD at Beijing Boai Hospital of the China Rehabilitation Research Center from January 1 to April 15, 2025, were selected as study subjects. Demographic and medical data were collected via the Renal Rehabilitation Electronic Information Management Platform. Medication adherence was assessed using the Morisky Adherence Scale, while social support was evaluated using the Social Support Rating Scale. Anxiety and depression states were assessed with the Self-Rating Anxiety Scale and Self-Rating Depression Scale, respectively. A logistic regression model was applied to analyze factors influencing medication adherence.  Results  A total of 99 patients were included, with 45.45% in the good adherence group and 54.55% in the poor adherence group. Compared with the poor adherence group, patients in the good adherence group exhibited lower serum potassium (t=2.015, P=0.047) and phosphorus (t=2.621, P=0.010) levels, higher urea clearance index (t=-2.769, P=0.007), and reduced anxiety scores (t=2.489, P=0.015). No statistically significant differences were observed in social support scores (t=1.160, P=0.249), subjective support scores (t=0.687, P=0.494), objective support scores (t=1.450, P=0.151), or support utilization (t=0.410, P=0.682) between the two groups. No significant correlation was found between medication adherence and social support scores (β=-0.139, P=0.169). Patients with higher satisfaction with social support exhibited relatively poorer medication adherence (χ²=5.727, P=0.014). Logistic regression analysis revealed that higher anxiety levels (OR=0.933, 95% CI：0.878～0.992, P=0.025), lower urea clearance index (OR=10.887, 95% CI 1.813～65.364, P=0.009), and greater satisfaction with social support (OR=0.362, 95% CI：0.138～0.951, P=0.039) were associated with poorer medication adherence.  Conclusion  Poor medication adherence is prevalent among MHD patients, and there is a complex interplay between medication adherence and social support. Nursing staff should provide health education to patients through various methods to enhance their social support and medication adherence.

Key words: Medication adherence, Social support, Maintenance hemodialysis