Abstract: Objective To investigate the adherence to medical therapies, the related factors, and the relationship between the adherence and clinical outcomes in maintenance hemodialysis (MHD) patients. Methods We performed a survey to evaluate the adherence in MHD patients in two tertiary hospitals in Beijing using the end-stage renal disease-adherence questionnaire (ESRD-AQ). One-way ANOVA was used to analyze the relationship between adherence and clinical outcome. Logistic regression was used to analyze the related factors for non- adherence behaviors. Results A total of 189 patients participated in this survey and valid questionnaires were collected from 182 patients (males 87; average age 57.8+14.4 years; dialysis vintage >5 years in 51.1% patients). The adherence rates of treatment, medication, fluid and diet were 70.9%, 93.4%, 79.1% and 76.9% respectively. Gender (OR=2.298, 95% CI 1.127～4.683, P=0.022), income (OR=2.539, 95% CI 1.123～5.740, P=0.025), education level (OR=3.453, 95% CI 1.080～11.039, P=0.037), employment state (OR=3.286, 95% CI 1.272～8.489, P=0.014), and race (OR=7.611, 95% CI 1.815～31.922, P=0.006) were the positively related factors for adherence. Conclusion The adherence in MHD patients is insufficient, especially for men, working patients, minority patients, patients with lower education level and low economic level. This study suggests that health care workers should pay more efforts on health education to improve the clinical indicators of MHD patients, and thus to improve their quality of life and health condition.

Key words: maintenance hemodialysis, fluid intake, medication, dietary control, adherence