Difficulties and self-perceived barriers to adherence to the dietary plan in patients with chronic kidney disease undergoing hemodialysis at the "Profesor Dr. Luis Güemes" Hospital, Buenos Aires, Argentina.

Abstract

Abstract

Introduction: 

Chronic Kidney Disease (CKD) represents a significant public health challenge, especially in patients requiring hemodialysis (HD). Adherence to nutritional therapy is essential for improving clinical prognosis, although it is often limited by various barriers perceived by patients.

Objective: 

Describe the difficulties and self-perceived barriers to adherence to the dietary plan in CKD patients undergoing HD at a hospital in the Province of Buenos Aires, between January and February 2025.

Materials and methods: 

A cross-sectional, observational, descriptive study with a mixed-methods approach and non-probability convenience sampling. Data were collected using a self-developed survey administered during the HD session.

Results: 

The total sample included 34 patients. 80% reported difficulty increasing their fish consumption and incorporating nuts, seeds, avocado, and raw oils into their diets. 50% reported some difficulty restricting fluid intake, minimizing their consumption of cheese and pastries, choosing reduced-sodium products, and restricting their salt intake. Finally, 40% reported difficulty minimizing their consumption of ultra-processed foods and incorporating legumes weekly.

Discussion: 

It was observed that dietary adherence in patients undergoing HD is influenced by individual factors and their environment. The main difficulties perceived in adhering to nutritional recommendations highlight the dietary pattern of this population. This agrees with Celi et al., who found that more than 60% had low adherence to Mediterranean diet and more than 50% had a high intake of ultra-processed foods (18). Furthermore, it was found that more than half of the participants were unemployed and had financial limitations that hindered their adherence to recommendations. They also mentioned barriers related to tastes and customs, expressing a need for greater flexibility, personalization, and other nutritional education strategies to improve their adherence.

Conclusion: 

The entire sample reported at least one difficulty and/or barrier to adhering to one or more recommendations. The importance of a comprehensive, personalized, and interdisciplinary approach for this population is emphasized, which broadens the perspective beyond strictly nutritional aspects and incorporates complementary strategies.