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.