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dc.contributor.authorHucker, Abigail
dc.contributor.authorLawrence, Christopher
dc.contributor.authorSharma, Shivani
dc.contributor.authorFarrington, Kenneth
dc.date.accessioned2019-07-29T11:01:24Z
dc.date.available2019-07-29T11:01:24Z
dc.date.issued2019-08-01
dc.identifier.citationHucker , A , Lawrence , C , Sharma , S & Farrington , K 2019 , ' Adherence Behavior in Subjects on Hemodialysis Is Not a Clear Predictor of Posttransplantation Adherence ' , Kidney International Reports , vol. 4 , no. 8 , pp. 1122-1130 . https://doi.org/10.1016/j.ekir.2019.04.028
dc.identifier.issn2468-0249
dc.identifier.urihttp://hdl.handle.net/2299/21479
dc.description© 2019 The Authors. Published by Elsevier Inc. on behalf of the International Society of Nephrology. This is an openaccess article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
dc.description.abstractIntroduction: Nonadherence is common in both hemodialysis (HD) and kidney transplant recipients and is a major risk factor for poor clinical outcomes. This retrospective study explored whether nonadherent HD patients become nonadherent transplant recipients. Methods: Data were collected for 88 patients from the electronic patient system at a subregional renal unit about adherence to HD regimens in the 6 months before transplantation, and for 1 year posttransplantation following return transfer to the posttransplantation clinic from the transplanting center. Pretransplantation definitions of nonadherence included whether the patients: on average, shortened their dialysis prescription by >10 minutes; shortened it by >15 minutes; missed 2 or more HD sessions; and had mean serum phosphate levels >1.8mmol/l. Posttransplantation definitions of nonadherence included mean tacrolimus levels outside 5 to 10 ng/ml; and missed 1 or more posttransplantation clinic appointments. Results: Nonadherence ranged from 25% to 42% pretransplantation and from 15.9% to 22.7% posttransplantation, depending on how it was operationalized. There was little relationship between pretransplantation data and posttransplantation adherence, with the exception of a significant relationship between pretransplantation phosphate and posttransplantation clinic attendance. Patients who had missed 1 or more transplant clinic appointments had higher mean pretransplantation phosphate levels. Nonadherent patients with high phosphate levels pretransplantation and missed clinic appointments posttransplantation were significantly younger. Conclusion: Our findings provide little support for the likelihood of a strong direct relationship between pre and posttransplantation behaviors. The findings require confirmation and further research to assess whether interventions in relation to pretransplantation adherence may enhance adherence posttransplantation and improve outcomes.en
dc.format.extent9
dc.format.extent343305
dc.language.isoeng
dc.relation.ispartofKidney International Reports
dc.subjectadherence
dc.subjecthemodialysis
dc.subjectimmunosuppression
dc.subjectkidney
dc.subjectphosphate
dc.subjecttransplant
dc.subjectNephrology
dc.titleAdherence Behavior in Subjects on Hemodialysis Is Not a Clear Predictor of Posttransplantation Adherenceen
dc.contributor.institutionDepartment of Psychology and Sports Sciences
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionBasic and Clinical Science Unit
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionCentre for Research in Psychology and Sport Sciences
dc.contributor.institutionHealth and Clinical Psychology Research Group
dc.contributor.institutionPsychology
dc.description.statusPeer reviewed
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85068740661&partnerID=8YFLogxK
rioxxterms.versionofrecord10.1016/j.ekir.2019.04.028
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue


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