Objectives: The study objective was to identify the factors that influence dietary adherence in Hispanic patients receiving maintenance hemodialysis and to determine the differences in dietary adherence between Hispanic and non-Hispanic patients.
Design: We performed a cross-sectional study using a descriptive-comparative design.
Setting: The study took place at hemodialysis centers at Winthrop-University Hospital, New York.
Participants: The participants were adult patients of Hispanic descent receiving maintenance hemodialysis three times per week for 3 months or more and an equal number of age- and sex-matched non-Hispanic patients.
Intervention: Information was obtained by a questionnaire about knowledge of the diet, preferred language for education, consumption of potassium- (K(+)) and phosphorus- (PO(4)) containing foods, and adherence attitudes and behaviors. Serum albumin (SAlb), K(+), and PO(4) for the past 3 months were obtained from medical records and evaluated to assess dietary adherence.
Main outcome measure: The main outcome measure was a mean SAlb of 3.2g/dL or greater, K(+) of 5.5 mEq/L or less, and PO(4) of 5.5 mg/dL or less.
Results: A total of 17 Hispanic and 17 comparison patients were included. Both groups were adherent to the diet because their mean levels of SAlb, K(+), and PO(4) were within acceptable limits. Dietary adherence was observed in 76% of the Hispanic patients for SAlb, 88% for K(+), and 65% for PO(4), whereas the rate of adherence was 59%, 88%, and 76%, respectively, for the comparison group.
Conclusion: Both groups were adherent to the restrictions of the renal diet. More patients from both groups were adherent to K(+) than to PO(4) restrictions. Among the factors that probably influenced dietary adherence to the renal diet in this dialysis facility are knowledge of the renal diet, language, food frequency consumption, socioeconomic status, family support, and attitudes toward the renal diet. Patient education provided in Spanish with family involvement is an important element for promoting adherence among Hispanic patients receiving dialysis.