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Similarly, a study conducted on Zimbabweans showed that more than 50% of patients were not adhering to the scheduled hemodialysis plan.In fact, 93% of the respondents had missed at least one session of HD with 61% missing most of the scheduled sessions. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Worldwide, End Stage Renal Disease (ESRD) has become a public health concern increasing the number of patients maintained on hemodialysis prior to renal transplantation.
Numerous studies have also revealed that nonadherence is the cause of mortality, frequent hospitals visits, and hospital admissions [12, 13]. , missed and shortened dialysis treatment time resulted in physical problems such as hypotension, cramps, fatigue, and clots in access site.
Informal observations and clinical experience in Rwandan renal units reveal poor adherence to hemodialysis among ESRD patients.
Only seven percent had attended to all the hemodialysis sessions as scheduled.
Sixty-seven percent had rescheduled the prescribed hemodialysis sessions more than once . , nonadherence to treatment plan among patients with ESRD was problematic with approximately half of patients missing their sessions.
This makes it difficult for far away rural populations in other provinces to access hemodialysis services, forcing the majority of the patients with ESRD to go to urban dialysis centers.
Nonadherence to hemodialysis on the other hand remains a major obstacle in the management of End Stage Renal Disease (ESRD) population.There are four (4) dialysis units in Rwanda for which three are in the city center of Kigali and one in the rural setting in the southern province.There are approximately twenty working machines in the three dialysis units in the city center of Kigali and six (6) in the southern province .Nevertheless, hemodialysis is also expensive but the preferred modality of treatment of ESRD patients in Rwanda .In 2015, Rwanda Demographic Health Survey data showed a projected total population of 11,274,221 people with approximately 84 percent of them living in rural area.The increase of ESRD patients necessitates management on dialysis for better outcomes, thus making adherence to prescribed treatment essential .Although kidney transplantation is the best choice of treatment of renal failure, resource constraints and shortage of kidney donations remain an issue .Moreover, there are limited studies in Rwanda about adherence to hemodialysis among ESRD.Yet, the health profile of Rwanda 2014 (WHO update) reveals that renal diseases were the fourteenth leading cause of death among 50 top causes of death in Rwanda .Descriptive statistics were used to describe the demographic variables and the level of adherence to hemodialysis.Inferential statistics of chi-square was used to establish factors associated with adherence to hemodialysis. Twenty-one (51%) of ESRD participants adhered highly (scores End Stage Renal Disease (ESRD) is a known increasing public health concern globally .