Abstract
Worldwide, hemodialysis is the most common renal replacement therapy for patients with end-stage renal disease (ESRD). Hemodialysis can be a very stressful treatment, due to its complex dietary and fluid control demands that are crucial for dialysis adequacy, patients’ quality of life, and survival. Consequently, non-adherence is high (up to 82% for dietary and 74% for fluid restrictions) and is currently considered a major health problem, due to its association with poor clinical outcomes (e.g., bone demineralization, clots in the access site, swelling, fatigue, electrolyte imbalances, pulmonary congestion, heart failure), increased risk of hospitalization, and early mortality.
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