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A Holistic Approach to Management of Complications in Hemodialysis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: 19 February 2027 | Viewed by 599

Editor


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Guest Editor
Department of Nursing, University of West Attica, 12243 Athens, Greece
Interests: hemodialysis; nephrology nursing; non-pharmacological interventions; caregivers

Special Issue Information

Dear Colleagues,

Hemodialysis (HD) serves as a vital therapy for patients suffering from end-stage renal disease (ESRD). As a predominant form of renal replacement therapy, it addresses the critical decline in kidney function experienced by a growing global population. Although it extends life expectancy, HD is often linked to various acute and chronic complications that can affect not only clinical results but also patients’ overall well-being and quality of life. The burden of these complications is substantial, frequently interacting in a vicious cycle that exacerbates patient prognosis. In spite of advancements in dialysis technology and clinical practices, issues such as intradialytic hypotension, cardiovascular incidents, complications related to vascular access, inflammation, malnutrition, and infections associated with dialysis remain significant challenges.

Effective management requires personalized, patient-focused strategies, collaboration with multiple disciplines, and monitoring of complications while also addressing the emotional, social, and psychological needs of patients.  This integrative approach is essential to move beyond mere life extension and towards enabling a more sustainable and fulfilling life for patients on chronic dialysis.

This Special Issue aims to investigate contemporary and holistic approaches to the care of HD patients. We invite original research articles and reviews that focus on clinical practices, technological advancements, preventive strategies, patient-centered interventions, etc., with the objective of improving clinical outcomes and quality of life of individuals receiving hemodialysis.

Dr. Georgia Gerogianni
Guest Editor

Manuscript Submission Information

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Keywords

  • hemodialysis
  • complications
  • holistic care management
  • quality of life
  • well-being malnutrition
  • hypotension
  • cardiovascular diseases
  • inflammation
  • vascular access

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Published Papers (1 paper)

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Research

12 pages, 260 KB  
Article
Association Between Pain Self-Efficacy and Adherence to Hemodialysis Regimen
by Ioanna Mitsia, Vasiliki Matziou, Maria Polikandrioti, Sofia Zyga and Victoria Alikari
J. Clin. Med. 2026, 15(12), 4824; https://doi.org/10.3390/jcm15124824 - 21 Jun 2026
Viewed by 358
Abstract
Background/Objectives: Pain is a common symptom in patients undergoing hemodialysis (HD) and may influence their quality of life. Pain self-efficacy may play an important role in self-management and adherence behaviors. This study aimed to examine the association between pain self-efficacy and adherence [...] Read more.
Background/Objectives: Pain is a common symptom in patients undergoing hemodialysis (HD) and may influence their quality of life. Pain self-efficacy may play an important role in self-management and adherence behaviors. This study aimed to examine the association between pain self-efficacy and adherence to the HD regimen in patients undergoing HD. Methods: In this descriptive and cross-sectional study, 199 patients undergoing HD from a single private hospital (convenience sample) in Athens, Greece, completed the Greek-Simplified Adherence Questionnaire-HD (GR-SMAQ-HD) to assess adherence and the Pain Self-efficacy Questionnaire (PSEQ) to assess pain self-efficacy. Sociodemographic and clinical data were also recorded. Bivariate analyses and multiple linear regression were performed to identify factors associated with adherence. Statistical significance was set at p < 0.05. Results: Patients demonstrated moderate levels of pain self-efficacy (mean PSEQ = 33.96 ± 9.74) and moderate adherence to the HD regimen (mean GR-SMAQ-HD = 4.78 ± 2.54). No significant correlation was found between pain self-efficacy and adherence in bivariate analysis (rho = 0.125, p = 0.221). However, in multivariate analysis, pain self-efficacy was a significant independent predictor of adherence (β = 0.056, p = 0.032). Longer duration of End-Stage Renal Disease (ESRD) (β = −0.158, p < 0.001), higher pill burden (rho = −0.237, p = 0.030) were associated with lower adherence. Marital status was also a significant predictor of adherence (β = 1.631, p = 0.016). The model explained 24% of the variance in adherence (Adjusted R2 = 0.24). Conclusions: Pain self-efficacy may indirectly affect adherence to the HD regimen, although its direct effect is modest. Adherence appears to be negatively influenced by pill burden and ESRD duration, while social support may play an important role. Full article
(This article belongs to the Special Issue A Holistic Approach to Management of Complications in Hemodialysis)
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