One of the challenges that are faced by patient who needs to be on dialysis is unable to

attend a dialysis or ending the dialysis session early. Most dialysis patient confess that
the reason they skip their session is because they feel too unwell. Some of the them
confer that sometimes they have conflicting medical appointment. Many patients who
skip kip dialysis or end the session early says that sometimes the staff are unsuccessful
in motivating them to stay. This is because the patient has difficulty to convey their
health consequences, hence they would leave the session earlier.

The second challenged faced by patient is that the patient is not following the
recommended doses of the medication. This is mainly due to their forgetfulness.
However, cost of medication can be factor why patient are not able to follow the
recommended dose of the medication. Patient who suffer from chronic kidney dieases
also most likely to suffer from hypertension and diabetes mellitus. It harder for them
to keep track of their medication this making them mom compliant. Patient also avoid
taking their medication because they are afraid of the side effect and how it will affect
them.

The third challenge of dialysis patients is they are eating and drinking more than the
recommends amount. Patient who undergo dialysis , will have thirst and dry mouth.
This is because some the side effect of the medication and complication form diabetic
mellitus . Some patient do not understand the important of consuming the excess fluid.
This is because the patient lack the primary education resorucess . The patients are not
well infomed about the side effect of the excess fluid and food

Poor compliance in kidney dialysis causes a risk for peritonitis. Other complication of
non-adherence includes pulmonary oedema, hypertension, hospital readmissions and
septicaemia. Poor dialysis adherence has been identified as the leading cause of drug
failure, as well as additional and unneeded testing, dosage adjustments, treatment plan
changes, emergency department visits, and hospitalizations, all of which drive up
medical expenses. Treatment-related fatigue and dizziness, lower-extremity oedema,
ascites, left ventricular hypertrophy and congestive heart failure, hypertension,
shortness of breath, and pulmonary vascular congestion or acute pulmonary oedema
are all side effects of excessive fluid intake and chronic fluid overload. In CKD
patients, excessive fluid overload contributes to increased morbidity and mortality.

As future practicing doctor, I think it is our responsibility as a doctor to make sure our
patient is compliant to their medication. I would offer then well- informed pamphlet
about dialysis treatment to the patient so they could have a better understanding of the
dialysis patient. I would also advise the patient to join peer support to help them cope
with the new changes of lifestyle. They also have a safe space to share their concern
and seek help within themselves. As doctor we should have a better communication
with the patient so they would feel comfortable sharing their health concerned with us.
As doctor we should also have non-judgmental relationship when the patient is non-
complaint to dialysis treatment and we should work together to find out the best
course of treatment for the patient.