Kidney dialysis patients often struggle to stick with their treatment plans, which can be dangerous. Researchers tested two types of therapy to see which one helps patients follow their doctors’ orders better. Ninety patients received either emotion regulation therapy (which helps manage feelings), cognitive behavioral therapy (which changes thought patterns), or standard care. Both therapy types helped patients follow their treatment plans much better than standard care alone. Cognitive behavioral therapy worked faster and stronger at first, while emotion regulation therapy helped patients stick with their medications longer. The study shows that adding either therapy to kidney care could help patients stay healthier.

The Quick Take

  • What they studied: Whether two different types of talk therapy could help kidney dialysis patients follow their treatment plans better
  • Who participated: 90 kidney dialysis patients split equally into three groups: one getting cognitive behavioral therapy, one getting emotion regulation therapy, and one getting standard care only
  • Key finding: Both therapy types significantly improved how well patients followed their treatment plans compared to standard care. Cognitive behavioral therapy showed faster, stronger improvements (28% increase), while emotion regulation therapy showed more modest but steadier improvements (10% increase)
  • What it means for you: If you or a loved one receives kidney dialysis, adding therapy to your care plan may help you stick with treatments better, which could improve your health. Talk to your doctor about which approach might work best for you

The Research Details

This was a randomized controlled trial, which is one of the strongest types of medical research. Researchers randomly divided 90 kidney dialysis patients into three equal groups. One group received cognitive behavioral therapy (a type of talk therapy that helps change unhelpful thinking patterns), another received emotion regulation therapy (a type of talk therapy that helps manage difficult feelings), and the third group received only standard kidney care. The researchers measured how well patients followed their treatment plans in five areas: showing up for dialysis, taking medications, limiting fluid intake, following diet rules, and overall adherence. They checked results right after treatment ended and again three months later.

The study was carefully designed to make sure the groups were similar at the start by checking age, weight, how long they’d been on dialysis, and education level. The researchers used statistical methods to account for these starting differences when analyzing the results.

Understanding which therapy works best helps doctors choose the right treatment for their patients. Since kidney dialysis requires strict adherence to survive, finding ways to help patients follow their plans is critically important. This study directly compares two different therapy approaches, which helps doctors know which one to recommend.

This study has several strengths: it randomly assigned patients to groups (reducing bias), it had a control group for comparison, it measured multiple aspects of adherence, and it followed patients over time. Some limitations include the relatively small sample size and the fact that some patients dropped out. The study was published in a peer-reviewed journal, meaning other experts reviewed it before publication.

What the Results Show

Both therapy groups showed major improvements in following their treatment plans compared to the control group. Cognitive behavioral therapy produced the strongest immediate results, with total adherence scores jumping 28% from the start to right after treatment. Emotion regulation therapy also helped significantly, with a 10% improvement in total adherence scores.

When researchers checked three months later, cognitive behavioral therapy maintained its stronger results, though both groups showed some decline from their peak improvements. The control group, which received only standard care, actually got worse at following their treatment plans over time.

Cognitive behavioral therapy was especially effective at helping patients limit their fluid intake (56% improvement), which is one of the hardest parts of dialysis treatment. Emotion regulation therapy was better at helping patients stick with their medications over the longer term, even though the immediate improvement was smaller.

Both therapies helped patients follow their dialysis appointments better, though both groups showed slight declines by the three-month follow-up. The medication adherence improvements were particularly strong with emotion regulation therapy at the follow-up point. Dietary adherence also improved in both therapy groups but declined somewhat by follow-up. The control group showed consistent worsening across all five measured areas of adherence.

This research adds important new information by directly comparing two different therapy approaches in kidney dialysis patients. Previous studies have shown that talk therapy can help dialysis patients, but this study specifically shows that cognitive behavioral therapy works faster and stronger initially, while emotion regulation therapy may provide better long-term support for medication adherence. The findings suggest that combining both approaches might work even better than using just one.

The study included only 90 patients, which is a relatively small number. Some patients dropped out of the study, which could affect results. The study only followed patients for three months, so we don’t know if the benefits last longer. The study was conducted in one location, so results might differ in other places or populations. Additionally, the study didn’t measure whether improved adherence actually led to better health outcomes for the patients.

The Bottom Line

If you’re a kidney dialysis patient struggling to follow your treatment plan, ask your doctor about cognitive behavioral therapy for faster initial improvements or emotion regulation therapy for better long-term medication adherence. The evidence suggests both approaches are significantly better than standard care alone (high confidence). Consider discussing with your healthcare team which approach might fit your personality and needs better (moderate confidence).

Kidney dialysis patients who struggle with treatment adherence should definitely discuss these options with their doctors. Family members and caregivers of dialysis patients may also benefit from understanding these approaches. Kidney doctors and dialysis centers should consider offering these therapies as part of standard care. People with other chronic conditions requiring strict adherence might also benefit from similar approaches, though this study specifically tested dialysis patients.

Cognitive behavioral therapy showed strong improvements within weeks of starting treatment. Emotion regulation therapy took longer to show benefits but appeared to maintain them better over three months. Most patients would likely need at least 8-12 weeks of therapy to see meaningful improvements in their adherence.

Want to Apply This Research?

  • Track adherence across five specific areas daily: dialysis appointment attendance (yes/no), medications taken on schedule (count), fluid intake in ounces, dietary sodium intake in grams, and overall adherence score (1-10 rating). Create a simple dashboard showing weekly trends in each category.
  • Use the app to set daily reminders for medications and fluid limits. Create a mood check-in feature that helps users notice emotional triggers that make them want to skip treatments, then suggest coping strategies based on either cognitive behavioral therapy (challenging unhelpful thoughts) or emotion regulation therapy (naming and managing emotions) techniques.
  • Establish a baseline adherence score in the first week, then track weekly improvements. Set realistic goals (5-10% improvement per month). Create alerts when adherence drops below 80% in any category. Generate monthly reports to share with healthcare providers. Include a reflection feature where users note what helped or hindered adherence that week.

This research shows that therapy can help kidney dialysis patients follow their treatment plans better, but it should not replace medical advice from your doctor or dialysis team. If you’re a dialysis patient, talk to your healthcare provider before starting any new therapy to make sure it’s right for your specific situation. This study was conducted over three months, so long-term effects are unknown. Results may vary based on individual circumstances, motivation, and other personal factors. Always follow your doctor’s recommendations for your dialysis treatment and medications.