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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Abstract titles should be brief and reflect the content of the abstract.
Language and culture strongly shape equity in chronic kidney care. In Paraguay’s bilingual context, limited Spanish–Guaraní communication hinders comprehension, adherence, and nutrition understanding in hemodialysis. Cultural views on food and illness reinforce these barriers. This VIVA Project study explores how socio-linguistic factors affect self-care in Concepción, aiming to guide inclusive bilingual strategies for patient education and improved kidney-care outcomes.
A cross-sectional study (Jan–Jun 2025) at the Concepción Regional Hospital Hemodialysis Unit, within the VIVA Project, assessed language, understanding, and adherence among adults on dialysis ≥3 months. Thirty-eight participants completed a bilingual Spanish-Guaraní questionnaire on demographics, comprehension, and self-care. Data were analyzed with descriptive and inferential statistics; qualitative answers revealed linguistic and cultural barriers to patient education.
Among the 38 participants, the mean age was 54.2 ± 11.8 years; 71% lived in rural communities. Guaraní was the predominant spoken language (76%), with Spanish reported as primary by 18% and both languages by 6%. Only 24% indicated full comprehension of Spanish-based medical discussions. Patients reporting limited Spanish comprehension were more likely to omit medication doses (68% vs. 27%, p = 0.009) and to exceed recommended fluid intake limits (p = 0.041). See Table 1.
Table 1. Relationship between Language Proficiency and Treatment Adherence (n = 38)
Figure 1 – Language Predominance and Comprehension of Medical Explanations in Hemodialysis Patients (n = 38)
Distribution of comprehension levels by primary language among hemodialysis patients at the Regional Hospital of Concepción (n = 38). Guaraní-speaking patients showed markedly lower understanding of medical explanations compared with Spanish or bilingual speakers (p < 0.001), underscoring the communication inequity in chronic kidney disease management
Patients reported three barriers: unclear Spanish explanations causing anxiety, dietary advice conflicting with traditional foods, and hierarchical care discouraging dialogue.
A representative statement:
“Che ndahendúi la médico he’íva, ha ndaipóri oipytyvõva oñemombe’u Guaraníme.”
(“I don’t understand what the doctor says, and there’s no one to explain it in Guaraní.”)
Language and cultural barriers strongly influence self-care among Paraguayan hemodialysis patients. Guaraní predominance and Spanish-only communication cause misinterpretations in diet and medication adherence. This aligns with global evidence linking language discordance to poor outcomes. The VIVA Project pioneers bilingual education and community engagement. Despite its small sample, it reveals that integrating linguistic and cultural dimensions in nephrology enhances adherence and equity in kidney care.
