Background: Chronic kidney disease (CKD) is a gradual and difficult-to-treat impairment of kidney function. Kidney failure is a leading cause of death compared to infectious diseases. Hemodialysis, a renal replacement therapy, can potentially cause various complications, requiring patients to restrict fluid intake. Compliance with fluid restriction is influenced by gender, education level, knowledge, duration of hemodialysis, and family support. Family support is a psychosocial factor that influences health behaviors in hemodialysis patients. The duration of hemodialysis can encourage patients to adapt physiologically and psychologically. Purpose: To analyze the relationship between family support and duration of hemodialysis and adherence to fluid restriction in hemodialysis patients. Method: This study used a quantitative observational design with a cross-sectional approach. The population in this study were all hemodialysis patients at Dr. Moewardi Hospital, Surakarta, and was conducted from October 2025 to March 2026. The minimum sample size was calculated using the Kothari formula, and 131 respondents were analyzed. Family support was measured using the Perceived Social Support from Family questionnaire, and fluid restriction adherence was measured using the End-Stage Renal Disease Adherence Questionnaire (ESRD-AQ). Bivariate analysis of family support was performed using the Fisher's Exact test, and hemodialysis duration was performed using the Chi-Square test, with fluid restriction adherence as the variable. Results: A high proportion of family support was found for informational support, with 119 respondents (90.8%). The distribution of hemodialysis duration showed that the largest proportion was in the >24 months category, with 49 respondents (37.4%). Data analysis revealed an association between family support (p-value = 0.002) and hemodialysis duration (p-value = 0.003) and fluid restriction adherence in hemodialysis patients. Conclusion: There is an association between family support and fluid restriction adherence in hemodialysis patients. Despite receiving adequate family support, the majority of respondents demonstrated non-adherence to fluid restrictions. Compliance with fluid restrictions in hemodialysis patients is not only related to individual characteristics, such as gender, age, and education level, but also to the duration of hemodialysis and family support. Suggestion: A responsive approach is needed, including empathy, the provision of practical solutions, and active family involvement as a form of support in helping patients manage their fluid intake optimally. Keywords: Compliance; Family Support; Fluid Restriction; Hemodialysis.
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