The nutritional adherence rate of CKD-HD patients are still low. This low adherence rate increases readmission rates, morbidity and mortality of CKD-HD patients. This study aims to analyze the factors that influence dietary non-adherence in CKD-HD patients qualitatively to obtain more comprehensive and rational information so that it can be a reference for determining the next solution steps. A qualitative study with indepth semi-structured interviews was conducted on 14 participants consisting of patients, families, the medical team of the HD unit. Participants were recruited by purposive sampling. Audio recordings were transcribed verbatim and analyzed by thematic analysis. Three main themes and nine categories of causes of nutritional non-adherence were found. Theme 1 is individual factors was formed from 3 categories low level of nutritional knowledge, low socio-economic and clinical condition perception of the patient. Theme 2 is the influence of social factors was formed from 3 categories the need for support from spouse/ family, the need for support from friends and the need for support from the community and the surrounding community. Theme 3 is the support factor from the medical team with regular evaluations, active involvement of the nutrition team and medical nutrition training. This study found that the causes of nutritional non-adherence in CKD-HD patients were low levels of nutritional knowledge, low socioeconomic status, lack of family and community support, lack of regular nutrition education and evaluation and the absence of a structured monitoring system to improve patient adherence with management. CKD-HD nutrition.