#2620 WHY DIALYSIS PATIENTS CHOOSE OR REFUSE KIDNEY TRANSPLANTATION AS RENAL REPLACEMENT THERAPY: A QUALITATIVE STUDY

Abstract

Abstract Background and Aims Kidney transplantation is considered the best renal replacement therapy (RRT) for patients with end-stage renal disease, nevertheless, some dialysis patients refuse to be transplanted. Many patients are concerned about their quality of life as a patient on dialysis compared to life with a new, functioning kidney. The results from many studies have shown that patients who have been living with a transplanted kidney for 10 years demonstrate a greater likelihood of still being alive than those on dialysis. For every 10 patients receiving a new kidney, eight will still have that kidney working three years after the operation. So, considering survival alone, individuals receiving a new kidney do better than those on dialysis. But not all the CKD and CKD on HD share the same opinion and a number refuse kidney transplantation. The aim of this paper is to identify the reasons for choosing or refusing kidney transplantation as renal replacement therapy among patient with Chronic Kidney Disease (CKD). Method We used purposeful sampling because it was more relevant to identify and to select the individuals who seemed in-keeping with the social facts we wanted to study. We wanted to retrace participants’ paths of care to identify the reasons for their choice. Patients who were treated using hemodialysis as well as those who opted for peritoneal dialysis were interviewed. We also interviewed health professionals (doctors, nurses, a psychologist) for their opinions on the nature of their relationship with patients in the decision making process regarding kidney transplantation. Results Data were collected through interviews with CKD patient and CKD patient treated by dialysis. Health professionals, medical doctors and nurses were also interviewed. A thematic analysis was used to analyze the data. The collected data showed that various reasons account for CKD patients’ refusal replacement therapy without positive outcome, refusal to have an allograft. There are also situations such as the lack of organ, the age factor, contraindications to kidney transplantation that not allow some CKD patients to have a kidney transplant. Among the patients who choose kidney transplantation, lots of them have lack of information about transplantation process others see kidney transplantation as a cure which will finally make them machine dependent and a small group see it as a normal process. Conclusion This paper shows that the choice of kidney transplantation depends on patients’ perceptions of its outcomes. Some circumstances, such as the lack of an available organ or specific medical criteria including age factor and malignancy, reduce CKD patients’ participation in the decision-making process.