Refusal for Dialysis by Acute and Cronic Renal Failiar Patients at Sheikh Ziad Hospital Rahim Yar Khan

Abstract

Background:- Patients suffering from advanced renal faillairare diagnosed in advanced stages of the disease but acute renal failure patients are diagnosed on early stage. Patients who are admitted in the ward are afraid of hemodialysis. All the patients who were suffering from end stage renal disease or acute renal failier having indications for hemodialysis were enrolled in the study. Patients were asked regarding acceptance or refusal of hemodialysis and the causes of their decisions Socioeconomic, demographic and clinical characteristics of the patients were compared between patients who underwent or refuse for hemodialysis. 150 patients were included in this study. Mean ages of the patients were 42.6 ± 15 years. Of all 99 (66%) patients refuse for dialysis while 51 (34%) patients were agreed for dialysis. Patients with AV fistula (30 Vs. 8 % P 0.021) and those with good socioeconomic background, well-educated group 63.1 vs. 39.4 (P=.031) underwent hemodialysis. Hemodialysis will save lives ( 85% ) was a main cause for accepting this modality. Repeated session for dialysis in remaining life (56.4%), poor quality of life with hemodialysis (39%) and fear of severe pain and complication of needle incursion during hemodialysis (45%) were the most common factors causing refusal of hemodialysis. Treatment with homeopathic and herbal medications was more common cause for refusal of hemodialysis specially patients belongs to remote area and low socioeconomic area Keywords: -End stage renal disease, Chronic Kidney disease, Hemodialysis, Acute kidney injury.