REFUSAL OF DIALYSIS AMONGST PATIENTS OF CHRONIC KIDNEY DISEASE (CKD)

Abstract

Abstract

Objective:  This study was conducted to determine the refusal of dialysis amongst patients of chronic kidney disease presenting for the first time for dialysis in ure-mic condition.

Study Design:  Cross sectional Study.

Place and Duration of the Study:  Outpatient depar-tment of Nephrology, Mayo Hospital, Lahore from 1^st Jan 2012 to 31^st December 2012.

Patients and Methods:  Patients of CKD due to any cause presenting with uremia for the first time for dia-lysis were included in the study. History and physical

Anees M.¹

Assistant Professor Nephrology

Chairman, Department of Nephrology

King Edward Medical University, Lahore - Pakistan

Khan J.A.²

Assistant Professor Gastroentrology

Shaikh Zayed Hospital, Lahore - Pakistan

Basit A.³

King Edward Medical University, Lahore - Pakistan

Ibrahim M.⁴

Associate Professor of Statistics

Registrar, Govt. M.A.O College, Lahore - Pakistan

Mumtaz A.⁵

Professor of Pathology. Shalamar Medical and Dental College, Shalamr Hospital, Lahore - Pakistan

examination was done and demographic data was col-lected in pre designed form. Patients were offered for dialysis while explaining to them the advantages of getting and disadvantages of not getting dialysis. Pat-ient's response on the offer was recorded and the rea-son for the refusal were noted.

Results:  According to the criteria 150 patients were included in the study. Most of the patients were male 92 (61.3%) and illiterate 78 (52.0%). Major cause of CKD was diabetes mellitus 58 (38.7%) followed by hypertension 38 (25.3%). Mean age of the patients was 42.59 ± 13.72 year and income of the most of the pat-ients 126 (84%) was less than US$100/-month. Most of the patients 126 (77.0%) were asked about the need of dialysis in less than three months, 61 (41.3%) offe-red for the first time and amongst them 85 (54.0%) were offered dialysis already. Majority of the patients 101 (67.3%) refused dialysis when it was offered to them for the first time. Major reason of the refusal was fear of dialysis procedure in 76 (76%) patients follo-wed by treatment by spiritual 14 (14%) and alternative ways and others 11 (11%). Middle age persons refused dialysis significantly.

Conclusion:  Diabetes mellitus is the leading cause of CKD. Most of the patients were informed about dialy-sis at very late stage. Majority of the patients refused dialysis. Major reason of the refusal was fear of dialy-sis procedure followed by treatment from some spiri-tual ways and alternative treatment.