Financial burden, long wait time dissuades Iranian patients on PD from transplantation
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Patients in Iran reported negative outcomes, such as financial burdens, and doubtful factors, like long wait times, as reasons for not switching from peritoneal dialysis to transplantation, according to data published in a study.
Further, data in Peritoneal Dialysis International suggest insurance coverage of transplant coverage could change patients’ perspectives.
“[A]bout 2500 patients in Iran annually need to undergo a kidney transplantation,” Fateme Biabani, a member of the nursing and midwifery faculty at Birjand University of Medical Sciences in Iran, and colleagues wrote. They added, “However, refusal of kidney transplantation by patients undergoing dialysis, especially PD, has not been well investigated especially in Middle Eastern countries, such as Iran. So, the aim of this study was to describe the reasons given by Iranian PD patients for refusing kidney transplantation.”
In a qualitative study, researchers examined 18 patients who had been on PD for at least 6 months. Researchers conducted open-ended and semi-structured interviews with each patient between April and October 2021. Questions explored patients’ experiences and perspectives on kidney transplantation.
A second interview was conducted with five patients to clarify any misconceptions derived from the first analysis. Researchers used conventional qualitative content analysis to study interview data.
Overall, researchers identified two main reasons that patients refused transplantation. First, patients feared the negative outcomes of kidney transplantation, such as financial burdens, psychosocial problems and physical complications. Another reason patients refused was doubtful factors for transplantation. This included negative attitudes toward kidney transplantation, long wait time and compatibility of PD with daily life.
Analyses revealed financial burden and long wait time for transplantation were the most important factors in why patients on PD refused transplantation.
“Reducing the time of kidney transplantation and insurance coverage of transplant costs can change the attitude of PD patients toward transplant,” Biabani and colleagues wrote. “It should be noted that this issue is different across countries according to the laws governing the health care system.”
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