Barriers to Kidney Transplantation in Urban Hemodialysis Centers in Pakistan: A Cross-Sectional Study

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-03-17 DOI:10.1016/j.transproceed.2025.02.048

Hasaan Salman Shafi , Syed Abdullah Ali Shah , Irfan Ahmad , Nabiha Rizvi , Salman Tahir Shafi , Omair Farooq

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引用次数: 0

Abstract

Background and aims

End-stage kidney disease is a global health challenge that has greatly affected low-income and middle-income countries. While a living donor kidney transplant (LDKT) is the most optimal treatment for end-stage kidney disease, many medical and nonmedical barriers persist which hinder transplant rates. This study aims to identify the various medical, psychological, and socioeconomic barriers to LDKT among patients in urban hemodialysis centers in Pakistan.

Methods

A cross-sectional study of patients undergoing hemodialysis in urban hospitals across three urban cities in Pakistan was conducted. Participants were given a structured questionnaire addressing demographics, medical history, socioeconomic status, and transplantation awareness.

Results

The median age was 54 years (IQR 20), with 56.2% male participants. Barriers were identified as socioeconomic (61.4%), medical (32.6%), and psychological (6%). Significant differences in median age were observed across groups (P < .01), with socioeconomic barriers associated with younger patients (median age 49 years) compared to medical (median 63 years) and psychological (59 years) barriers. Patients with socioeconomic barriers were younger (P ≤ .01), had lower income (P = .02), and had relatively lower rates of marriage (P = .02) compared to those in other categories. Lack of donors and lack of financial resources were the most common barriers, cited by 50.2% and 50% of participants, respectively.

Conclusions

Socioeconomic barriers are the leading obstacles to LDKT in Pakistan. Efforts must be made to address these barriers, such as a deceased donor program, financial aid, and improving patient knowledge about LDKT. Further studies should explore rural populations and psychological barriers in greater depth.

查看原文本刊更多论文

巴基斯坦城市血液透析中心肾移植障碍：一项横断面研究。

背景和目的：终末期肾病是一项全球性的健康挑战，严重影响了低收入和中等收入国家。虽然活体肾脏移植（LDKT）是终末期肾脏疾病的最佳治疗方法，但许多医学和非医学障碍仍然存在，阻碍了移植率。本研究旨在确定巴基斯坦城市血液透析中心患者中LDKT的各种医学、心理和社会经济障碍。方法：在巴基斯坦三个城市的城市医院进行血液透析患者的横断面研究。给参与者一份结构化的问卷，包括人口统计、病史、社会经济地位和移植意识。结果：中位年龄为54岁（IQR 20），男性占56.2%。障碍被确定为社会经济（61.4%）、医疗（32.6%）和心理（6%）。各组间中位年龄差异显著（P < 0.01），与医学（中位年龄63岁）和心理（59岁）障碍相比，社会经济障碍与年轻患者（中位年龄49岁）相关。社会经济障碍患者年龄较轻（P≤0.01），收入较低（P = 0.02），结婚率较低（P = 0.02）。缺乏捐助者和缺乏财政资源是最常见的障碍，分别有50.2%和50%的参与者提到。结论：社会经济障碍是巴基斯坦LDKT的主要障碍。必须努力解决这些障碍，如死者供体计划、财政援助和提高患者对LDKT的认识。进一步的研究应更深入地探讨农村人口和心理障碍。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.