Comparative psychosocial analysis of patients on maintenance hemodialysis and transplanted patients.
Faissal A M Shaheen, Ramprasad Kurpad, Besher A Al-Attar, Bangash Muna, Abdullah A Al-Khader
Ann Transplant 2005; 10(1): 17-21
OBJECTIVE: Many previous studies have shown that renal transplantationis associated with superior psychosocial rehabilitation than patients on dialysis. Our objective wasto test if the same findings apply in Saudi patients. PATIENTS AND METHODS: Questionnaires probing demographicdata, income, mental status, literacy and unemployment rates, family support, home ownership, satisfactionwith previous transplantation and views and preferences about different types of transplantation weredistributed to transplanted patients (n= 150) and patients on maintenance hemodialysis (HD) (n=210) atthe Jeddah Kidney Center, King Fahd Hospital, Jeddah, Saudi Arabia. Illiterate patients were helped incompleting the questionnaires by the social worker. RESULTS: We found that the male to female ratio inthe transplanted group was 1.7:1 whereas it was 1:1 in the HD group. It was also found that more peoplein the transplant group owned houses than in the HD group (52% vs. 36.7%). Twice as many transplantedpatients earned more than 7000 Saudi Riyals monthly. The unemployment rates were equal in the two groups(25-26%). Interestingly, the rate of illiteracy in the transplant group was almost half the rate in theHD group. More transplanted patients were assessed as being mentally balanced and, rational (92%) ascompared to 66.2% in the HD group. Gratifyingly, however, both groups reported solid family support inthe majority of patients (>80%). Of particular interest was the finding that well over one third (37%)of the patients on dialysis preferred to have live-unrelated transplants. This is far higher than thosewishing for live-related (16.7%) or cadaveric (17.1%). CONCLUSION: Many of our findings coincide withwhat has been reported earlier. More patients with higher income were transplanted and there was no detectedimprovement in the employment rate associated with transplantation. Moreover, the vast majority of patients(92.7%) had no objection to receiving a living unrelated kidney and, in fact, as many as 37.6% actuallyfelt preference for a living unrelated kidney over other types of transplantations.