Comparison of barriers to wait listing for kidney transplantation between hemodialysis center

초록

Background and Objectives: Kidney transplantation is the preferred modality of treatment for patients with end-stage renal disease (ESRD). Many factors have been associated with ESRD patient placement on the waiting list of kidney transplantation. But, objectives of our study is to evaluate factors associated with rejection of placing on waiting listing of Kidney transplantation and to compare the difference between hemodialysis center of primary hospital and tertiary hospital. Method: We examined patients in hemodialysis center of 1 tertiary hospital and 4 primary hospitals. Total 198 patients were enrolled. We excluded the old patients (over 65) and patients placed on waiting list. We questioned the patients about barrier of kidney transplantation. Uniand multivariable logistic models were used to assess factors associated with waiting list placement, comparison between hemodialysis center. Result: The patients placed on the waiting list in tertiary hospital(21%,18 in 85 patients) are more than primary hospital(9.7%,10 in 103 patients). Total 48 patients(56%) in tertiary hospital and 59 patients (57%)in primary hospital were enrolled and completed questionaries. There were no difference in patients characteristics between two groups. Barriers of placement on waiting list were scare of surgery(37.5%, 18 ), low possibility of selection(35.4%,17), economic problem(20.8%,10) and lack of knowledge about transplantation(4.1%,2). But, economic problem(42%,25), lack of knowledge about transplantation(30.5%,18), low possibility of selection(22.0%,13) and scare of surgery(3.3%,2). Conclusion: The ratio of patients placed on the waiting list is still low. The factors of barrier to placement to the waiting list were variable. Especially, in hemodialysis center of primary hospital economic support and education