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Updated: Aug 15, 2025

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Published on: April 12, 2021
Reasons for kidney transplant refusal among patients receiving peritoneal dialysis: A qualitative study
Fateme Biabani1, Azad Rahmani2, Gholamhossein MahmudiRad1
1Nursing and Midwifery Faculty, Birjand University of Medical Sciences, Iran.
Background:
Even though kidney transplantation has better outcomes compared to dialysis therapies, some patients undergoing peritoneal dialysis (PD) refuse to consider kidney transplantation. Identification of the underlying reason for patient refusal may improve patients' acceptance of kidney transplantation.
Aim:
The aim of this study was to describe the reasons given by Iranian PD patients for refusing kidney transplantation.
Method:
Eighteen patients undergoing PD participated. Data were collected using semi-structured interviews and were analysed using conventional qualitative content analysis.
Results:
The analysis leads to the emergence of two categories and six subcategories: negative outcomes of kidney transplantation (financial burden, psychosocial problems and physical complications) and doubtful factors for kidney transplantation (negative attitudes towards kidney transplantation, long waiting time for kidney transplantation and compatibility of PD with daily life). The financial burden and long waiting time for kidney transplantation were the most important factors in the reluctance of kidney transplantation by PD patients.
Implication For Practice:
Patients undergoing PD declined kidney transplantation for several reasons, such as financial burden, fear of post-transplantation side effects, long waiting time for kidney transplantation. Reducing the time of kidney transplantation and insurance coverage of transplant costs can change the attitude of PD patients towards transplant.
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Kidney Transplant I: Introduction
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Dialysis
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Peritoneal Dialysis I: Introduction and Procedure

