Demographics and social factors associated with acceptance of treatment in patients with chronic kidney disease.

Dialysis and transplantation have prolonged survival and quality of life in patients with chronic kidney disease (CKD). This is an exploratory/descriptive study, looking into the socio-demographic profile and social factors in these patients associated with acceptance of therapy. Association between attitudes and demographics were examined. A total of 670 patients with CKD were prospectively evaluated during the years 2000-2003 and based on the degree of renal failure, were categorized into conservative therapy, dialysis alone, or transplantation. A detailed psycho-social assessment and counseling regarding the treatment options was done. The mean age of the study patients was 49.27 +/- 16.7 years. Of the study patients, 66.7% were males, 70.6% were married, 40% were undergraduates, 34% were employed, 41.6 and 37.3% were respectively from low- and middle-income groups, 60% lived in nuclear families and 64% had an urban background. Patients with CKD Stages II - IV (37.3%) were advised conservative treatment, while CKD Stage V patients were advised dialysis alone in 35.5% and dialysis and transplantation in 64.5%. The major psycho-social factors negatively influencing the acceptance of treatment were finance (69.3%), logistics (66.0%), no willing donors (11.0%), no medically fit donors (13.0%) and/or lack of social support (17.0%). Statistically significant association was noted between attitudes and marital status (p < 0.05, education and domicile (p = 0.05), occupation, income and family type (p < 0.05). Our study suggests that finance is one of the important factors deciding the acceptance of treatment. Social factors negatively affecting were logistics, lack of willing and medically fit donors and lack of social support.