Background: Kidney transplantation is the treatment of choice for end stage renal disease (ESRD) patients. It increases life expectancy, improves quality of life, achieves greater physical and occupational rehabilitation compared with maintenance haemodialysis. The rationale of this study is to determine reasons for preference of lifelong haemodialysis over kidney transplantation. This study may give us an insight to how this important and life altering decision is made by the patients. Objective: To determine the reasons for preference of kidney transplantation over lifelong hemodialysis.Material and Methods: A descriptive cross-sectional study on 329 ESRD patients was conducted in Nephrology Department, Khyber Teaching Hospital, Peshawar. During a period of 8 months, from September 2021 till April 2022. Data was collected by non-Probability consecutive sampling technique. Subjects who were willing to participate were included in the study after taking written informed consent.Results: A total of 329 patients were observed with mean age of 51 years with SD ± 10.21. Male patients were 204 (62%), and 125(38%) patients were female. In our study 227(69%) patients agreed for kidney transplant while 102(31%) patients refused kidney transplantation. Main reason for acceptance was freedom from haemodialysis 122(37%), on the other hand, 10(3%) patients refused because of surgical complications of transplant surgery & 33(10%) patients refused because of financial constraints.Conclusion: Our study concludes that 69% of ESRD patients were willing for kidney transplantation, main reasons being freedom from haemodialysis, fluid constraints, diet restrictions.Keywords: Kidney transplant, End stage renal disease (ESRD), Hemodialysis.
Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers are the mainstay of therapy for the prevention of progressive renal damage in diabetic and non-diabetic kidney diseases, especially glomerulonephritides. Sodium-glucose co-transporter-2 inhibitors are a relatively new class of oral antidiabetic drugs. Early evidence suggests that there are renal and cardiovascular benefits of this class of drugs that extend beyond glycaemic control for patients both with and without diabetes. With each and every trial, the limit for the glomerular filtration rate has been set lower, making the drugs more suitable from the perspective of nephrologists. This drug class has the potential to become the mainstay of reno-protective strategies used by nephrologists, in addition to angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers. This article reviews the evidence and reports that are already published regarding the use of sodium-glucose co-transporter-2 inhibitors to treat non-diabetic glomerular disease.
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