Dialyzing severely anemic patients who are objectors to blood transfusion due to conscience | ||||
| Journal of Current Medical Research and Practice | ||||
| Volume 6, Issue 4, October 2021, Page 373-378 PDF (382.05 K) | ||||
| DOI: 10.4103/JCMRP.JCMRP_153_19 | ||||
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| Authors | ||||
| Odigie Enahoro Ojeh-Oziegbe; Iyamu Robert | ||||
| Abstract | ||||
| Background Benchmark minimum packed cell volume (PCV) for blood transfusion in most dialysis centers is 20% (hemoglobin 6.7 g/dl). Below that level, the dialysis units in Benin City usually transfuse patients predialysis or intradialysis to make dialysis a safer procedure for the patient. However, some groups of patients like the Jehovah's witnesses refuse blood transfusion on grounds of conscience and have often times been refused dialysis on account of a PCV lower than 20% (hemoglobin 6.7 g/dl). We present our experience with 23 maintenance hemodialysis patients, all Jehovah's witnesses, in their first session in this center. Patients and methods A total of 23 patients, PCV range 14–19%, were dialyzed during the period of April 2018 to November 2018. Patients underwent routine dialysis sessions of 4 h. Ultrafiltration range was determined clinically by level of edema, respiratory distress, and blood pressure. Indications for dialysis were pulmonary edema, uremic encephalopathy, and uremic gastritis with markedly deranged urea and creatinine values. Results There were a total of 23 patients dialyzing for the first time during the period under review. There were 11 (47.8%) males and 12 (52.2%) females. Their age range was 16–80 years and mean age was 49.43 years. Mean predialysis blood urea was 170.52 mg/dl, with a range of 103–301 mg/dl. Mean postdialysis urea was 81.57 mg/dl, with a range of 13–167 mg/dl. Predialysis creatinine range was 2.43–28.4 mg/dl, with a mean of 11.46 mg/dl. Postdialysis creatinine range was 0.4–17.4 mg/dl, with a mean of 5.69 mg/dl. Mean urea reduction ratio was 54.67%, with a range of 22.4–91.4%. All the patients tolerated the dialysis sessions well. There were no intradialysis mortality. Conclusions Dialyzing patients with anemia who refuse to accept a blood transfusion on account of personal or religious beliefs appears to be generally safe and effective. There is a need to extend dialysis care to these group of our patients, most of whom are Jehovah's witnesses. | ||||
| Keywords | ||||
| Anemia; dialysis; Jehovah's witnesses; transfusion | ||||
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