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In the treatment of end-stage renal disease, kidney transplantation (KT) is the best and most cost-effective alternative with regard to both prognosis and quality of life. To identify the proportion and the characteristics of kidney transplant candidates who can be considered eligible, a total of 2066 hemodialysis patients were investigated as part of the ARTEMIS (Attitude toward Renal Transplantation and Eligibility among dialysis patients in a Moroccan Interregional Survey) study. We investigated all patients receiving hemodialysis in the 39 centers of four Moroccan departments. The mean age was 52.9 years and the mean duration of hemodialysis was 55.3 months. Fifty-eight percent of our patients were considered eligible for KT; 18.2% had an absolute contraindication and 23.8% had one or more relative contraindications. When compared with eligible patients (n = 1200) in the univariate analysis, those ineligible were significantly older (61 years vs. 51, P < 0.0001), had no residual diuresis (59.8% vs. 49.1%, P < 0.0001), were more often diabetic (25.1% vs. 11.9%, P < 0.0001) and hypertensive (54.5% vs. 45.8%, P < 0.0001), and their median dialysis duration was longer (61 months vs. 51, P < 0.0001). In the multivariate models, eligibility remained associated with young age, less term of dialysis and residual diuresis. Adequate control of cardiovascular risk factors before dialysis and early referral for transplantation might help to improve eligibility of the renal transplant candidates.

Introduction: Kidney transplantation (KT) is considered the treatment of choice for many patients with severe chronic kidney disease because quality of life and survival are often better than in patients who undergo dialysis. This study assessed patients' knowledge and attitudes regarding KT., Patients and Methods: A total of 2066 hemodialysis patients were investigated as part of the ARTEMIS (Attitude Toward Renal Transplantation and Eligibility Among Dialysis Patients in a Moroccan Interregional Survey) study., Results: Patients' mean age was 52.9 years, and the mean duration of hemodialysis was 55.3 months. Among these patients, 73.3% would like to undergo transplantation. Among the subjects wishing to be transplanted, 75.7% would accept the graft from a living or a cadaveric donor; 17.8% would refuse transplantation from a related living donor; and 6.5% would reject organs from donors after brain death. Approximately 17% of patients have a potential related living donor. The main motivating factor for KT was fluid restriction and diet constraints (43.3%). One third of patients believe that Islam does not allow organ donation from a related living donor, and almost one half think that it is prohibited from a brain-dead donor. Independent factors affecting patients' attitude toward KT were young age, male gender, persistence of residual diuresis, availability of a related living donor, and better information on the subject of transplantation., Conclusions: To improve hemodialysis patients' accessibility to KT, patients, their families, and other support providers need better information. Awareness campaigns are needed to promote organ donation., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Hemodialysis is the most used renal replacement therapy for children in Morocco. The objective of this study was to determine the prevalence of patients who started hemodialysis in childhood and study their characteristics and specificities of their care. For this we conducted a multicentric descriptive cross-sectional study of all chronic hemodialysis patients who started dialysis in pediatric age, in hemodialysis centers in four of the sixteen regions of Morocco. We collected 2066 patients undergoing dialysis in 39 hemodialysis centers; from these, only 72 patients (3.48%) started hemodialysis in childhood. The average age of patients was 20.64 ± 6.5 years with a sex ratio of 1.9. Duration of dialysis was 78.2 ±56 months. The cause of end stage renal disease was urological abnormalities in 18% of cases and glomerulopathy in 12.5% of cases; however, it remains unknown in half of the patients. Over 18 years, 74% of patients are without profession, it is active in 13% of cases, and pursuing studies are only in 13% of cases. Patients under 5 years and those with a low weight are rarely taken care of in chronic hemodialysis with little individualization of prescription. Greater attention should be paid to renal transplantation that is desired by the majority of these patients (92%). [ABSTRACT FROM AUTHOR]