Refusal of blood transfusion by a hemodialysis patient with renal anemia for religious reasons

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  • 透析導入時の腎性貧血に対し宗教的理由で輸血拒否した1例
  • 症例報告 透析導入時の腎性貧血に対し宗教的理由で輸血拒否した1例
  • ショウレイ ホウコク トウセキ ドウニュウジ ノ ジンセイ ヒンケツ ニ タイシ シュウキョウテキ リユウ デ ユケツ キョヒ シタ 1レイ

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Abstract

<p>We describe the case of a 61-year-old female, who had been receiving treatment for diabetes and chronic kidney disease. Seven months earlier, she had decided (of her own accord) to discontinue her outpatient treatment, which eventually resulted in her emergency admission to our hospital because of dyspnea on effort and marked weight loss. Despite severe anemia (hemoglobin: 6.0 g/dL) accompanying her end-stage renal failure on admission, she refused a blood transfusion for religious reasons. After providing a careful explanation and obtaining informed consent, she and her husband agreed for her to undergo an alternative non-transfusion-based treatment during the initiation of hemodialysis. Her anemia was effectively managed by increasing the doses of erythropoiesis-stimulating agents (ESA) and initiating iron replacement therapy. Although there are many factors that contribute to ESA resistance during the hemodialysis initiation period, it is suggested that non-emergent severe anemia can be managed without transfusions.</p>

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