Nurses’ Perceptions of the Causes and Impact of the Growing Burden of Chronic Kidney Disease: A Descriptive Qualitative Study
DOI:
https://doi.org/10.63623/c6d04d50Keywords:
Burden, Chronic kidney disease, Nurses, Perceptions, Renal unitAbstract
Background: Chronic kidney disease is characterised by an ongoing degeneration of kidney function due to various underlying conditions, posing significant challenges to patients, healthcare systems, and nursing professionals. As primary caregivers, nurses are often the first to encounter the increasing demands associated with chronic kidney disease management. Therefore, this study explored nurses’ perceptions of the causes and impact of the growing burden of chronic kidney disease.
Methods: A descriptive qualitative research design was used. Data were collected through face–to–face in-depth interviews from a purposively selected sample of nine nurses. The interviews were audio-recorded and transcribed verbatim. The six phases of Braun and Clarke’s thematic analysis were adopted to analyse the data.
Results: Participants revealed that personal dynamics such as lifestyle behaviour, lack of public awareness about CKD, poor screening, as well as medication and equipment shortages contributed to the growing burden of chronic kidney disease. Participants also reported that the CKD burden contributed to increased patient volume in the renal unit, burnout among nurses, and poor quality of patient care.
Conclusion: Healthcare systems and the lifestyle behaviour of the population contributed to the growing burden of CKD. To alleviate the burden, healthcare professionals need to scale up public health education for the general population. Moreover, governments need to train and recruit nephrology specialist healthcare professionals and construct additional renal units. Future research should investigate factors associated with poor treatment outcomes in patients with CKD.
References
[1]Sato Y, Takahashi M, Yanagita M. Pathophysiology of AKI to CKD progression. Seminars in Nephrology, 2020, 40(2), 206-215. DOI: 10.1016/j.semnephrol.2020.01.011
[2]Zhu Z, Hu J, Chen Z, Feng J, Yang X, Liang, W, et al. Transition of acute kidney injury to chronic kidney disease: Role of metabolic reprogramming. Metabolism, 2022, 131, 155194. DOI: 10.1016/j.metabol.2022.155194
[3]Matsushita K, Ballew SH, Wang AY-M, Kalyesubula R, Schaeffner E, Agarwal, R. Epidemiology and risk of cardiovascular disease in populations with chronic kidney disease. Nature Reviews Nephrology, 2022, 18(11), 696-707. DOI: 10.1038/s41581-022-00616-6
[4]Cockwell P, Fisher LA. The global burden of chronic kidney disease. The Lancet, 2020, 395(10225), 662-664. DOI: 10.1016/S0140-6736(19)32977-0
[5]Keshvari-Shad F, Hajebrahimi S, Pilar Laguna Pes M, Mahboub-Ahari A, Nouri M, Seyednejad, F. A systematic review of screening tests for chronic kidney disease: An accuracy analysis. Galen Medical Journal, 2020, 9, e1573. DOI: 10.31661/gmj.v9i0.1573
[6]Seidu S, Barrat J, Khunti K. Clinical update: The important role of dual kidney function testing (ACR and eGFR) in primary care: Identification of risk and management in type 2 diabetes. Primary Care Diabetes, 2020, 14(4), 370-375. DOI: 10.1016/j.pcd.2020.02.006
[7]Kalantar-Zadeh K, Jafar TH, Nitsch D, Neuen BL, Perkovic V. Chronic Kidney Disease. The Lancet, 2021, 398(10302), 786-802. DOI: 10.1016/S0140-6736(21)00519-5
[8]Ke C, Liang J, Liu M, Liu S, Wang C. Burden of chronic kidney disease and its risk-attributable burden in 137 low-and middle-income countries, 1990–2019: Results from the global burden of disease study 2019. BMC Nephrology, 2022, 23, 1-12. DOI: 10.1186/s12882-021-02597-3
[9]Hariparshad S, Bhimma R, Nandlal L, Jembere E, Naicker S, Assounga, A. The prevalence of chronic kidney disease in South Africa-limitations of studies comparing prevalence with sub-Saharan Africa, Africa, and globally. BMC Nephrology, 2023, 24(1), 62. DOI:10.1186/s12882-023-03109-1
[10]Deng Y, Li N, Wu Y, Wang M, Yang S, Zheng Y, et al. Global, regional, and national burden of diabetes-related chronic kidney disease from 1990 to 2019. Frontiers in Endocrinology, 2021, 12, 672350. DOI: 10.3389/fendo.2021.672350
[11]Fabian J, Kalyesubula R, Mkandawire J, Hansen CH, Nitsch D, Musenge E, et al. Measurement of kidney function in Malawi, South Africa, and Uganda: A multicentre cohort study. The Lancet Global Health, 2022, 10(8), e1159-e1169. DOI: 10.1016/S2214-109X(22)00239-X
[12]Muiru AN, Charlebois ED, Balzer LB, Kwarisiima D, Elly A, Black D, et al. The epidemiology of chronic kidney disease (CKD) in rural East Africa: A population-based study. PloS One, 2020, 15(3), e0229649. DOI: 10.1371/journal.pone.0229649
[13]Al-mansouri A, Al-Ali FS, Hamad AI, Mohamed Ibrahim MI, Kheir N, Ibrahim RA, et al. Assessment of treatment burden and its impact on quality of life in dialysis-dependent and pre-dialysis chronic kidney disease patients. Research in Social and Administrative Pharmacy, 2021, 17(11), 1937-1944. DOI: 10.1016/j.sapharm.2021.02.010
[14]Shlipak MG, Tummalapalli SL, Boulware LE, Grams ME, Ix JH, Jha V, et al. The case for early identification and intervention of chronic kidney disease: Conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney International, 2021, 99(1), 34-47. DOI: 10.1016/j.kint.2020.10.012
[15]Ali Assiri MA, Abdullah Saif AA, Saeed Al Zhrani TD, Ali Alshadidi YM, Alalhawt YA, Al Qahtani JA, et al. The critical role of nurses in improving outcomes for patients with lab diagnosed chronic kidney disease. Journal of International Crisis & Risk Communication Research, 2024, 7. DOI: 10.63278/jicrcr.vi.726
[16]Arooj H, Aman M, Hashmi MU, Nasir Z, Zahid M, Abbas J, et al. The impact of nurse-led care in chronic kidney disease management: A systematic review and meta-analysis. BMC Nursing, 2025, 24(1), 188. DOI: 10.1186/s12912-025-02829-z
[17]Pavkov ME, Collins AJ, Coresh J, Nelson RG. Kidney disease in diabetes. Diabetes in America, 2021.
[18]Chironda G, Bhengu B. Barriers to management of Chronic Kidney Disease (CKD) CKD in a renal clinic in KwaZulu-Natal Province, South Africa–A qualitative study. International Journal of Africa Nursing Sciences, 2019, 10, 116-123. DOI: 10.1016/j.ijans.2019.04.001
[19]Furidha BW. Comprehension of the descriptive qualitative research method: A critical assessment of the literature. Acitya Wisesa: Journal of Multidisciplinary Research, 2023, 2(4), 1-8. DOI: 10.56943/jmr.v2i4.443
[20]Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 2007, 19(6), 349-357. DOI: 10.1093/intqhc/mzm042
[21]Gray JR, Grove SK, Burns & Grove’s the practice of nursing research. Elsevier, 2024.
[22]Ruslin R, Mashuri S, Rasak MSA, Alhabsyi F, Syam H. Semi-structured interview: A methodological reflection on the development of a qualitative research instrument in educational studies. IOSR Journal of Research & Method in Education, 2022, 12(1), 22-29. DOI: 10.9790/7388-1201052229
[23]Coe R, Waring M, Hedges LV, Ashley LD. Research methods and methodologies in education. Sage, 2021.
[24]Holloway I, Galvin K. Qualitative research in nursing and healthcare. John Wiley & Sons, 2023.
[25]Renjith V, Yesodharan R, Noronha JA, Ladd E, George A. Qualitative methods in health care research. International Journal of Preventive Medicine, 2021, 12(1), 20. DOI: 10.4103/ijpvm.ijpvm_321_19
[26]Lavee E, Itzchakov G. Good listening: A key element in establishing quality in qualitative research. Qualitative Research, 2023, 23(3), 614-631. DOI: 10.1177/14687941211039402
[27]Naz N, Gulab F, Aslam M. Development of qualitative semi-structured interview guide for case study research. Competitive Social Science Research Journal, 2022,3(2), 42-52.
[28]Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology, 2006, 3(2), 77-101. DOI: 10.1191/1478088706qp063oa
[29]Johnson JL, Adkins D, Chauvin S. A review of the quality indicators of rigor in qualitative research. American Journal of Pharmaceutical Education, 2020, 84(1), 7120. DOI: 10.5688/ajpe7120
[30]Lincoln YS, Guba EG. Naturalistic inquiry. SAGE, Thousand Oaks, 1985, 289-331. DOI: 10.1016/0147-1767(85)90062-8
[31]Adler RH. Trustworthiness in qualitative research. Journal of Human Lactation, 2022, 38(4), 598-602. DOI: 10.1177/08903344221116620
[32]Bello AK, Okpechi IG, Levin A, Ye F, Damster S, Arruebo S, et al. An update on the global disparities in kidney disease burden and care across world countries and regions. The Lancet Global Health, 2024, 12(3), e382-e395. DOI: 10.2139/ssrn.5136140
[33]Weerakoon D, Siriwardana E, Jayasekara J, Damayanthi H, Dorji T, Lucero‐Prisno III DE. Chronic kidney disease in Sri Lanka: Health systems challenges of patients on hemodialysis. Public Health Challenges, 2024, 3(1), e155. DOI: 10.1002/puh2.155
[34]Iroegbu C, Lewis L, Matura LA. An integrative review: Chronic kidney disease awareness and the social determinants of health inequities. Journal of Advanced Nursing, 2022, 78(4), 918-928. DOI: 10.1111/jan.15107
[35]McCulloch M, Luyckx VA, Cullis B, Davies SJ, Finkelstein FO, Yap HK, et al. Challenges of access to kidney care for children in low-resource settings. Nature Reviews Nephrology, 2021, 17(1), 33-45. DOI: 10.1038/s41581-020-00338-7
[36]Langham RG, Kalantar-Zadeh K, Bonner A, Balducci A, Hsiao L-L, Kumaraswami LA, et al., Kidney health for all: Bridging the gap in kidney health education and literacy. Canadian Journal of Kidney Health and Disease, 2022,9. DOI: 10.1177/20543581221085075
[37]Alobaidi S. Knowledge of chronic kidney disease among the population of saudi arabia evaluated using a validated questionnaire: A cross-sectional study. Patient Preference and Adherence, 2021, 15, 1281-1288. DOI: 10.2147/ppa.s315369
[38]Chu CD, McCulloch CE, Banerjee T, Pavkov ME, Burrows NR, Gillespie BW, et al. CKD awareness among US adults by future risk of kidney failure. American Journal of Kidney Diseases, 2020, 76(2), 174-183. DOI: 10.1053/j.ajkd.2020.01.007
[39]Younes S, Mourad N, Safwan J, Dabbous M, Rahal M, Al Nabulsi M, et al. Chronic kidney disease awareness among the general population: Tool validation and knowledge assessment in a developing country. BMC Nephrology, 2022, 23(1), 266. DOI: 10.1186/s12882-022-02889-2
[40]Schrauben SJ, Chen HY, Lin E, Jepson C, Yang W, Scialla JJ, et al. Hospitalizations among adults with chronic kidney disease in the United States: A cohort study. PLoS Medicine, 2020, 17(12), e1003470. DOI: 10.1371/journal.pmed.1003470
[41]Vazquez MA, Oliver G, Amarasingham R, Sundaram V, Chan K, Ahn C, et al. Pragmatic trial of hospitalization rate in chronic kidney disease. New England Journal of Medicine, 2024, 390(13), 1196-1206. DOI: 10.1056/nejmoa2311708
[42]Okoye O, Mamven M. Global dialysis perspective: Nigeria. Kidney360, 2022, 3(9), 1607-1610. DOI: 10.34067/KID.0002312022
[43]Ameh OI, Ekrikpo U, Bello A, Okpechi I. Current management strategies of chronic kidney disease in resource-limited countries. International Journal of Nephrology and Renovascular Disease, 2020, 13, 239-251. DOI: 10.2147/ijnrd.s242235
[44]Francis A, Harhay MN, Ong AC, Tummalapalli SL, Ortiz A, Fogo AB, et al. Chronic kidney disease and the global public health agenda: An international consensus. Nature Reviews Nephrology, 2024, 20(7), 473-485. DOI: 10.1038/s41581-024-00820-6
[45]Billany RE, Thopte A, Adenwalla SF, March DS, Burton JO, Graham-Brown MP. Associations of health literacy with self-management behaviours and health outcomes in chronic kidney disease: A systematic review. Journal of nephrology, 2023, 36(5), 1267-1281. DOI: 10.1007/s40620-022-01537-0
[46]Kvarnström K, Westerholm A, Airaksinen M, Liira H. Factors contributing to medication adherence in patients with a chronic condition: A scoping review of qualitative research. Pharmaceutics, 2021, 13(7), 1100. DOI: 10.3390/pharmaceutics13071100
[47]Ulasi II, Awobusuyi O, Nayak S, Ramachandran R, Musso CG, Depine SA, et al. Chronic kidney disease burden in low-resource settings: Regional perspectives. Seminars in Nephrology, 2022, 42(5):151336. DOI: 10.1016/j.semnephrol.2023.151336
[48]Olivera LMd, Okuno MFP, Barbosa DA, Sesso RdCC, Scherrer G, Pessoa JLE, et al. Quality of life and spirituality of patients with chronic kidney disease: Pre-and post-transplant analysis. Revista Brasileira de Enfermagem, 2020, 73(suppl 5), e20190408. DOI: 10.1590/0034-7167-2019-0408
[49]Owokuhaisa J, Abaasa CN, Muhindo R, Musinguzi P, Rukundo GZ. Barriers and facilitators to screening for kidney disease among older adults with hypertension and diabetes in Mbarara Southwestern Uganda: Healthcare providers' perspective. Journal of Multidisciplinary Healthcare, 2024, 17, 855-865. DOI: 10.2147/JMDH.S451533
[50]Neale EP, Rosario VD, Probst Y, Beck E, Tran TB, Lambert K. Lifestyle interventions, kidney disease progression, and quality of life: A systematic review and meta-analysis. Kidney Medicine, 2023, 5(6), 100643. DOI: 10.1016/j.xkme.2023.100643
[51]George C, Echouffo-Tcheugui JB, Jaar BG, Okpechi IG, Kengne AP. The need for screening, early diagnosis, and prediction of chronic kidney disease in people with diabetes in low-and middle-income countries__a review of the current literature. BMC Medicine, 2022, 20(1), 247. DOI: 10.1186/s12916-022-02438-6
[52]Garcia P, Mendoza C, Barnoya J, Monzón J, Miller AC, Aguilar-González A, et al. CKD care and research in Guatemala: overview and meeting report. Kidney International Reports, 2020, 5(9), 1567-1575. DOI: 10.1016/j.ekir.2020.06.020
[53]Tesfaye W, Parrish N, Sud K, Grandinetti A, Castelino R. Medication adherence among patients with kidney disease: An umbrella review. Advances in Kidney Disease and Health, 2024, 31(1), 68-83. DOI: 10.1053/j.akdh.2023.08.003
[54]Rizvi F, Lakhani N, Omuri L, Roshan S, Kapasi T, Wilson PB, et al. The leicester, leicestershire and rutland integrated chronic kidney disease (iCKD) system programme: implementation within a primary care network. BMC Neurology, 2024, 25(1), 255. DOI: 10.1186/s12882-024-03668-x
[55]Zeng X, Liu J, Tao S, Hong HG, Li Y, Fu P. Associations between socioeconomic status and chronic kidney disease: A meta-analysis. Journal of Epidemiology and Community Health, 2018, 72(4), 270-279. DOI: 10.1136/jech-2017-209815
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Sisekelo O. Mamba, Welile M. Mamba
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
