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The following is a summary of “Lived experiences of people with chronic kidney disease on maintenance dialysis: a systematic review and thematic synthesis of qualitative studies,” published in the January 2025 issue of Nephrology by Elias et al.
Chronic Kidney Disease (CKD) is a global public health issue, with advanced stages requiring dialysis or kidney transplants. Research mainly focuses on clinical and epidemiological aspects, with limited exploration of the lived experiences of dialysis patients, especially in low- and middle-income settings.
Researchers conducted a retrospective study to synthesize the literature on the illness experience of people with CKD undergoing maintenance dialysis.
They followed PRISMA and PiCO guidelines for the systematic review, identifying original studies published between 2000 and 2024 across PubMed, Web of Science, and Scopus. A thematic analysis was conducted using Michael Bury’s biographical disruption model and a framework on internal and external factors affecting self-care.
The results showed that 59 studies were included, revealing 2 key themes: disrupted biographies, which encompassed diagnosis and dialysis initiation, disabling physical symptoms, impaired socio-occupational functioning, uncertainty and psychological distress, and changes in self-image; and biographical repair, which included coping with CKD and dialysis, coping styles, and coping strategies. Internal factors influencing experiences were personal beliefs, shame, guilt, financial constraints, and spirituality. External factors included family support, clinical team interactions, social stigma, dialysis service quality, and health insurance access.
Investigators enhanced understanding of the lived experiences of maintenance dialysis patients, emphasizing the need for a holistic, person-centered approach and improved dialysis access in low- and lower-middle-income countries.
Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-025-03952-4
