Barriers and perception on kidney transplantation as a modality of renal replacement therapy among end stage kidney failure patients and their relatives in Dar es salaam Tanzania

Abstract

ABSTRACT Background: End-stage kidney failure (ESKF) poses a significant health burden worldwide, with kidney transplantation recognized as the optimal modality of renal replacement therapy (RRT). Despite its potential to enhance patient survival and quality of life compared to hemodialysis, kidney transplantation remains underutilized in many developing countries, including Tanzania. Exploring barriers and perception among end-stage kidney failure patients and their relatives regarding kidney transplantation is essential for improving health outcomes. Materials and Methods: The study employed a descriptive exploratory qualitative design to explore barriers and perception to kidney transplantation as a modality of renal replacement therapy among patients undergoing hemodialysis therapy and their relatives in Dar es Salaam, Tanzania. A purposive sampling technique used to recruit study participants. Thirty-six (36) were involved in the study using a semi structured interview guide, interviews were digitally audio-recorded, transcribed verbatim, coded and thematically analyzed. Results: In the study three themes emerged, Perception on kidney transplant, perceived barriers, and strategies to overcome the barriers to kidney transplantation (KT) guided by the socio-ecological model (SEM). The study revealed individual, interpersonal, institutional, and policy related factors that hinder kidney transplants. Discrepancies in perceptions between public and government hospitals also emerged as a notable barrier. Additionally, participants suggested different strategies to overcome the barriers identified. The need for awareness and information about kidney transplants emerged, followed by need for government support on funds and insurance for kidney transplantation. Conclusion: Awareness of kidney transplantation among ESKF patients and their relatives in Dar es Salaam is often limited and influenced by misconceptions, lack of knowledge, and concerns about the procedure. Kidney transplant significantly offers benefits like improved quality of life, longer survival rates, and reduced long-term healthcare costs for ESKD patients in Tanzania. Key barriers include financial constraints, poor healthcare access, cultural beliefs, and lack of information. Overcoming these challenges requires strategies and efforts that can increase acceptance and uptake of kidney transplantation improving outcomes for ESKF patients in Tanzania.