Exploring the Choice of Kidney Transplantation as a Treatment Option Among Post-kidney Transplant Recipients at Kenyatta National Hospital

Abstract

Background: Kidney transplantation (KT) offers better quality of life and the best chance at survival compared to other forms of kidney replacement therapy. In comparison, it is also relatively cheaper. Though its uptake is gaining momentum, little is still known about what informed the choice of KT as a treatment modality among post-kidney transplant recipients. Objective: To explore the choice of kidney transplantation as a treatment option among post-kidney transplant recipients at Kenyatta National Hospital. Methods: This was a qualitative study which utilized exploratory research design. The study was conducted among post-kidney transplant recipients attending post-kidney transplant care clinics at Kenyatta National Hospital’s Renal Unit between October and December, 2022. Fifteen (15) post-kidney transplant recipients were recruited as study participants using purposive sampling method. Data was collected through face to face interviews using an interview guide containing open-ended questions based on the study objectives. The study tool included questions on health practitioners’ influence, personal reasons and other persons that influenced the study participants’ choice of KT as a treatment option. The interviews were transcribed with the data deductively probed using thematic analysis. Ethical considerations observed included participants’ informed consent, confidentiality and anonymity in data handling and reporting, voluntary participation and right of withdrawal. Ethical approval for the study was issued by the KNH-UoN ERC [Ref: KNH-ERC/A/417]. Results: Most of the study participants were male (73.3%), aged 30 years and above (86.7%) and had tertiary education (86.7%). The participants’ occupations were varied though most were formally employed (53.3%). Close to half had undergone the KT in less than one year ago (46.6%) while the rest (53.4%) underwent KT one or more years ago. All (100%) heard of KT from their renal health care team. In relation to health practitioners’ influence on the choice of KT as a treatment option among the study participants, receiving information emerged as the main theme with benefits of KT and requirements for KT as its sub-themes. In relation to the personal reasons that led to the choice of KT as a treatment option among the study participants, desire for better QoL emerged as the main theme with dissatisfaction with dialysis experience, securing required finances and desire for a normal life as its sub-themes. In relation to other persons that influenced the choice of KT as a treatment option among the study participants, help from family and friends emerged as the main theme with support [financial, psychosocial and informational] and kidney organ donation as its sub-themes. Conclusions: The choice of kidney transplantation as a treatment option among the study participants was influenced by a range of variables including receipt of information about KT, desire for greater QoL and help from family and friends. Recommendations: Health practitioners at KNH’s renal unit should make educating patients about KT an integral component of the care they offer patients with ESKD who attend the hospital for kidney related health care services. The families of patients with ESKD should also be allowed to participate actively in important care decisions