Challenges and Lived Realities of Patients With Chronic Kidney Disease in Ghana: A Qualitative Inquiry

Abstract

Background: Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are rising public health concerns in low- and middle-income countries such as Ghana, where late diagnosis and limited access to renal replacement therapy are common. Qualitative evidence on their lived experiences in Ghana remains limited. Aim: To explore the lived experiences and challenges of patients with CKD and ESRD receiving hemodialysis in Ghana. Methods: An exploratory descriptive qualitative study was conducted with 17 patients with CKD/ESRD on hemodialysis for at least six months at Ho Teaching Hospital, Ghana. Data were collected through face-to-face semi-structured interviews (July-August 2025), audio-recorded, transcribed verbatim, and analyzed using conventional content analysis. Reflexivity and team-based coding ensured rigor. Results: Three themes emerged: (1) Structural and health system failures shaping illness trajectories, encompassing delayed and misdiagnosis, perceived neglect, limited dialysis availability, and severe financial hardship; (2) Fear of death and loss of self, reflecting persistent mortality anxiety, and identity disruption and (3) Endurance through relationships, faith, and treatment-related hope, highlighting the critical role of family support, spiritual coping, and temporary symptom relief from dialysis in sustaining resilience. Conclusion: Patients with CKD/ESRD in Ghana face significant structural, financial, and psychosocial challenges that affect their illness experience and treatment engagement. Although family support, faith, and symptom relief promote resilience, they do not compensate for gaps in renal care. Improving early diagnosis, equitable dialysis access, psychosocial integration, and policy reform is essential to enhance outcomes and quality of life.