Recommendation to improve chronic kidney disease management guideline in primary healthcare, KwaZulu-Natal

Abstract

Background: The prevalence of chronic kidney disease (CKD) is high in KwaZulu-Natal (KZN), especially in individuals with risk factors such as HIV, diabetes mellitus and hypertension. Despite existing guidelines, the study identified multifactorial gaps in implementing CKD management measures at the primary healthcare (PHC) level. This leads to late-stage diagnoses and increased burdens on tertiary institutions, as identified in institutional statistics. The study was therefore conducted in four different settings: a tertiary hospital in Durban and three PHC centres across KZN (two urban centres and one in a township).

Objectives: The study’s objective is to describe the perceptions of healthcare professionals on the management of CKD, in the PHC setting in KZN, South Africa.

Method: A qualitative, exploratory design involving healthcare professionals was adopted. Purposeful sampling was used. Open coding and conventional content analysis were adopted to analyse data.

Results: Findings revealed three overarching themes: (1) knowledge and awareness about existing guidelines, (2) fragmented system and a lack of clear guidelines and (3) implications of clear guidelines on patient care. Participants demonstrated diverse awareness of guidelines, revealing a need for continuous education. Participants expressed needs for continuous education and clear guidelines.

Conclusion: The study highlights an urgent need to bridge the knowledge gap and establish a cohesive healthcare system to address the growing CKD burden in KZN effectively.

Contribution: The study emphasises the potential benefits of implementing clear guidelines to improve patient outcomes, early detection and appropriate interventions, thereby reducing the burden on tertiary facilities.